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Blood Res 2023; 58(S1):

Published online April 30, 2023

https://doi.org/10.5045/br.2023.2023004

© The Korean Society of Hematology

Transfusion support in hematopoietic stem cell transplantation

Dong Wook Jekarl1, Jae Kwon Kim1, Jay Ho Han1, Howon Lee1, Jaeeun Yoo2, Jihyang Lim3, Yonggoo Kim1

Departments of Laboratory Medicine, 1Seoul St. Mary’s Hospital, College of Medicine, Seoul, 2Incheon St. Mary’s Hospital, College of Medicine, Incheon, 3Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence to : Yonggoo Kim, M.D., Ph.D.
Departments of Laboratory Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Banpo-dong, Seocho-gu, Seoul 06591, Korea
E-mail: yonggoo@catholic.ac.kr

*This study was supported by a grant from National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (2021R1F1A1046464).

Received: January 3, 2023; Revised: January 16, 2023; Accepted: January 20, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Transfusion support for hematopoietic stem cell transplantation (HSCT) is an essential part of supportive care, and compatible blood should be transfused into recipients. As leukocyte antigen (HLA) matching is considered first and as the blood group does not impede HSCT, major, minor, bidirectional, and RhD incompatibilities occur that might hinder transfusion and cause adverse events. Leukocyte reduction in blood products is frequently used, and irradiation should be performed for blood products, except for plasma. To mitigate incompatibility and adverse events, local transfusion guidelines, hospital transfusion committees, and patient management should be considered.

Keywords Transfusion, Hematopoietic stem cell transplantation, ABO blood group, RhD blood group

Article

Review Article

Blood Res 2023; 58(S1): S1-S7

Published online April 30, 2023 https://doi.org/10.5045/br.2023.2023004

Copyright © The Korean Society of Hematology.

Transfusion support in hematopoietic stem cell transplantation

Dong Wook Jekarl1, Jae Kwon Kim1, Jay Ho Han1, Howon Lee1, Jaeeun Yoo2, Jihyang Lim3, Yonggoo Kim1

Departments of Laboratory Medicine, 1Seoul St. Mary’s Hospital, College of Medicine, Seoul, 2Incheon St. Mary’s Hospital, College of Medicine, Incheon, 3Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence to:Yonggoo Kim, M.D., Ph.D.
Departments of Laboratory Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Banpo-dong, Seocho-gu, Seoul 06591, Korea
E-mail: yonggoo@catholic.ac.kr

*This study was supported by a grant from National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (2021R1F1A1046464).

Received: January 3, 2023; Revised: January 16, 2023; Accepted: January 20, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Transfusion support for hematopoietic stem cell transplantation (HSCT) is an essential part of supportive care, and compatible blood should be transfused into recipients. As leukocyte antigen (HLA) matching is considered first and as the blood group does not impede HSCT, major, minor, bidirectional, and RhD incompatibilities occur that might hinder transfusion and cause adverse events. Leukocyte reduction in blood products is frequently used, and irradiation should be performed for blood products, except for plasma. To mitigate incompatibility and adverse events, local transfusion guidelines, hospital transfusion committees, and patient management should be considered.

Keywords: Transfusion, Hematopoietic stem cell transplantation, ABO blood group, RhD blood group

Fig 1.

Figure 1.The attachment site of ABO blood group antigen and ABO blood group antigen formation. These figures are modified based on previous studies [1]. Reproduced from The Korean Society for Laboratory Medicine, Laboratory Medicine 6th edition, page 1063, Figure 92-1 with permission from The Korean Society for Laboratory Medicine.
Blood Research 2023; 58: S1-S7https://doi.org/10.5045/br.2023.2023004

Table 1 . Donor and recipient relationship associated with RhD..

Donor antigenRecipient antigen
D negative with anti-DD negative without anti-DD positive
D negative with anti-DIdenticalIdenticalMinor incompatibility
D negative without anti-DIdenticalIdenticalMinor mismatch
D positiveMajor incompatibilityMajor mismatchIdentical

This table was modified based on previous studies [14-16]..


Table 2 . Transfusion strategy for peritransplantion..

ABO incompatibilityRecipientDonorPhase IPhase IIPhase III
All productRBCPLT 1stPLT 2ndPlasmaAll product
MajorOARecipientOAAB, B, OADonor
OBRecipientOBAB, A, OBDonor
OABRecipientOABA, B, OABDonor
AABRecipientAABA, B, OABDonor
BABRecipientBABB, A, OABDonor
MinorAORecipientOAAB, B, OADonor
BORecipientOBAB, A, OBDonor
ABORecipientOABA, B, OABDonor
ABARecipientAABA, B, OABDonor
ABBRecipientBABB, A, OABDonor
BidirectionalABRecipientOABB, A, OABDonor
BARecipientOABA, B, OABDonor

This table was modified based on previous studies [1-3]..


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