Preparing donor blood for an intrauterine transfusion (IUT) can be more complicated than for other transfusions. Dr. Moise has kindly provided us with some standard operating procedures for preparing blood for IUTs.
Standard Operating Procedures For Preparing blood for Intrauterine Transfusion
Source: Blood should be from the donor within the last 72 hours if possible. In rare cases, frozen blood can be used.
CMV Status: Donor should be CMV negative. If no other crossmatched unit can be found, CMV antibody positive blood can be used.
Crossmatch: Blood should be crossmatched to the maternal sample. We do extended phenotyping [C, c, E, e, K, k, Jka, Jkb, Fya, Fyb, S, s] on the mother and crossmatch to these antigens as well to prevent the formation of new maternal antibodies from the IUT.
Preparation of blood:
- Washed and concentrated to hematocrit of 75 – 80% (hematocrit documented on bag).
- Irradiated with 25 Gy just prior to release from blood bank.
- In early procedures (< 24 weeks), we will split the unit and use the second half at the next procedure to minimize donor exposure.
- We use standard blood tubing in the operating room with filter.
- Blood is warmed in the operating room using bear hugger and warm saline bottle next to it. We do not use a blood warmer due to the hemoconcentration of the blood.