Transfusion medicine handbook

4. Blood Components

4.10 Granulocyte Components

Granulocyte components may by collected by apheresis or harvested from buffy coats obtained from whole blood donations. Granulocytes components must be ABO and RhD compatible with the recipient and must be irradiated before transfusion.

NZBS Policy for Collection and Transfusion of Granulocytes is available on the website.
(https://www.nzblood.co.nz/clinical-information/transfusion-medicine/information-for-health-professionals/clinical-guidelines-and-policies/

A request for granulocyte components must be made in consultation with a NZBS Transfusion Medical Specialist / Medical Officer.

Clinical Indications

The clinical efficacy, indication and dosage of granulocyte transfusions have not been established [5]. Systematic reviews have looked at granulocyte transfusions as treatment for infection and as prophylaxis. In people with neutropenia due to myelosuppressive chemotherapy or a haematopoietic stem cell transplant, there is insufficient evidence to determine whether granulocyte transfusions affect all-cause mortality [6]. This is because of the relatively low number of participants in the studies reviewed. In the setting of prophylaxis there is only low-grade evidence of a decrease in the risk of bacteraemia or fungaemia [5].

However, some believe that granulocyte transfusions may be beneficial and even lifesaving in severely neutropenic patients with systemic bacterial or invasive fungal infections not responding to antimicrobial therapy after 24 to 48 hours, and in whom there is the potential for recovery of marrow function.

Adverse Reactions

As with other blood components, adverse reactions may occur, with febrile non-haemolytic transfusion reactions (FNHTR) being the most common and often dose related. The development of HLA antibodies and subsequent immune refractoriness to platelet components may further complicate blood transfusion support in recipients of granulocytes.