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Blood Usage Transfusion Indications

Red Blood Cells

ADULT

Average hematocrit of a unit of RBCs is 55 65%

1. Symptomatic anemia with Hgb

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ALL CHILDREN > 4 MONTHS

1. Hgb

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Plasma

Published evidence regarding specific procedures consistently demonstrates that preprocedure

laboratory tests do not provide a reliable rationale for the use of preprocedure transfusion

therapies. The best decisions are made in the context of each patients full clinical pictures and

not on the basis of laboratory values alone.

1. Multiple clotting factor deficiencies, when the INR is > 1.7 in the following circumstances:

2. Rapid reve rsal of warfarin effect in patients with active bleeding or imminent invasive

procedure

3. To correct congenital deficiencies of clotting factors

4. Thrombotic microangiopathies (TTP, HUS, HELLP syndrome)

Cryoprecipitate

For active bleeding or before invasive procedure/surgery in any of the following circumstances:

1. Fibrinogen levels

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Specialty Blood Product Indications

CMV Negative

1. Seronegative Stem Cell Donor-Recipient Pairs / Recipient Candidates

2. Seronegative Oncology Diagnosis Receiving Chemotherapy

3. Seronegative Heart / Lung Transplant Recipients / Candidates

4. Seronegative Pregnant Woman5. Very Low Birth Weight Infants (< 1500 grams)

6. Seronegative Patients Living w/ HIV / AIDS

7. All Intrauterine Transfusions

Irradiation

1. Stem Cell Transplant Recipients

2. Myelodysplastic Syndromes / Myeloproliferative Diseases

3. Leukemias / Lymphomas

4. Plasma Cell Dyscrasia5. Bone Marrow Failure States

6. HLA Matched / Crossmatched Platelets and All Directed Donors

7. Congenital Cellular Immunodeficiency Syndromes (e.g., SCID, DiGeorge)

8. Pediatric Solid Tumors (e.g., Wilms Tumor, Neuroblastoma)

9. Very Low Birth Weight Infants (< 1500 grams)

10. Intrauterine Transfusions / Neonatal Exchange Transfusions / Neonatal ECMO

Leukocyte ReductionLeukocyte Reduction is Achieved by Pre-Storage Component Production or Bedside Filtration

1. Chronic or Prolonged RBC or Platelet Transfusion Support

2. Stem Cell Transplant Candidates/Recipients

3. Bone Marrow Failure States

4. Leukemias/Lymphomas

5. Myelodysplastic Syndromes/Myeloproliferative Diseases

6. Sickle Cell Disease/Sickling Hemoglobinopathies/Thalassemia

7. Heart/Lung Transplant Recipients/Candidates

8. History of Repeated Febrile Non-Hemolytic Transfusion Reactions (FNHTR)9. Cardio Thoracic surgical procedures with Median Sternotomy