The steep decline in the incidence of HDFN following the introduction of maternal anti-D Ig prophylaxis, more effective antenatal monitoring and treatment, and the use of intensive phototherapy and intravenous immunoglobulin postnatally has made red cell exchange transfusion an uncommon procedure that should only be performed in specialist units by experienced staff. It removes antibody-coated neonatal red cells and reduces the level of plasma unconjugated bilirubin (the cause of bilirubin encephalopathy). Neonatal red cell exchange transfusion is mainly used in the treatment of severe hyperbilirubinaemia or anaemia in babies with HDFN. 10.2.1: Neonatal red cell exchange transfusion Transfusion triggers in neonates are controversial and mainly based on expert clinical opinion, although recent randomised controlled trials of ‘liberal’ versus ‘restrictive’ red cell transfusion policies in very low birth weight preterm babies are starting to influence clinical guidelines. Most neonatal transfusions are carried out in low birth weight preterm infants treated on neonatal intensive care units (NICUs). Neonates are defined as infants up to 28 days after birth. Annex 6: Advanced Therapy Medicinal Products (ATMPs)ĭownload as PDF 10.2: Neonatal transfusion.Annex 5: Blood Components for Contingency Use.Annex 2: ISBT 128 check character calculation.Annex 1: Standards available from NIBSC.27: Specification for labelling consumables used in therapeutic product production.26: Specification for blood pack base labels.25: Standards for electronic data interchange within the UK Blood Transfusion Services.24: Specification for the uniform labelling of human tissue products using ISBT 128.23: Specification for the uniform labelling of blood, blood components and blood donor samples.21: Tissue banking: tissue retrieval and processing.20: Tissue banking: selection of donors.15: Molecular typing for red cell antigens.14: Guidelines for the use of DNA/PCR techniques in Blood Establishments.13: Patient testing (red cell immunohaematology).12: Donation testing (red cell immunohaematology).10: Investigation of suspected transfusion-transmitted infection.9: Microbiology tests for donors and donations: general specifications for laboratory test procedures.8: Evaluation of novel blood components, production processes and blood packs: generic protocols.6: Evaluation and manufacture of blood components.5: Collection of a blood or component donation.4: Premises and quality assurance at blood donor sessions.3: Care and selection of whole blood and component donors (including donors of pre-deposit autologous blood).Quality in blood and tissue establishments and hospital blood banks
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