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Criteria for Transfused Red Blood Cells

Red Blood Cell Units for exchange transfusion should meet the following criteria:

  1. ABO and Rh compatible with the infant
  2. Crossmatch compatible with maternal serum
  3. Negative for antigens that correspond with maternal antibodies
  4. Less than 7 days old to minimize potassium and avoid decreased levels of 2,3 DPG
  5. Irradiated to avoid the risk of TA-GVHD
  6. Cytomegalovirus (CMV) “safe” (leukoreduced and/or CMV seronegative)
  7. Negative for HbS to avoid sickling in low O2 tension

RBC units are normally crossmatched with maternal plasma, although the infant's plasma can be used if a maternal blood specimen is unavailable.