Irradiated Blood and Components

Irradiated blood and components are used for the prevention of transfusion-associated graft versus host disease (TA-GVHD) in cellular blood products.

Irradiated blood and components are available under the following different brand names: N/A.

Dosages of Irradiated Blood and Components:

• Please see specific component monograph (i.e., red blood cells, platelets, granulocytes, or whole blood) for dosing as there is no difference in dosing irradiated blood products from non-irradiated blood products.

Dosage Considerations – Should be Given as Follows:

Prevention of Transfusion Associated Graft Versus Host Disease

• Please see specific component monograph (i.e., red blood cells, platelets, granulocytes, or whole blood) for dosing as there is no difference in dosing irradiated blood products from non-irradiated blood products.

Other Indications and Uses

Prevention of Transfusion Associated Graft Versus Host Disease (TA-GVHD) in cellular blood products given to

• Patients receiving products from first-degree relatives* or HLA-matched donors regardless of patient’s immune status
• Immunocompromised patients such as:
  • Infants (particularly premature) up to 4, 6, or 12 months depending on institutional policy
  • Intrauterine transfusion* and/or neonatal exchange transfusion recipients
  • Congenital immunodeficiency disorders of cellular immunity (i.e., SCID, DiGeorge)*
  • Hematopoietic progenitor cell transplant recipients*
  • Hodgkin's disease*, Leukemia, or Lymphoma patients
  • Patients treated with nucleoside analogs (i.e., fludarabine)
  • Patients requiring granulocyte transfusions*
  • Solid Organ Tumor patients undergoing intense chemotherapy (controversial and not universal)
  • Solid-organ transplant recipient (controversial and not universal)
  • Aplastic anemia with severe lymphocytopenia (controversial and not universal)

• Irradiation of thawed plasma and cryoprecipitate are not necessary as they have never been associated with TA-GVHD. Fresh liquid plasma (never frozen) may have a small number of viable lymphocytes and should be irradiated if the patient has indications for irradiated cellular blood products.

These are considered absolute indications for irradiation of cellular blood products. Many of the other indications listed are considered probable or controversial indications depending upon the linkage of TA-GVHD to these conditions. The utilization of irradiated products for these conditions should be based upon institutional policy as well as patient-specific determinants.

Consult with your blood bank medical director for questions regarding indications of irradiated blood products

Side effects of irradiated blood and components include:

• Hemolytic Transfusion Reactions
• Febrile Non-Hemolytic Reactions
• Allergic Reactions ranging from hives to anaphylaxis
• Septic Reactions
• Transfusion Related Acute Lung Injury (TRALI)
• Circulatory Overload
• Transfusion Associated Graft Versus Host Disease
• Postransfusion Purpura

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Irradiated blood and components have no listed severe interactions with other drugs.
• Irradiated blood and components have no listed serious interactions with other drugs.
• Irradiated blood and components have no listed moderate interactions with other drugs.
• Irradiated blood and components have no listed mild interactions with other drugs.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings

• This medication contains irradiated blood and components. Do not take irradiated blood and components if you are allergic to irradiated blood and components or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Irradiation is contraindicated for hematopoietic progenitor cell and donor lymphocyte infusions as it will inhibit their ability to engraft and achieve their desired effects
• Irradiation is generally not indicated for patients with
• HIV
• Most solid tumors
• Routine immunosuppressive medications such as corticosteroids
• Isolated humoral immunodeficiency
• Hemoglobin disorders (i.e., sickle cell disease or thalassemia) that have not had a hematopoietic progenitor cell transplant
• Hemophilia

Effects of Drug Abuse

• No information available

Short-Term Effects

• See "What Are Side Effects Associated with Using Irradiated Blood and Components?”

Long-Term Effects

• See "What Are Side Effects Associated with Using Irradiated Blood and Components?”

Cautions

• The life span of irradiated red blood cells is shortened (expires no greater than 28 days after irradiation) and potassium leakage from the red cells into the extracellular fluid occurs more rapidly with concentrations ranging from 55-100 mEq/L within a few days after irradiation. This may be dangerous for large volume/rapid infusions, or when infused close to the heart via central venous catheters particularly in infants and small children. Washing of stored irradiated RBC units may be indicated in these patients. Please see washed component monograph for more information on washing cellular components
• Additionally, the extracellular free hemoglobin concentration increases more rapidly during storage than in non-irradiated units
• There are no known significant alterations in platelet function with irradiation of 25 Gy
• All transfusions must be given via blood administration sets containing 170- to 260-micron filters or 20- to 40-micron micro aggregate filters unless transfusion is given via a bedside leukocyte reduction filter. No other medications or fluids other than normal saline should be simultaneously given through the same line without prior consultation with the medical director of the blood bank
• Patient’s should be monitored for signs of a transfusion reaction including vitals pre, during, and post-transfusion
• Please see the specific component monograph for full safety information
• Consult with blood bank medical director or hematologist if you have questions regarding special transfusion requirements

Pregnancy and Lactation

• Please see specific component monographs for pregnancy/breastfeeding information.