Advantages of using a filter during transfusion

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Offline mrtariqkhan

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Advantages of using a filter during transfusion
« on: June 20, 2007, 10:23:22 AM »
Hi!

     I have recently started reading on the net for my daughter who is a thal major and found this forum pretty useful i have to say people like andy and sajid are doing an awesome job keep it up  :hugfriend.

     Can someone tell me the advantages of using a filter during transfusion and also one of the doctors said that it will lower the amount of iron that goes in due to transfusion (is it true) . In Pakistan it costs around $40, could someone please guide me that spending this amount is really necessary each time.

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Offline Zaini

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Re: Advantages of using a filter during transfusion
« Reply #1 on: June 20, 2007, 11:47:13 AM »
Hi Mr Tariq Khan,

 :welcome to the forum,you'll find this highly useful,i am from karachi a mother of thal major daughter,about your question,as far as i remember doctor told us that filter stops white blood cells from entering the body,as what the body of a thal major requires is red blood cells,so keeping WBC count in control,please anyone correct me if i am wrong.But what amazes me isthe cost of filter,where are you going for your daughter's transfusion?i remember Sajid mentioning a center named "jamila sultana center",he said it has an awesome setup and staff, and reasonable prices ,perhaps you can check it out there.

I hope your daughter is doing well.

LOVE,

ZAINI.
^*^Xaini^*^

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Offline §ãJ¡Ð ساجد

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Re: Advantages of using a filter during transfusion
« Reply #2 on: June 20, 2007, 11:51:38 AM »
Hello Mr. Tariq,

:welcome to the site.

Thanks for the compliments. :blush I'm no expert compared to Mr. Andy or anyone else on the site. I just call it a 25 years experience.

Anyway, the filters are good to filter out the impurities that are present in the blood if your child gets reactions from them. However, the Iron that comes from the blood is trapped inside the RBCs and is required for an essential function of RBCs. It cannot be removed by filters. The only way to remove the Iron that comes with the blood is via chelation therapy and that only happens when the transfused RBCs complete their life and break up to release the iron molecule.

Take care, Peace!
اَسّلامُ علیکم Peace be Upon you
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Offline §ãJ¡Ð ساجد

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Re: Advantages of using a filter during transfusion
« Reply #3 on: June 20, 2007, 03:16:15 PM »
Hi,

Just wanted to add that JSF don't use filters but they have an extensive cross match protocols to minimise reactions unlike at Holy Family Hospital which issue the blood in few minutes.

Take care, Peace!
اَسّلامُ علیکم Peace be Upon you
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Offline mrtariqkhan

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Re: Advantages of using a filter during transfusion
« Reply #4 on: June 21, 2007, 09:15:11 AM »
Hi again!!
 
             Thanks Brother Sajid and Zaini for the warm welcome. tell you the truth i wasn't expecting a reply so soon. REally you guys are the best.  :thumbsup

       Br. Sajid you'r quite a modest person - I get a lot of hope reading about you and hope that one day my daughter will live up to be like you. ( Strong and Confident - Believing in religion, Everything the whole package that makes you) i will surely one day make my daughter read your posts...  :yes

      Zaini you deserve a round of applause  :clap supporting your daughter i hope she does well through her life you are an inspiration to my wife.

      I was taking my daughter to PIMS ( Pakistan instutite of medical sciences) till the last time then i read the post from Br.Sajid yesterday pointing to Jamila Sultana and immediately took off from work and went to register my daughter they were very nice, everybody was very supportive the best thing is that my wife didn't even knew that it was a thalassemia center as everyone was in casual clothes ( I told her that it was some marrige counselling place and she was like " we don't need marrige counselling" :rotfl ).
     
   Anyways, jokes apart it was just like Br. sajid said very nice infact i didn't believe at first as we here in pakistan are not used to such nice treatment and that too for free - but these guys are simply awesome  :yahoo. The biggest challenge according to sajid is getting blood and at this place they help out a lot usually everyone requires a blood donation ( it's not easy to get it every time so far me and my wife have been donating ours with 3 months gap) at Jamila sultana they try to minimize this.

