This document discusses various aspects of blood transfusion including: - The history of blood transfusion from the 1600s to modern times. - Blood components that can be separated from whole blood including packed red blood cells, platelets, plasma, and more. - Methods for processing blood into components like centrifugation and separation. - Indications and guidelines for transfusing different blood components in various clinical situations. - Special types of red blood cell transfusions like washed, leukoreduced, and irradiated red blood cells.

2.  Introduction
 Blood groups and grouping methods
 Cross matching
 Blood collection
 Blood components
 Whole blood
 Red blood concentrate
 Platelet
 FFP
 And others
 Apheresis

3. History of Transfusion
 Blood transfused in humans since mid-1600’s
 1818 – First successful human blood transfusion
 1900 – Landsteiner described ABO groups
 1918 – First use of blood storage.
 1939 – Levine described the Rh factor

4. INTRODUCTION
 Blood transfusion is one of the oldest forms of
therapy.
 Critical care frequently requires the urgent use of
large numbers of blood component, often as a
lifesaving supportive measure.
 Blood component transfusion plays a very
important role in modern transfusion.
 Through modern medical methods, many kinds of
blood components are separated from whole blood.

5.  The routine separation of donor blood into
components and plasma fraction has made it
possible for blood banks to provide the
specialized blood products required for the
support of patients in multiple treatment
modalities.
 The infusion of blood component is called
component transfusion or blood component
therapy.

6.  Each blood donation can help as many as
4 people
 43732 blood donations in one day is the world
record held by INDIA (Haryana) in 2010

7. Types
Autologous
Allogenic

8. Autologous
 Transfusion of patients own blood.
 Can be undertaken by
1. Autologous pre deposit donation
2. Intra operative normovolaemic
hemodilution.
3. Intra operative cell salvage
4. Post operative cell salvage

9. Indications
 Where patients have formed multiple alloantibodies,
particularly those to high frequency antigen, so that
selection of compatible allogenic unit is not practical.
 Any surgeries which might need post surgical
transfusion.
Advantages
 Safe,
 No risk of disease transmission
 Rare blood group.

10. Contraindications
 Infections or risk of bacteraemia
 Aortic stenosis
 Angina
 Significant cardiac or pulmonary disease
 Coronary heart disease
 Cyanotic heart disease
 Uncontrolled HTN

11. Blood groups
 Major
 ABO
 Rh
 Minor
 Duffy blood group
 I blood group
 Kell blood group
 Kidd
 Lewis
 Lutheran
 MNS
 Bombay blood group

12. ABO- A, B, AB, O
Rh- D, c, C, e, E

13. Blood groups

14. Blood grouping methods:
Landsteiner’s law :
1. The first law holds true for all types of blood grouping.
2. The second law is a fact for ABO blood groups.
3. The Rh and other blood groups do not follow the second
part of Landsteiner's law.

15. Cont..
Three manual methods can be used when performing blood
grouping
 Glass slide or white porcelain tile
 Glass test tube
 Microwell plate or microplate
Newer techniques
 Column technique (sephadex gel)
 Solid phase tests

16. FRONT TYPE –what’s on the cells?
Agglutination indicates presence of antigen

17.  BACK TYPE – what’s in the serum?
 Agglutination indicates presence of antibody

18. INTERPRETATION OF RESULTS

19. Bombay blood group
• First discovered in Bombay by Dr.Y.M.Bhende
• Individuals with the rare Bombay phenotype (hh) do not
express H antigen (also called substance H), the antigen
which is present in blood group O.
 Persons will lack H, A & B antigens on RBC & whose
plasma contains antiH, antiA & antiB
 Present in about 4 per million of human population
generally.
 In Mumbai it is 1 in 10,000
 More common in India.

20. Cross matching
 The two main functions of the cross-match test can be
cited as,
I- It is a final check of ABO compatibility between
donor and patient.
2-Detects clinically significant unexpected antibodies.

21.  Major cross-match test, consisting of mixing the
patient’s serum with donor RBCs.
 Minor cross-match test, consisting of mixing the
donor’s plasma with patient’s RBCs
 The minor cross-match test has been completely
eliminated in most blood banks, because donor
samples are screened beforehand for the more common
Antibodies.

