Скачать или смотреть Indications for Washed Red Blood Cell Component Therapy

Washed Red Blood Cell (RBC) Component Therapy involves removing plasma proteins, antibodies, electrolytes (especially potassium), and other residual cellular elements from red blood cells before transfusion. This process is typically done using sterile saline and is reserved for patients with specific transfusion needs where standard RBC units may pose risks.

🩺 Key Indications for Washed RBC Therapy
1. Severe Allergic or Anaphylactic Transfusion Reactions
For patients with recurrent allergic reactions (e.g., urticaria, anaphylaxis) to plasma proteins in standard RBC units.

Washing removes 98–99% of plasma constituents that trigger these reactions.

2. Immunoglobulin A (IgA) Deficiency
Patients with absolute IgA deficiency and anti-IgA antibodies are at risk of life-threatening anaphylaxis.

Washed RBCs are used when IgA-deficient donor units are unavailable2.

3. Neonatal and Pediatric Transfusions
Especially in neonates with renal failure, where potassium overload is dangerous.

Washing reduces extracellular potassium, minimizing the risk of hyperkalemia.

4. Risk of Hyperkalemia
In patients with renal impairment, massive transfusion, or ECMO, where potassium accumulation from stored blood is a concern.

Washed RBCs help prevent cardiac arrhythmias due to elevated potassium levels.

5. Recurrent Febrile Non-Hemolytic Transfusion Reactions
When reactions persist despite leukoreduction and antipyretic therapy, washing may help by removing residual cytokines and leukocyte fragments.

6. Atypical Hemolytic Uremic Syndrome (HUS) with T-antigen Activation (Controversial)
In rare cases, washed RBCs may be considered to reduce exposure to plasma components that could exacerbate hemolysis.

⚠️ Important Considerations
Reduced RBC yield: Washing can result in a 10–20% loss of red cells.

Short shelf life: Washed RBCs must be used within 24 hours if stored at 1–6°C, or 4 hours at room temperature.

Not a substitute for leukoreduction: Washing reduces leukocytes but not to levels considered leukocyte-reduced.

Time-consuming: Washing requires specialized equipment and trained personnel.

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