  So thanks a lot people for the insanely incredible advice and support. I being my greedy self would love to see more of it from your side  :bighug  thanks a zillion 
« Last Edit: June 21, 2007, 10:01:43 AM by mrtariqkhan »

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Offline mrtariqkhan

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Re: Advantages of using a filter during transfusion
« Reply #5 on: June 21, 2007, 10:18:29 AM »
Hi!
 
    Just wanted to ask another thing from zaini. What did you give to your daughter to eat when she was around 1 and half year old. I mean i know what to give and what not to give. but didn't she gave you any trouble while eating, my daughter just doesn't take plain youghart or plain cheese but we give it maybe with a little rice she will take it but that's the only thing that she eats otherwise she will be eating only some potato Chips (btw can we give thal patients Chips???)..

   So please advice what did you do with your daughter in order to eat you know with interest????

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Offline Zaini

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Re: Advantages of using a filter during transfusion
« Reply #6 on: June 21, 2007, 12:30:02 PM »
Hi ,

Thanx for your compliments Mr Tariq khan,what else a mother can do? other then supporting her kids,so coming to your question, to tell you the truth, my daughter was diagnosed at the age of three,she basically is an intermedia,a wrongly diagnosed thal intermedia to be precise,untill then there were no problems, she never needed a transfusion till the age of three,but then when she was 2 years and 9 months old she started looking pale, we went to her physician,he asked for a hb test,and it was 6gm,then we visited a heamotologist and after doing hb electrophoresis, she said our daughter was a thal major,( i think idea of a DNA test never crossed her mind) it was like a disaster for us ofcourse,and what i was unable to understand was that if she is a thal major ,how come she didn't need any transfusion in last three years,but the answer to my question by doctor was "aisa ho sakta hay "meaning it's nothing unusual" ,,i never accepted that answer, i always knew at my heart that there is something gone wrong in her diagnosis,bcoz it's a general knowledge and i knew that thal majors start transfusing in very early months of there lives, nobody ever told me about any such thing existing as thal intermedia,i came to know about that about one and a half year ago,but it was far too late,after two years of consecutive transfusing,she is now a transfusion dependent child, though a doctor here told me to go for hydrea,and stop transfusing, but i am really afraid now,bcoz as far as her health is concerned she is doing great Alhumdulillah,she has an ideal weight and height for her age Mashallah,and i want to keep it that way.

Coming to your question about your daughter's diet,it's a fact that most of the time kids give tough times to their parents in eating habits,it's necessary to know what they like,there is no harm in giving potato chips to thals :) but if taken too much they can cause indigestion ,excess of everything is bad,try some porridge,khichree,some sweet dishes like custard,egg pudding,even a little bit of jelly if she likes it,give her some yakhni (chiken soup),and try to take her out at some time of the day, let her play in fresh air,( i think weather is not that hot like khi in islamabad),it will do wonders,and some children naturally have a  small appetite,like if a normal kid will have his/her meals in 3 times a day,they'll take it in 4 to 5 times a day,try some noodles also,knorr noodles with any flavour she likes,as far as iron intake is concerned,red meat is the biggest source of iron, avoid it,try some scrambled eggs as the protien source, plus chicken and fish, she likes chips,ask your wife to fry fish fingers,with french fries,sometimes, kids need a lil bit of distraction,try some cartoon watching or musical  toys etc.i know your wife may have tried everything,as she is a mother,and mothers are always conscious about their kid's eating habits,still i hope my long boring reply will help.:).

As far as your wife is concerned,ask her to visit this forum regularly, it will help her a lot in facing everything,and if she needs any sisterly advice or support she can obviously PM me,or even call me.

Lots of love fore your daughter,

ZAINI.

