ABSTRACT
This chapter presents the laboratory and clinical issues involved in transfusion support of hematopoietic stem cell transplantation and solid-organ transplantation. The transfusion service plays an important supporting role in hematopoietic stem cell transplantation and solid organ transplantation by providing blood components and guidance on optimal blood component therapy during the peritransplantation period. The primary mechanism of transfusion-induced alloimmunization has been summarized elsewhere. Transfusion-associated graft-versus-host disease results from the passive transfer of donor immunocompetent T cells capable of engrafting and initiating an immune response against the recipient. Group B patients may need to be switched to group O blood when their transfusion requirements exceed the available group B supply. Transplant recipients are among the most complex patients requiring transfusion support. The immunosuppression required for successful transplantation requires specialized blood components to minimize the risk of transfusion-related complications. Donor lymphocyte transfusions collected by apheresis have also been used in solid-organ transplant recipients to treat hematopoietic malignancies.
