lung injury (TRALI) has now become the leading cause of transfusion-related
morbidity and mortality worldwide. Defined criteria for diagnosis of TRALI have
been adopted. Mortality increases for critically ill patients. Treatment centers on
supportive therapy and limiting further transfusions.^21
Graft-versus-host disease is a transfusion related condition that is seen in
immunocompromised patients. This is especially important to pediatric surgeons
in that many of their patients either are immunocompromised due to age and
underdeveloped immune systems (neonates) or have acquired
immunodeficiency due to chemotherapeutic regimens (oncologic patients). This
disease can present up to 28 days following transfusion. Associated mortality is
extremely high, up to 90%, with most deaths occurring within one month.
Irradiation of all blood products transfused in immunodeficient patients readily
decreases this risk [22]. Patients who should receive irradiated components
include:
- Infants < 6 months of age
- All pediatric oncology patients
- Patients undergoing myelosuppresive therapy
- Patients with congenital immunodeficiency syndromes