blood donors

Hi,
It's been awhile since I posted but my husband and I are adopting a child with Thal Major and hope to have her home with us this summer - she just had her first birthday.  We just received paperwork telling us her blood type and it turns out that most of our family members have the same blood type and are willing to be tested to find out if they will be able to donate for her.  My question is- how likely is it that any of us will be a match?  What all are they looking for when they match people for transfusions?  Do any of you use the same donors for transfusions? 

I greatly appreciate this board and you all have been a wealth of information for myself and family.

Diana

Hi Diana

Before starting transfusion for the first time, a geneotype test should be made for the receiver to avoid any antibodies complications.

As for the relatives a cross match test is done to see if the blood of the donor is suitable for the baby or not and itis very important to have the blood filtered before transfusing ( removing white blood cells ) as well as washed ( removing plasma) to avoid complications.

If your child transfuse every month, it will be hard to have blood from the same donor as you have to donate every 3 months so i guess that safe blood banks will be more suitable.

Remember that chelation usually starts after 15 to 20 transfusions or when the ferritin levels exceed the 1000. Chelation is very important to avoid any complications related to iron overload.

If safe blood is available and you have compliance to chelation, be sure that your child will live a happily healthy life as any other child. Please keep us updated and feel free to ask anything

Find below a link explaining everything about transfusion, good luck

http://www.thalassemiapatientsandfriends.com/index.php?topic=2257.0

manal

Hi Diane, 

Congratulations on your new baby:)  Manal has given you very important information, it will help you avoid any transfusion related complications and problems with iron.

Just a quick note, I think that I may have been a little unclear in my previous posts -  genotype testing is actually possible even after transfusions because it looks at DNA - and it looks at white blood cells rather than red blood cells (red blood cells do not have a nucleus, only WBC do) so transfused patients can still have genotype testing even if they are being transfused.  Phenotype testing is what becomes difficult to test once a patient has been transfused because it looks at markers on red cells rather than DNA - and once a patient is transfused it is difficult to differentiate donor vs host rbcs.  Therefore, please be sure to have genotype testing as soon as possible for your child. 

Sharmin

Thanks Sharmin for this very important clarification

Please Diana consider this test to avoid any risk, thanks

manal

Hi Diana,

Welcome on the forum,wishing you luck and joy with your baby.It's not really necessary to give blood by the same person everytime your child transfuses,you just have to make sure that blood is properly screened.

Sharmin,

If the baby is thal major and is one year old,she must have gotten a few transfusions till now,so phenotyping is out i guess?

Zaini.

Thank you for the information.  We do not know what kind of testing she has had so far, as she is in Asia (we are in the US) and we have not been able to have any contact with her or her physicians.  Hopefully we'll find out more when we travel to pick her up.  I understand about frequency of blood donation limiting using the same donors - I'm just a nervous mom, wanting to make sure my baby always has blood available when she needs it.  I'm sure my nerves will settle once she has been with us awhile and we have gotten used to her needs. 

thank you for the information
Diana

Diana,

When she gets here it will be a good idea to be in touch with a comprehensive thal care center, they can do the testing there.  It is vital to have genotype testing when she gets here, in order to get well matched blood.   We will be here to guide you through any other questions you may have. 

Zaini,  yes, it will be very difficult to do phenotype testing once she is regularly transfused for 2 reasons - 1) it is difficult to separate host from donor rbcs (it is possible with sophisticated equipment but a lot of the patient's own retics are required) 1) with regular transfusions, thal major's bone marrow is suppressed and it is difficult to get enough retics without letting the patient's hg drop considerably.  This test is best done before the patient is transfused.   The genotype testing looks at actual DNA from the nuclei of WBCs so it can be done at any time. 

Depending on how long she will be transfused before getting here you will also look into checking her iron levels and deciding on chelation treatments. 

Sharmin