Chapter 36 - Irradiation of Blood Products

Abstract

This chapter discusses the process of irradiation of blood products. Irradiation of blood products is performed to abrogate the risk of transfusion associated graft verses host disease (TA-GVHD) which is a rare and almost fatal complication of blood transfusion with no successful treatment options. The radiation process results in generation of electrons which damage the DNA of lymphocytes and therefore make them unable to proliferate. A table is provided that illustrates the indications for irradiated cellular blood products to prevent TA-GVHD as well as guidelines and standards for irradiation and mitigation of TA-GVHD as stated by AABB. All cellular blood products, defined as red blood cells, platelets, granulocytes, whole blood and fresh plasma contain variable T lymphocytes that are capable of causing TA-GVHD and so these products should be irritated to minimize the risk of TA-GVHD. Both gamma rays and x-rays are used to irradiate blood products and cause adequate T lymphocyte inactivation at the doses described. The dose of irradiation must be sufficient to inhibit lymphocyte proliferation, but not so high as to significantly damage RBCs, platelets and granulocytes.