Rarely a red blood cell or platelet product needs to be washed prior to transfusion.
Washing involves replacing the suspending solution in the product with sterile normal saline. This is best done using automated equipment with closed processing.
Indications:
(1) unexplained allergic reaction to plasma or additives after a careful workup
(2) IgA deficient patient with anaphylactic reaction to IgA (if IgA product not available
(3) reduce potassium in a red blood cell product (neonate in the ICU, other)
The primary significance is that the outdate of the product becomes critical.
Product
Storage
Outdate Once Processing Starts
red blood cells
refrigerated
24 hours
platelets
room temperature
4 hours
Other issues:
(1) Some product (red blood cells or platelets) are lost during the washing.
(2) The risk of bacterial contamination is increased.
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