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Granulocyte Transfusion

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4. Granulocyte Transfusion

When transfused to patients with severe neutropenia and infection, granulocytes can to combat infection. Granulocyte therapy is difficult as neutrophils represent only a very small fraction of the formed element and have a very short survival. Granulocytes have a very short shelf-life and they should be transfused within 12 hours.

Granulocyte Preparations

Granulocyte can be prepared from a whole blood unit collected into triple interconnected bags or alternatively blood cell seperator may be used to collect granulocytes directly from a donor.

Indications

Indications for granulocyte transfusion are limited to carefully selected cases in which possible benefits are thought to outweight the considerable hazards. Few of the specific indications are as follows:

1. Absolute neutrophil count less than 0.2 x 10/1 (200/ui)
2. Neonates with bacterial sepsis
3. Severe persistent neutropenia and infections
4. Abnormal neutrophil function and persistent infection

Granulocytes given to newborn infants must be irradiated to prevent graft versus hot disease.

Dose

For therapeutic purposes at least 1 X 10^10 functioning granulocytes should be transfused which is equivalent to one donation on cell separator or huffy coat collected from 12-18 single units of whole blood. Therapy should continue for 4-7 days before reassessing the position. in neonates 0.2 x 1010 granulocytes 12 hourly should be infused for 3-4 days.

Role of Granulocyte Transfusion

Routine use of granulocyte transfusion is controversial due to the problems associated with collection of granulocytes, along with serious transfusion reactions which follow transfusion of granulocytes. Availability of recombinant haematopoletic growth factors (GM-CSF, G-CSF) has reduced the role of granulocyte transfusion in clinical practice.

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