Cầu hạt cần được truyền càng sớm càng tốt sau khi thu thập và không bao giờ được truyền bằng cách sử dụng một bộ lọc leukoreduction. Điều này có thể ngăn cản hoàn thành kiểm tra thông thường cho dấu hiệu của virus và sự biện minh về sự cần thiết lâm sàng có thể được yêu cầu bằng văn bản từ các bác sĩ quy định. | Leukocytes Indications and Dosing 127 Table . Granulocytes concentrates 1. Type of Products a Buffy coat from whole blood donations i Buffy coat volume 30-50 ml 8-15 of total RBC 65-75 of total leukocytes 1 x 109 b Apheresis Granulocytes Volume 200 ml Hct of approximately 20 Standard product 1-3 x 1010 granulocytes GCSF stimulated donors 4-10 x 1010 granulocytes 2. Granulocytes should be transfused as soon as possible after collection and never transfused using a leukoreduction filter. This may preclude completion of the usual tests for viral markers and justification of the clinical need may be required in writing from the prescribing physician. 3. Commonly granulocytes are irradiated Chapter 37 since the recipient is frequently immunocompromised Some centers routinely irradiate all granulocyte concentrates. 4. These products may need to be manufactured from donations which are cytomegalovirus seronegative as a leukoreduction filter cannot be used. 5. Transfuse over two hours reactions are not uncommon and managed by slowing infusion steroids acetaminophen or antihistamine as appropriate. Amphotericin B infusion should not be concurrent with granulocyte transfusions. Table . Granulocytes indication and dosage 30 1. a Buffy coat Neonatal sepsis with neutropenia b Apheresis Granulocytes Suspected or proven gram negative sepsis or fungal infection i With evidence of persisting infection . fever C x 48 h despite treatment with appropriate multiple antibiotics using an appropriate dosage regimen. and ii Neutrophil count x 109 L without expectation of white cell recovery for 5 days and iii Adult with an expected survival of 2 months 2. Dosage and Scheduling a Buffy coat 1 product b Apheresis Granulocytes 1 product QD x 3-5 days 128 Clinical Transfusion Medicine It is possible however that granulocyte concentrates will prove of greater benefit in the future if data on collections from GCSF stimulated donors show better 30 clinical responses and .
