Biochemistry
Haematology and Transfusion
Clinical Microbiology (Including Virology)
Cellular Pathology
General Information
Immunology
Molecular Pathology
Preferred Sample Type
Suitable Specimen Types
EDTA Whole BloodIssuing Granulocytes
Specimen Volume
4mLSpecimen Transport
Standard transport to laboratory.Sample Preparation
Sample Processing In Laboratory
Sample should be centrifugedSample Stability
Up to 7 days depending on patients transfusion history.General Information
Granulocytes should ideally be requested the day prior to transfusion to allow diversion of appropriate donations for testing and manufacture.
Granulocytes have a short shelf life and will expire at midnight on the day of receipt. Units should be ABO compatible and tube spin compatible for those not suitable for electronic issue. Granulocytes are not processed with non-ABO antibodies in mind, there is therefore a risk for patients with other red cell antibodies of undergoing delayed haemolytic transfusion reactions. A decision regarding risks and benefits needs to be made by the clinician caring for the patient and the NHSBT consultant where the patient has non-ABO alloantibodies and there is a risk of delayed haemolytic transfusion reactions as tube spin crossmatch will not identify non-ABO incompatibility.
Notes
Granulocyte components contain large numbers of immunocompetent T lymphocytes. Many potential granulocyte recipients, especially those undergoing allogenic transplantation procedures are susceptible to transfusion associated graft versus host disease to prevent this, the components are irradiated.
Granulocytes should ideally be requested the day prior to transfusion to allow diversion of appropriate donations for testing and manufacture. Haematology consultants MUST be involved in the discussion with the clinical area prior to granulocyte requests being taken.
CMV IgG negative granulocytes should ideally be provided for recipients who are at risk of CMV disease (infants, pregnant women, CMV negative recipients (or recipients whose CMV status is unable to be determined) of allogeneic bone marrow transplants). CMV negative granulocytes should be issued where possible for CMV negative recipients at risk of CMV disease.
Prior to any blood or blood components being released which are group specific for a patient the patient’s blood group should be confirmed on two separate samples taken on two separate venepunctures. One of the samples should be valid for cross matching as for a red cell crossmatch.