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Posted: February 20, 2002

Addenda: April 16, 2002

Links Updated/Removed: Sept. 19, 2002; Jan. 2, 2007

 

Experience with OVERLY irradiated blood products?

As you are probably aware, it has been demonstrated that transfusion-associated graft-versus-host disease (TA-GVHD) can result from the transfusion of non-irradiated blood to immunodeficient, and in certain circumstances, immunocompetent patients. TA-GVHD can effectively be prevented in susceptible individuals by the irradiation of blood components prior to transfusion. Because TA-GVHD carries a high mortality rate, with death occurring in more than 90% of cases, blood irradiation has become standard practice before transfusion to certain groups of immunodeficient patients, and in situations where the donor of the component is a blood relative of the recipient, or the donor of the component is selected for HLA compatibility by typing or crossmatching. A blood banker in Maryland wants to know what level of blood product irradiation is at risk of damaging the product and causing harm to a transfusion recipient. The inquiring blood banker's hospital protocol requires the use of an indicator label (such as RadTag® or RadSure®) to provide unequivocal verification that blood units have been irradiated to the required dose. The indicator label is attached to the bag of blood before the blood is irradiated. The sensitive portion of this device is clear at the time it is attached to the unit. After irradiation, the label changes color.

Editor's NOTE: It is important to realize that such a label serves as a process indicator (for detection of inadequate irradiation) and not as a radiation dosimeter. Institutions performing blood product irradiation are urged to comply with good manufacturing practices to assure that your blood irradiator is delivering an appropriate dose (not too much, not too little) of irradiation to each blood product that is irradiated. The e-network might be interested in the Guidance for Industry document on Gamma Irradiation of Blood Products posted by CBER on Sept. 6, 2001.

The Maryland blood banker wants to know if any e-networker has experience with overly irradiated blood products, and if so, did this result in gross (or at least visible) hemolysis and/or patient harm. Is anyone aware of indicators that detect over-irradiation?

Editor's NOTE: The following links are to discussions or documents in the CBBS e-network archives or other sources that refer to irradiation of blood products. E-network members might find one or more of these documents/discussions of interest. 


The following response was submitted.

ADDENDA April 16, 2002

  1. A representative of RADTAG® wrote that if any e-Network Forum member would like more information on how their above-cited product (RadTag) works, that information is available on their web site.

Submit comments to the e-Network Forum at enetworkforum@cbbsweb.org

Ira A. Shulman, MD
CBBS e-Network Forum Senior Editor & Moderator

W. Tait Stevens, MD
CBBS e-Network Forum Editor & Moderator

Elizabeth M. St. Lezin, MD
CBBS e-Network Forum Associate Editor & Moderator

James Iqbal, MD
CBBS e-Network Forum Associate Editor & Moderator

The e-Network Forum is supported in part by the California Blood Bank Society (CBBS) and the American Red Cross Blood Services (ARCBS) and endorses collegial discussion among blood banking and transfusion medicine professionals. However, neither the CBBS nor the ARCBS in any way endorse the specific views and opinions expressed in the forum. The forum is not intended as a substitute for medical or legal advice and the content should not be relied upon for any medical or legal purposes. Readers should make their own determinations as to: (i) what constitutes appropriate medical, technical, and administrative practices, and (ii) how best to comply with laws and regulations relevant to their questions. For the latter, they should consider consulting, as to any medical matters, a qualified physician, and, as to any legal matters, an attorney familiar with related state and federal laws. The user of the forum, by accessing same, assumes all risks arising out of such use and releases CBBS and their respective members, directors, officers and agents from and against any loss, damage, claim or liability arising out of such use of the Forum.
 
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