22. Immediate Spin Technique (IST)
 Detects only IgM antibody, reactive at 22oC.
 Clinically significant IgG antibody reactive at 37oC not detected
Patient
serum
2
drops
Donor
RBC
1 drop,
5%
Immediate
centrifuge
ABO
incompatibility
22o
C

23. Conventional AHG-crossmatch
Patient serum
2
drops
Incubation
37oC, 1 hr
Donor RBC
1 drop,
5%
3
washes
Centrifuge
2 drops AHG
Mix properly
Agglutination =
incompatible
No agglutination
= compatible
Detects clinically significant (IgG) antibody

24. Serological cross match
Phase Detects
IS phase ABO incompatibilities
AHG phase Rh, Duffy, Kidd, others
Points to remember:
 Preserve recipients serum & donor red cell segment for a week.
However, fresh sample of the patient is needed after 48 hrs of
transfusion

25.  No compatibility testing required for platelets and
plasma components
 Only ABO matching is required for fresh frozen
plasma
 No need for compatibility, ABO and Rh matching for
platelet concentrates and cryoprecipitate

26. Clinical urgency
Immediate Within an hour(45 min)Minutes (15)
Group O Rh
neg Packed
RBCs
ABO & Rh D type
Group specific
blood
ABO & Rh D type
Complete
crossmatch
Cross matching: Special Circumstances

27. Blood collection
Types of donor
1. Replacement
2. Voluntary donor
Volume collected- 350 to 450 Ml ( according to
weight)

28. 28
Blood collection process
Registration
Donor provides
identification and
demographic
information
Donor reads
information about
blood donation
(Educational material)
Donor consents to
blood donation
Health history and
limited physical
examination
Health history
questions asked by
blood center staff
Blood pressure, pulse
and hemoglobin
levels are checked
Donation
Arm is cleansed
Blood is drawn (6-10
minutes)
Needle is removed
Recovery
Rest ~
15mins
Snacks
1 2 3 4
Average donation process takes just under one hour

29. Mandatory screening test
1. HBsAg
2. Anti HCV
3. Anti HIV 1 and 2
4. VDRL
5. Malaria parasite

30. Blood collection bag

31. Blood processing
Differential Centrifugation
First Centrifugation
Whole Blood
Main Bag
Satellite Bag
1
Satellite Bag
2
RBC’s
Platelet-rich
Plasma
First
Closed System

32. Differential Centrifugation
Second Centrifugation
Platelet-rich
Plasma
RBC’s
Platelet
Concentrate
RBC’s
Plasma
Second

33. Fresh Whole Blood
Packed Red Cells
Light spin, o
C(within 8 hrs)
Platelet Rich Plasma
Platelet Concentrate Fresh Plasma
Store at o
C Freeze(FFP)
Heavy spin, o
C

34. TYPES
Blood- Fresh Whole Blood
Reconstituted whole blood
Blood Products
Cellular Components- Red Cell Concentrates
Platelet Concentrates
Granulocyte Concentrate
Plasma Components- Fresh Frozen plasma
Cryoprecipitate
Stored plasma
Plasma Derivatives- Albumin
Immunoglobulin
Coagulation Factors

35. WHOLE BLOOD
 Contains RBCs and plasma
clotting factors.
 Only few units are stored as
whole blood.
 Can be reconstituted from a
unit of RBCs and FFP.
 Once WB has been stored for
24 hours at 4°C, platelet
function is lost.
 Furthermore, by day 21 of
storage, factors V and VIII lose
5% to 30% of their activity

36. However, in most cases blood components are
preferred because each component has specific
optimal storage conditions and component
therapy maximizes the use of blood donations.
Stored at 2°C to 6°C.

37. Indications.
Only use whole blood for patients who have
 a symptomatic deficit in oxygen-carrying capacity
combined with hypovolemia of sufficient degree to be
associated with shock, particularly in clinical
situations where the transfusion of viable platelets and
therapeutic levels of labile coagulation factors are also
required. (Massive trauma)

38. Packed Red Blood Cells (PRBCs)
The whole blood is spun to sediment out the RBCs,
and most of the plasma is removed by pushing it into a
pre-attached satellite bag.
After plasma is separated from red cells from 350 ml
whole blood, the RBC component has a volume of
about 200 ml and Hct of about 80 %.

