[PAGID] transfusion guidelines for IgA deficient patients

[Dr. med. Jan Rohr]

Dear colleagues,

I am asking for your advice concerning several questions related to the 
issue of transfusions in IgA-deficient patients (since I am new to this 
listserver please forgive me if this topic has already been discussed in 
the past). As IgA-deficient patients carry an increased risk for severe 
anaphylactic reactions during the transfusion of blood products, I was 
wondering whether there are official guidelines concerning this issue. 
However, I have been unsuccesful in finding such guidelines. Since I am 
not sure whether such guidelines exist at all, I am asking for your 
experiences and approach to this topic. In particular, I would be 
interested in the following points:

1.) Is there a clear cut-off value for the serum IgA-level below which 
the risk of transfusion reactions increases ?
2.) What should be the lower limit of detection of the method used for 
the determination of IgA-levels ?
2.) Is the determination of Anti-IgA-levels helpful in identifying 
patients at risk ?
3.) What kind of blood products are being used (washed red blood cells 
or thrombocytes ? red blood cells and thrombocytes from IgA-deficient 
donors ?) ?
4.) What recommendations do you have if such blood products are not 
available in a timely manner ?

Your help is appreciated. Best wishes,

Jan Rohr

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Dr. med. Jan Rohr
Klinik I: Allgemeine Pädiatrie
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Zentrum für Kinderheilkunde und Jugendmedizin
Universitätsklinikum Freiburg
Mathildenstr. 1
79106 Freiburg
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Tel.:    +49 761-270-4300
E-mail:  Jan.Rohr at uniklinik-freiburg.de
Web:     http://www.uniklinik-freiburg.de