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The Director of a hospital-based Transfusion Service in Kentucky asks about washing RBCs for open-heart cases. He states, "We have a new cardiovascular surgeon that demands washed RBCs (allogeneic) for his heart cases. Intraoperative autologous cell salvage is also being used in these cases." He states that they discontinued washing RBCs for pediatric hearts several years ago after switching to leukoreduced RBCs less than 10 days old (irradiated for congenital immunodeficiency and neonates < 4 months old), and have never washed allogeneic RBCs for adult hearts. He asks "What are colleagues providing as to allogeneic RBCs for adult cardiovascular cases? Is there current cardiovascular literature to support washing leukoreduced allogeneic RBCs in additive solution?" The following comments have been received. ADDENDA June 5, 2007 1. The Medical Director of a Transfusion Service at an academic institution in Southern California shares: "At our institution, we provide leukoreduced, irradiated blood for heart transplant patients. If the patient is < 10 kg, we provide washed RBCs. If the patient is < 2 years old, we provide fresh (e.g. < 10 day old) units. If the patient is < 6 months old, we add CMV seronegative to the other requirements. We would be reluctant to begin washing units for adults without evidence of its efficacy." |
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Please submit comments to the e-Network Forum. Ira A. Shulman, MD W. Tait Stevens, MD |
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