39. Generally 100 to 110 mL of a nutrient additive solution is
added back to the packed RBCs, creating an “additive RBC”
product that has a final hematocrit of 55% to 60%.
These solutions prolong the shelf life of the RBC product
from 21 days (packed RBCs in CPD) to 42 days (additive
RBCs).
PRBCs are the most commonly used blood product in
transfusions.
Red blood cells (RBCs) are transfused to increase the
oxygen-carrying capacity of the blood and, to maintain
satisfactory tissue oxygenation.

40. Available forms of RCCs
The following forms of RCCs
are available for the treatment
of anaemia.
 RBC concentrates.
 RBC concentrates deprived of
the buffy coat.
 RBC concentrates with
additive solutions.

41.  RBC concentrates deprived of the buffy coat
and re suspended in additive solutions.
 Washed RBC.
 Leukocyte depleted RBC.
 Frozen RBC.
 Aphaeretic RBC.
 Irradiated RBC.

42. ANTICOAGULANT-PRESERVATIVE
SOLUTIONS (Additive solutions)
Function :
(1) Maintain blood products in an anticoagulated state,
(2) Support the metabolic activity of red cells and
maintain function of cellular constituents while in storage,
and
(3) Minimize the effects of cellular degradation during
storage.

44. Red Cell Concentrates
Indications
 Treatment of symptomatic anemia
 Prophylaxis in life-threatening anemia
 Restoration of oxygen-carrying capacity in case of
hemorrhage
 RBC are also indicated for exchange transfusion
1. Sickle cell disease
2. Severe parasitic infection (malaria, babesiosis)
3. Severe methemoglobinemia
4. Severe hyper bilirubinemia of newborn

45. Red Cell Concentrates
Thalassemia
 Periodic regular blood transfusions
 Every 3 to 4 weeks.
 Pre transfusion Hb level -9-10g/dl
 Post transfusion Hb should not rise >14g/dl

46. Red Cell Concentrates
Thalassemia
 Annual blood consumption=total blood transfused over 12
months/ patient’s weight in middle of the year.
 If blood consumption is >200ml/kg/ year
splenectomy should be
considered

47. Sickle cell disease
Indications for simple top up transfusion
 Severe anemia / hemolysis
 Splenic or hepatic sequestration
 Stroke (chronic transfusion)
Indications in surgery
 Organ transplantation
 Eye, major abdominal surgery
Raising HB >10g/dl will cause increase in viscosity.

48. Red Cell Concentrates
Dose for blood transfusion-10ml/kg
cardiac failure-5ml/kg
Increase Hb by~ 2 g/dl
Rate of Blood Transfusion -3ml/kg/hr, slow for 1st 15 min.
 NEVER mixed with
 Calcium containing solutions
 May cause clumping or clots
 Dextrose
 May cause hemolysis or clumping

49. Leucoreduced Red Blood Cells
 Most of the plasma & 70-80% WBC (buffy coat) is
removed.
 WBC : <5  102 /mm3
 Hct : 50–60 %
 Volume : 350 ml
 Shelf life : 35 to 42 days
 Stored at 2- 60c

50. Preparation techniques
 Centrifugation
 Saline washing
 Freezing and deglycerolisation
 Spin- cool filtration
 Leukocyte filtration* ( Pre storage or during
transfusion )

51. Indication
 Prevention of febrile non-haemolytic transfusion
reactions (FNHTRs) caused by the presence of
antibodies to white blood cells:
 - patients with recurrent FNHTR;
 - patients who need prolonged transfusion support.
(Thalassemia)
 Reduction of the incidence of
1. CMV transmission,
2. Epstein-Barr virus (EBV) and
3. Human T-cell lymphotrophic virus type I (HTLV-I),
Which are transmitted by the cellular components of
the blood (primarily the leukocytes)

52.  Reduction of the risk of rejection in candidates
for haematopoietic stem cell transplantation.
 Intrauterine transfusions and transfusions to
premature babies, neonates, and infants up to 1
year.
 Candidates for renal transplantation.

53. Washed Red Blood Cells
 RBC washed with 1-2 L Normal Saline
 Removes residual plasma.
 RBC : 20% reduced
 WBC count: <5  102 /mm3
 Prevents febrile non hemolytic reactions.
 Washing eliminates antibodies, metabolic &
other plasma constituents
 To be transfused within 24 hours.

54. Washed Red Blood Cells
Indications
 Multiple transfused patients with recurrent febrile
reactions
 Urticarial reactions
 Anaphylactic reactions
 IgA deficiency with IgA antibodies
 Patients with T activated cells by infections who
require transfusion.

