- Prevention of recurrent febrile non-hemolytic transfusion reactions
- Prevention of the transmission of CMV
- Prevention of alloimmunization to donor HLA antigens (i.e. platelet dependent patients who may become refractory to platelet transfusions, and organ/bone marrow transplant candidates)
- Leukoreduced RBCs still contain enough leukocytes capable of producing transfusion-associated graft versus host disease (TAGVHD) in susceptible patients. Prevention of TAGVHD can only be accomplished by irradiation of the RBCs unit.
- Intrauterine transfusions, transfusions to premature or low-birth weight infants (weighing <1200 gm at birth), newborns with erythroblastosis fetalis, and patients with congenital immunodeficiencies.
- Patients with hematologic malignancies, some solid tumors (incl. Hodgkin disease, neuroblastoma, sarcoma).
- Patients undergoing fludarabine therapy (purine analog), bone marrow transplantation or peripheral blood stem cell transplantation.
- Patients receiving granulocyte components, components that are HLA matched, or directed donations (from blood relatives).
The volume of one unit of RBCs contains approximately 200mL red blood cells, 100 mL of an additive solution, and ~30mL plasma, with a hematocrit approximately 55%.
In the absence of hemorrhage or active bleeding, the initial recommended dose is one unit for adults and 10mL/Kg for pediatrics with a reassessment post transfusion to determine the need for additional RBCs.
One unit of RBCs in an adult and 10mL/Kg in a pediatric patient will increase the hematocrit by approximately 3% or the hemoglobin by 1 g/dL in a normovolemic patient.