Blood Components for Pediatric Transfusions

Blood transfusion plays an important role in the treatment of sick children, just as do pharmaceutical medications, intravenous fluids, and nutritional supplements. Unlike these therapeutic tools, however, blood is not manufactured in a factory but obtained from volunteer donors. Today, donated blood is rarely transfused as whole blood, and individual components are most often transfused to address the specific needs of the recipient. Blood can be obtained first as a whole blood donation with subsequent separation into components via centrifugation, or specific blood components can be directly obtained via apheresis. Blood components undergo leukocyte depletion before storage and further processing, thus arriving at hospital blood banks already leukoreduced, obviating the need to use bedside leukocyte filters.

Packed red blood cells (pRBCs), the most commonly transfused blood component, can be obtained directly via apheresis or by centrifugation of whole blood. After leukoreduction, pRBCs can be stored in citrate, phosphate, dextrose, adenine (CPDA) solution to achieve a shelf life of 35 days, or with additive solutions, such as adenine, dextrose, sorbitol, sodium chloride, and mannitol (ADSOL), to achieve a longer shelf life of 42 days. Whereas the hematocrit level of a CPDA unit is 65% to 80%, that of a unit prepared with additive solution is 55% to 65%. This difference in hematocrit value affects the volume calculations for transfusion, as shown in the Table, …