55. Irradiated blood products
 Irradiation of all cellular
products with min 25 Gy units.
 Inactivate T-Lymphocytes
 Prevent GVHD
 Shelf life-28 days

56. Indications
 Bone marrow/ stem cell transplant
 Intrauterine transfusions
 Congenital immunodeficiency syndrome
 Premature newborn
 Neonatal exchange transfusion-give within 24 hours.

57.  History of treatment with purine analogues (anti cancer)
and related drugs
 Fludarabine
 2CDA (Cladribine®)
 Deoxycoformycin (Pentostatin®)
 Clofarabine (Clolar®)
 Bendamustine (Treanda®)
 Nelarabine (Arranon®)
 Hodgkin disease

58. Frozen RCCs
 Indicated in patients with complex immuno
haematological profiles in the absence of
compatible donors.
 Blood is collected, RBCs separated and can be
frozen using glycerol and stored up to 10 years
 To use, must be thawed and washed.

59.  RBCs frozen in 40% glycerol, stored at -65°C
 RBCs frozen in 20% glycerol, stored at
-120°C
 After thawed and washed, unit expires in 24
hours and cannot be re-frozen

60. Guidelines for Paediatric red cell
transfusions
Neonates and Infants
 Hb< 13.0 g/dL and severe pulmonary disease
 Hb < 10.0 g/dL and moderate pulmonary disease
 Hb < 13.0 g/dL and severe cardiac disease
 Hb < 10.0 g/dL and Perioperative, critical care
 Hb < 8.0 g/dL and symptomatic anemia

61. Guidelines for Paediatric red cell
transfusions Children and adolescent
 <8 g/ dL hemoglobin
 No specified hemoglobin
 <10 g/dL hemoglobin
 <8 g/dL hemoglobin
 <8 g/dL hemoglobin
 Perioperative, critical care
 >25% of Acute blood loss
 Acute or chronic anemia and
severe cardio respiratory
disease
 Symptomatic chronic anemia
 Bone marrow failure

62. ABO group selection for RBC
Transfusion
Recipient ABO
Group
Component ABO Group
1st Choice 2nd Choice 3rd Choice 4thChoice
A A O None None
B B O None None
AB AB A B O
O O None None None
Oh (Bombay
Group)
Oh None None None

63. Chronic Anaemia
 In anemias that are likely to be present from a long time, it is
also important to balance the detrimental effects of anemia on
growth and development v/s the potential toxicity associated
with repeated transfusions.
 With chronic anaemia, the decision to transfuse RBCs should
not be based solely on blood haemoglobin levels because
children compensate well and may be asymptomatic despite
low haemoglobin levels.
 Patients with iron-deficiency anaemia are often treated
successfully with oral iron alone, even at haemoglobin levels
of <5 g/dL.

64. When to transfuse in chronic anemia?
Transfusion should be considered in a asymptomatic
child with a Hb level of less than 4 g/dL.
• Transfusion should be considered in a child with a
Hb level of less than 5 g/dL with clinical signs of
cardiac or respiratory distress .
Only increases in heart rate or respiratory rate alone
may be normal compensatory mechanisms and are
not necessarily indications for transfusion.

65. .
• Blood is not generally recommended for children with
a Hb level between 4 and 5 g/dL who are clinically
stable.
 These children should be admitted for evaluation and
treatment of the cause of their anaemia and should be
monitored closely for changes in Hb level and signs of
decompensation.
 Treat the cause as infection , nutritional and mild
blood loss anaemia with specific therapeutic agents as
indicated (iron, folic acid, B12).

66.  Respiratory distress is unlikely to be due to chronic
anaemia if the Hb level is 5 g/dL or greater.
• Children should be transfused with 10 to 15 ml/kg of
PRBCs.
 Transfusions must be given slowly (over a 4 hour
period. At the rate of 2-3 ml/kg/hr.
 Monitored closely to avoid volume overload.
 Diuretics should be used if the patient is in congestive
cardiac failure.

67. Platelets Concentrate
Types of Platelets
1. Recovered platelets(Random donor
platelets)
2. Apheresis platelets(single donor platelets)

68. Platelets Concentrate
Random donor platelets
Made from units of whole blood by centrifugation.
Prepared by 2 methods
1. Platelet rich plasma
2. Buffy coat removal
 I unit :50109 platelets
 Volume: 50 ml
 The storage time from collection to transfusion of
platelets (RDPs) is 5 days.

