Protocols - Hemorio

ADVERSE EFFECTS RELATED TO THE TRANSFUSIONS IN FALCIFORM DISEASE:
In addition to the inherent adverse effects to any and all blood transfusion, there is one, in particular, that it
may attack the person who has Falciform Disease, which is:
BYSTANDER HEMOLYSIS: that, by definition, is a complication of the late hemolytic reaction, in which the
red blood cells of the receptor are destroyed during an immune hemolytic reaction.
2 – TRANSFUSIONAL CONDUCT AT THE MAJOR THALASSEMIA AND INTERMEDIATE
HYPERTRANSFUSION: the subjects will be transfused every 2 to 3 weeks, with the purpose to keep the
Hb at least 10 g/dl and less than 15g/dL.
INDICATIONS:
- Major thalassemia – all cases
- Intermediate thalassemia – with facial changes, retardation in the growth, pathologic fractures and/or
extramedullary hematopoiesis.
CHARACTERISTICS OF THE TRANSFUSIONAL COMPONENTS
Transfuse de-leukocytated blood prophylactically.
Transfuse phenotyped blood for the antigens Rh and Kell (Rh1, Rh2, Rh3, Rh4, K1).
Whenever possible, also respect the antigens Fy a and Fy b , Jk a and Jk b , S and s.
In allo-immunizing subjects, transfuse red blood cells destituted of the antigen(s) against which the subject
has developed the antibody, in addition to mandatory respect the antigens Rh1, Rh2, Rh3, Rh4, K1, Fy a and
Fy b , Jk a and Jk b , S and s.
The interval between each transfusion will be determined case by case, due to the usage of transfusion
and the levels of pre-transfusion hemoglobin. As a general rule, this interval must be of two to three
weeks.
The volume to be transfused must also be determined case by case, due to the weight of the subject and
the response to the transfusions.
The serum dosage of ferritin of the subject must be verified every three months. Levels of ferritin above
1,000 µg% indicate that the case must be evaluated and discussed jointly by the Hemotherapy and
Hematology Services.
3 – TRANSFUSIONAL CONDUCT AT THE HERITABLE SPHEROCYTOSIS AND G6PD DEFICIENCY
- Transfusions when symptomatic and hemoglobin