Washed Red Blood Cells

Washed red blood cells are used to treat recurrent severe allergic transfusion reactions.

• Washed red blood cells are available under the following different brand names: N/A.

Side effects of Washed Red Blood Cells may 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
• Posttransfusion purpura

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheartedness, or passing out.

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

Dosages of Washed Red Blood Cells:

• Please see the specific component monograph (i.e., red blood cells or platelets) for dosing, as there is no difference in dosing washed blood products from non-washed blood products.
• Platelet products may lose up to 33% of the platelets in the washing process. The platelet's functionality may also be altered providing a suboptimal response.

Dosage Considerations – Should be Given as Follows:

Recurrent Severe Allergic Transfusion Reactions

• Washed RBC units may not provide a full 1 g/dL increase in hemoglobin per unit because 10-20% of the RBCs are lost in the washing process.
• Platelet products may lose up to 33% of the platelets in the washing process. The platelet's functionality may also be altered providing a suboptimal response.

Other Indications and Uses

• Recurrent severe allergic transfusion reactions such as anaphylaxis or severe urticarial reactions not prevented by pre-transfusion antihistamine and corticosteroid administration
• Depletion of potassium and anticoagulants before transfusion to a fetus or a neonate with renal failure or when a large amount of RBC component is needed for neonate (i.e., red blood cell exchange, dialysis, ECMO, etc.) when fresh RBCs are not available.
• IgA deficiency with documented anti-IgA antibodies when IgA deficient donors are not available to prevent anaphylactic transfusion reactions
• Maternal platelets collected for neonates with neonatal alloimmune thrombocytopenia (controversial)
• Atypical HUS with T-antigen activation (controversial)
• Recurrent febrile non-hemolytic transfusion reactions not prevented by leukocyte reduction and antipyretics Consult with your blood bank medical director for questions regarding indications of washed blood products

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.

• Washed red blood cells have no listed severe interactions with other drugs.
• Washed red blood cells have no listed serious interactions with other drugs.
• Washed red blood cells have no listed moderate interactions with other drugs.
• Washed red blood cells 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 about 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 washed red blood cells. Do not take washed red blood cells if you are allergic to washed red blood cells or any ingredients contained in this drug. This medication contains washed red blood cells. Do not take washed red blood cells if you are allergic to washed red blood cells or any ingredients contained in this drug.
• Keep out of reach of children. In case of an overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Washing is NOT indicated for leukocyte reduction as this technique only reduces the leukocytes by approximately 85% and is insufficient to consider the product as leukocyte reduced.
• Washing is NOT adequate for the prevention of TA-GVHD. Patients at risk of TA-GVHD should receive irradiated cellular components regardless of whether they are washed.

Effects of Drug Abuse

• No information is available.

Short-Term Effects

• See "What Are Side Effects Associated with Using Washed Red Blood Cells?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Washed Red Blood Cells?"

Cautions

• Washing is a time-consuming process that lowers the yield of red blood cells or platelets and may alter the functionality of platelets. Additionally, washing requires “spiking” of the unit and loss of sterility requiring the unit's storage time to be drastically reduced to prevent potential bacterial contamination and septic transfusion reactions. Therefore, washing should only be utilized in cases in which it is clearly indicated.
• 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 the blood bank medical director or hematologist if you have questions regarding special transfusion requirements.

Pregnancy and Lactation

• Please see the specific component monograph for pregnancy/lactation information.