69. Platelets Concentrate
Single donor platelets
 Made from single donor
 Apheresed using cell separator machine
 1 unit SDP = 6 units RDP
 Volume of 1 unit SDP: 200-350 ml
 SDPs can be stored for up to 5 days.
 Stored at 22*C

70. Recommendation for platelets use
 Platelets should never be filtered through a micropore
blood filter before transfusion.
 Should be transfused as rapidly as pt can tolerate 1
unit/20 min.
 ABO compatible platelet is preferred.
 The usual recommended dose of platelets for neonates
is 1 unit of platelets per 10 kg body weight, which
amounts to 5 mL/kg.
 The predicted rise in platelet count from a 5-mL/kg dose
would be 20 to 60,000/cubic mm.

71. Indications
Thrombocytopenia: quantitative defects
 Prophylactic transfusion for PLT <10k
 Platelets < 20,000 and bone marrow infiltration,
severe mucositis, DIC, anticoagulant therapy.
 For invasive procedure, trauma , bleeding with PLT
count <50k
 Rapidly falling PLT count with bleeding
 Platelet dysfunction: qualitative defects
 Uremia
 Aspirin ingestion
 Post- Cardiopulmonary Bypass

72. Contraindication
 Single anatomic site is thought responsible for the bleeding.
 Although not absolutely contraindicated, ITP patients are
unlikely to benefit from platelet transfusion due to rapid
immune-mediated peripheral platelet destruction.
 Bleeding >5 Ml/ Kg/ Hr, needs surgical intervention.
 Thrombotic Thrombocytopenic Purpura
 Heparin Induced Thrombocytopenia

73. ABO group selection for Platelet
Transfusion
Recipient
ABO
Component ABO
1st Choice 2nd Choice 3rd Choice 4thChoice
A A AB B O
B B AB A O
AB AB A B O
O O A B AB

74. Fresh frozen plasma
 Source plasma
 Recovered plasma

75. Content
 Plasma proteins
 Albumin
 Immunoglobulins
 Complement
 Coagulation factors (2, 7, 9, 10, 8, 13, vWF,
fibrinogen)
 ~400 mg fibrinogen.

76.  Its use is appropriate to restore hemostatic levels of
coagulation proteins resulting from multiple factor
deficiency.
 Each unit contains 200-250 mL.
 Frozen within 8 hrs of collection
 Stored -18º C for up to 1 year
 Once thawed, can be kept at 2-6º C for 24 hrs

77. Indications
 Treatment of multiple coagulation factor
deficiencies
 Massive transfusion
 Trauma
 Liver disease
 DIC

78.  Warfarin reversal prior to emergent invasive procedures
(5-8 ml/kg)
 PT/PTT > 1.5x normal
 DOSE: 10-15 ml/kg.

79. Thaw at o
C & heavy spin
Fresh Frozen Plasma
Cryoprecipitate
-Refrozen within hr
-Store at < -
o
C
Cryoremoved Plasma
Freeze - o
C immediately
Stored at - o
C

80. Cryoprecipitate
 Cold insoluble white precipitate that forms when FFP is
thawed at 1-6º C
 Once thawed, kept at room temperature
 CONTAINS:
 80 to 150 IU of Factor 8:C (anti hemophilic factor)
 250 mg fibrinogen
 Von Willebrand Factor
 Fibronectin
 Factor XIII

81. Cryoprecipitate
Each unit =10-15 mL
Dosage – 1 unit for every 5 to 10 Kgs.
 Indications:
 Deficiency of fibrinogen (DIC), Factor VIII
(Hemophilia A) or XIII, Von Willebrand factor
deficiency
 Improve platelet function in uremia
 Afibrinogenemia,
 Protein C deficiency and protein S deficiency when
specific factor replacement is not available.
 post streptokinase therapy (hyper-fibrinogenolysis)

82. Cryopoor Plasma
Contains
 Stable clotting factors (2, 7, 9, 10)
 No factor 5, 8 & fibrinogen
Indication
 Replacement in plasma exchange for TTP

83. ABO group selection for Plasma/FFP
Transfusion
Recipient
ABO
Component ABO
1st Choice 2nd Choice 3rd Choice 4thChoice
A A AB None None
B B AB None None
AB AB None None None
O O AB A B

