irradiated blood

[marylinda]

Can someone explain why a doctor would be opposed to irradiated blood given in transfusions. Is it less potent or much more expensive or difficult to obtain. How safe is packed red cells leukocyte reduced and the patient given steroids and antihistmines before transfusion? there is so much to know

[patti]

Marylinda,

Our doctor was opposed to it because, “there is no scientific evidence proving it is worthwhile or called for.” I don’t know that there’s much expense involved in irradiating. Once the machine is purchased it only takes a few minutes of someone’s time to run it. I’m not sure about the steroids and antihistmines. Do you mean pre-meds like tylenol and benadryl to help if there’s any allergic reaction? Mom gets tylenol and benadryl to try and prevent or help if she ends up having an allergic reaction to the blood (we saw one guy have a reaction when we were there one time and it was ugly). I suppose how “safe” packed red cells are depends on how much you trust the Red Cross and blood banks to screen the people giving and testing the blood they take from people. I’m not sure I want to even think about that! Just about everyone you’d talk to would tell you it’s about 99% safe now from the Red Cross because of their testing procedures and intake reviews.

Hope this helps.

patti

[Jack_dup1]

Marylinda,
Click on the search tab and type in Irradiated blood, you will find a wealth of informations from past forum topics on the subject.
Jack

[Neil]

Hi Marylinda,
The primary reasons a doc might be reluctant to issue instructions for irradiated/filtered blood are:
The patient is elderly and the doc does not feel the patient will survive long enough to be faced with the effects.
The local blood bank does not have any.
The cost.
Lastly the doc sounds like he conducts a practice dressed in animal skins, sitting around a fire in a cave.
The purpose of irradiating/filtering is to remove leukocytes. Irradiation will lower the risk of graft-versus-host disease. Filtering reduces the risk of sensitization to proteins present in transfused blood and reduces the risk of transmitting cytomegalovirus.
If a patient is a candidate for a BMT/SCT it is imperative they receive blood products that have been checked and are found to be negative for cytomegalovirus.
At some point down the line antibodies will develop if I/F blood is not used. If this occurs it will become more and more difficult to find a match as the antibodies build up. A good number of facilities have a comment on the documentation provided at the end of a TX that no antibodies have been found in the patient.
Some docs feel that if a patient is not a candidate for a BMT/SCT, it is not necessary to use I/F blood. They tend to completely ignore the future problems in obtaining matched products.
Have been told that if I need packed red cells or platelets while traveling and the facility refuses to provide I/F products I should leave and go to a facility that will provide them.
My doc is very emphatic on the issue.

[Bec]

As some of you “long timers” know, I fought long and hard for my Dad to receive filtered and irradiated blood. He is still receiving tx and still looking for “TX busters”. He was diagnoised five years ago. Neil and this forum helped us to make the decision that we needed filtered irradiated blood. But we ahd to fight for it.

What I do not understand, is that if a patient wants something that can not HURT them, then why do Dr.s fight???

HAPPY NEW YEAR
Bec

[Jim]

My doc was “on the fence” about it when I ask. He’s willing to get it irradiated and filtered if that’s what I want. My major concern for the near future is Platelet transfusions.

[marylinda]

Thank you all for you responses they are all appreciated and I did go to the search function and researched after reading Jack’s good advise, I just didn’t think of it. It’s sometime hard to just think straight.
Happy New Year All

[Neil]

Hi Jim,
Platelets should be irradiated also.
Single donor platelets should also be considered.
A patient can receive a limited number of platelet TX till they become refractory to them. At some point in the future platelet TX will not increase counts.
The use of irradiated and single donor plts seems to extend that time till one becomes refractory.
At one point I was considering a second opinion on some treatment options. The facility I was going to phoned and told me I would have to get a platelet TX prior to a BMB since my count was under 20,00. I explained that I was asymptomatic and never had any bleeding issues with a BMB. It did not matter. Their policy was all patients with platelet counts under 20,000 had to have a platelet TX before a BMB. I cancelled my appointment.
That was about 5 years ago. Still resisting platelet TX. Had one in 2004 when I had surgery. Got 2 six packs that took me up to 53,000. That TX kept my counts up for almost 2 weeks!
I also get a boost for a couple days after a Procrit shot. Procrit seems to give my normal set of megakaryocytes a jump start as well as my red cells.
I mention this to reinforce the differences between MDS patients. I have been very fortunate. My platelets have been in the 10,000 range for about 6 years. Every once in a while they drop to 6,000 – 7,000 for about 6 weeks. About the time I begin to get panicky they bounce back to the 10,000 range.
I realize there are others out there that have bleeding/bruising issues at much higher levels, but if a patient with low platelets does not have symptoms, they might be able to get by and delay the time when it becomes necessary to start.
If there is a point where counts get very low, always ask the doc/techs to prepare a slide and do a manual count to verify where they really are. The black box has had me as low as 3,000 but a manual count has put me back in the 10,000 range.
There have been times when my doc was not in the office when I got a CBC. New techs tend rt get a bit nervous when they see my counts. It takes my docs nurse and sometimes a call to him to put the situation in perspective.

[Jim]

Neil,
“Single donor” for platlets– I assume you mean always getting your platelets from one person. Can they be anybody or is a family member preferred? Also have you any idea of an average (if there is such a thing) on how many platelet transfusions one can have before they don’t do any good?

Right now I’m in the low 20,000 range, have trouble with brusing but that’s about it. Also got a BMB last week with no major problem.

[Neil]

Hi Jim,
Idealy it would be best to get platelets from one donor—if you can find someone who can provide enough over time. Plts can be frozen and stored for future use. The next best is to get plts from the same donor at each TX.
The donor may or may not be a relative. Depends upon histocompatibility. Your body may recognize transfused platelets as foreign and produce antibodies that will destroy the transfused platelets. The optimum is to get plts from some one that is match with you for histocompability (HLA) antigens.
Don’t know if there is an average number of TX.
For some it is a small number. Others can get many. Much depends upon the circumstances leading up to the present and the ability to get an HLA match.

[Author]

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