What are indications for washed red blood cells (RBCs)?

By William Aird

  • Patients with history of severe allergic reactions to plasma-containing products.
  • Patients who have absolute immunoglobulin A (IgA) deficiency and for whom no IgA-deficient RBCs are available.
  • Patients at risk of hyperkalemia.
  • Neonates with neonatal alloimmune thrombocytopenia requiring maternal RBC transfusion that contains antihuman platelet antigen-1a (however, use of washed RBCs is not required.)

According to AABB:

  • Description:
    • Washed components are typically prepared using 0.9% Sodium Chloride, Injection USP with or without small amounts of dextrose.
    • Washing removes unwanted plasma proteins, including antibodies and glycerol from previously frozen units.
    • The shelf life of washed components is no more than 24 hours at 1 to 6 C or 4 hours at 20 to 24 C.
    • Washing is not a substitute for leukocyte reduction, and only cellular components should be washed.
  • Indications:
    • To reduce exposure to antibodies targeting known recipient antigens.
    • To remove constituents that predispose patients to significant or repeated transfusion reactions (eg, removal of IgA-containing plasma in providing transfusion support for an IgA-deficient recipient or in rare recipients experiencing anaphylactoid/anaphylactic reactions to other plasma components).