84. Plasma derivatives
 Factor VIII
 Factor IX
 Factor VIII- vWF concentrates
1. Factor VIII
Indication-
Hemophilia A
Loading dose, maintenance dose
Loading dose = desired factor VIII level –
patient’s baseline level 
Body weight(kg)/2

85. Plasma derivatives
2.Factor IX
Indication-
Hemophilia B
Loading dose + maintenance dose
Loading dose=desired factor IX level –
patient’s baseline level 
Body weight(kg)

86. Plasma derivatives
3.Factor VIII- vWF concentrates
 Indications-
 Type IIB & severe type III Von Willebrand’s disease
 Mild disease-FFP
 Moderate disease-cryoprecipitate

87. Plasma derivatives
Albumin
2 preparations
 Human albumin solution4.5%(plasma protein fraction)
 Human albumin solution20%(salt poor
albumin)
Indications
 Nephrotic syndrome
 Liver disease with fluid
overload

88. Plasma derivatives
Immunoglobulin
Normal immunoglobulin
 Prepared from normal plasma
 Indication :
 Hypo gamma globulinaemia
 Infections
 Immune thrombocytopenic purpura
Specific immunoglobulin
 Obtained from donors with high titers of antibodies
 Eg- anti-D, anti-hepatitis B& anti-varicella zoster

89. Apheresis
 Apheresis is the process by which the required
component of whole blood is separated and collected
from the donor using an automated blood cell
separation device.
 Components that can be donated by apheresis include
 Platelets (platelet pheresis),
 Plasma (plasma pheresis),
 leucocytes (leuco pheresis) and
 Red blood cells (erythrocyto pheresis).

90. Automated apheresis
blood separators may be
used for donation or
therapeutic applications

91. Indications
 Severe clotting deficiency (including DIC) with
bleeding
 Severe clotting deficiency in a neonate undergoing an
invasive procedure
 Vitamin K deficiency with bleeding
 Dilutional coagulopathy with bleeding
 Severe anticoagulant protein deficiency

92. Granulocyte Transfusions
Granulocyte concentrates are collected from single
donors by use of a blood cell separator.
Each concentrate contains approximately 10
10
granulocytes.
Granulocytes are fragile and may be stored no
longer than 24 h.
 The usual concentrate contains about 250 ml of
plasma and has a Hct of 15 to 20 percent.
ABO compatibility is necessary.

93.  GTX is recommended only when infections are
clearly unresponsive to antimicrobial drugs,
infected children with sustained bone marrow
failure (malignant neoplasms resistant to
treatment, aplastic anemia, and hematopoietic
progenitor cell transplant recipients) may benefit
when GTX is added to antibiotics.
 The use of GTX for bacterial sepsis unresponsive
to antibiotics in patients with severe neutropenia
(<0.5 × 109/L) is supported by many controlled
studies .

94. Guidelines for Pediatric Granulocyte
Transfusions
CHILDREN AND ADOLESCENTS
 Neutrophils of < 500/mm3 and bacterial infection
unresponsive to appropriate antimicrobial therapy
 Qualitative Neutrophil defect and infection (bacterial
or fungal) unresponsive to appropriate antimicrobial
therapy
INFANTS WITHIN THE FIRST 4 MO OF LIFE
Neutrophils of < 3000/mm3 (1st wk of life) or <
1000/mm3 (thereafter) and fulminant bacterial infection

95. Human serum albumin
HSA is comprised of 96 percent albumin and 4 percent
α-and β –globulin.
Dose is 0.5- 2 gm/kg
Indications –
 Hypovolemic shock,
 Hypotension associated with hypovolemia in liver
failure or protein-losing conditions,
 Inadequate diuresis in fluid overloaded
hypoproteinemic patients.

96. INTRAVENOUS IMMUNOGLOBULIN
 IVIG is a concentrated purified solution of
immunoglobulins with stabilizers such as
sucrose.
 Contain >90% immunoglobulin G (IgG) with
small amounts of immunoglobulin M (IgM) and
immunoglobulin A (IgA)

97. Indications.
 Alloimmune disorders
 Congenital immunodeficiency syndromes.
 Hyper immune immunoglobulins- several infectious
agents including Varicella-zoster virus and respiratory
syncytial virus, rabies.
 Severe sepsis
Dosing ==of 500 to 900 mg/kg.