Chapter 46 - Transfusion of Patients Undergoing HPC and Solid-organ Transplantation

Abstract

This chapter focuses on transfusions for patients who are undergoing solid-organ or hematopoietic progenitor cell (HPC) transplantation. This category of patients typically requires transfusion of blood and specialized blood products and blood product selection needs to take into account the ABO type and the risks of transfusion in these patients. For patients undergoing HPC transplantation, a number of factors must be taken into consideration when ordering blood products. These factors include type of transplant and expected time to engraftment, presence of ABO mismatch between donor and recipient, transfusion triggers for red blood cell (RBC) and platelet transfusions and platelet refractoriness among others. Transfusion requirements of HPC transplant recipients vary depending on the preparative conditioning regimen. Recipients of non-myeloablative transplants have decreased transfusion requirements as compared to recipients of fully myeloablative transplants. Leukocyte reduction of RBCs and platelets has been proven to decrease febrile non-hemolytic transfusion reactions, CMV transmission, and HLA alloimmunization that may lead to patients becoming refractory to future platelet transfusions.