Canterbury DHB

Context

Blood Component Therapy and SCT

Within NZBS all donor products are now leucodepleted at source, which is deemed sufficient to limit CMV exposure via blood products.

Refer to the NZBS clinical guideline: NZBS Policy on the Provision of CMV Antibody Negative Blood Components (111P067)

In This Section

Guidelines for ABO Incompatibility

Rhesus Incompatibility

Major ABO Incompatibility i.e., A, B, or AB donor and O recipient

Minor Incompatibility i.e., O donor and A, B, AB recipient or A1 donor and A2 Recipient

Mixed, Major and Minor Incompatibility i.e., A Donor to B Recipient, Or B Donor to A Recipient

Rh (D) incompatibility

Minor ABO Incompatibility with Donor PBSC Product

Guidelines for ABO Incompatibility

Refer to Types of Donor-Recipient ABO Incompatibilities.

Reference

Booth G, Gehrie E, Bolan C, Savani B. Clinical Guide to ABO-Incompatible Allogenic Stem Cell Transplantation. Biology of Blood and Marrow Transplantation. 2013 August;19(8):1152-59.

Rhesus Incompatibility

Rh-

Rh+

Major*

Rh+

Rh-

Minor

* Only if anti-D present.

Major ABO Incompatibility i.e., A, B, or AB donor and O recipient

Minor Incompatibility i.e., O donor and A, B, AB recipient or A1 donor and A2 Recipient

Note: Delayed haemolysis due to isohaemagglutinins produced by donor lymphocytes, clinically significant 15-71% of cases; onset is abrupt at 9-16 days, DCT positive. Usually self-limiting without serious morbidity; may be serious in 10-15 %. Note that haemolysis may also affect transfused blood group 0 red blood cells, by an innocent bystander mechanism.

Mixed, Major and Minor Incompatibility i.e., A Donor to B Recipient, Or B Donor to A Recipient

Rh (D) incompatibility

Minor ABO Incompatibility with Donor PBSC Product

Anecdotal reports of severe (including fatal) delayed haemolytic transfusion reactions have been reported with the use of cytokine primed donor PBSC products, where donor lymphocyte numbers are much higher than those found in marrow stem cell products. Experience, however suggests that such events rarely occur when immunosuppression, for GvHD prophylaxis with 2 or more drugs are given (e.g. CSA + MTX, CSA + MMF).

About this Canterbury DHB document (9332):

Document Owner:

Steve Gibbons (see Who's Who)

Issue Date:

August 2014

Next Review:

August 2016

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 9332