P.S What are your daughter's ferritin levels,have you ever got them checked?
« Last Edit: June 21, 2007, 12:53:44 PM by ZAINI »
^*^Xaini^*^

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Offline Manal

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Re: Advantages of using a filter during transfusion
« Reply #7 on: June 21, 2007, 12:43:07 PM »
Hello :welcome :urwelcome

Welcome to the site. I am sure you will find here all the answers to your questions and all the support you will need

Take care

Manal

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Offline §ãJ¡Ð ساجد

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Re: Advantages of using a filter during transfusion
« Reply #8 on: June 21, 2007, 01:54:56 PM »
Hello Mr. Tariq,

I came back few hours ago and I did meet your wife with your beautiful daughter.

I know her first experience wouldn't have been a great one as your daughter's veins are so small and her blood was going very slow. Apart from that today there were too many patients and your wife and I had to sit throughout our TransX on the attendants' sofa. This shows the magnitude of the disease here in Pakistan. I was surprised they actually registered you as we had decided in our meeting that we won't register new patients until we get expanded to the lower building.

Anyway, it was good to know that it was your daughter besides me; but frankly speaking I didn't knew it until I came back home and my mom said (as she had been chatting with your wife) that the lady besides me had found JSF via Internet. I was like :doh "That must have been Mrs. Tariq and her daughter!"

As far as your question goes about the diet goes, well I'm developing the official website for JSF and on it you will find a chart for diet. I will approve it from Dr. Shazia and she will distribute it among all patients. You can access it online as well, but the site is still under construction. I can send you the list via email but I'd recommend that you wait till it gets approved by the doctor and she further refines it.

Take care, Peace!
اَسّلامُ علیکم Peace be Upon you
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Offline §ãJ¡Ð ساجد

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Re: Advantages of using a filter during transfusion
« Reply #9 on: June 21, 2007, 02:19:15 PM »
Hi,

Just wanted to tell you that I have already added a Google Earth Place mark file yesterday in the "Treatment Center" section for locating JSF, it would have made it easier for you to locate JSF if you had downloaded that file yesterday, but I guess that you already have found it on your own.

Take care, Peace!
اَسّلامُ علیکم Peace be Upon you
§ãJ¡Ð ®âµƒ
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Offline Sharmin

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Re: Advantages of using a filter during transfusion
« Reply #10 on: June 21, 2007, 05:28:16 PM »
The filter can also minimize antigens from entering the body, therefore reducing the liklihood of developing anibodies against various types of blood - if children begin developing many antibodies it limits the donors who can donate blood to that child.  And as Sajid and Zaini have mentioned it reduces the other contents of the blood, which your child does not require, from entering the body.   I am sure that Andy can expand on this, I really believe that a filter is important during blood transfusions.  Know however, that some antigen's may cross the filter and your child may still produce antibodies - but you are reducing the chances of this with a filter, and possibly introducing fewer varieties of antigens to your child. 

Sharmin
Sharmin

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Offline Andy Battaglia

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Re: Advantages of using a filter during transfusion
« Reply #11 on: June 22, 2007, 06:55:36 AM »
Filters filter out the white blood cells (leukocytes). Removing the white cells removes much of the antibodies present in the blood. These antibodies can cause reactions and are a main cause of post-transfusion fever. If at all possible, filtered blood should always be used.

There are two very good sites that discuss this subject.

http://www.scbcinfo.org/publications/bulletin_v1_n2.htm

Quote
Preventing or delaying alloimmunization to leukocyte antigens in selected patients who are chronic transfusion candidates. Platelet survival is frequently diminished in patients who require repeated transfusions. This is most commonly due to antibodies directed against HLA Class I antigens expressed both on white cells and platelets. There is evidence that it is the leukocytes in platelet concentrates, rather than the platelets, which induce the formation of HLA antibodies. Rates of platelet alloimmunization can be reduced if the white cell content of red cells or platelets is less than 5.0 x 106/unit. Leukodepletion of this order can be achieved with most of the third generation filters, and also with newer apheresis platelet collection procedures.

http://www.emedicine.com/med/topic107.htm

Quote
Deterrence/Prevention

    * Delayed hemolytic transfusion reactions
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          o Properly identify the serology of alloantibodies prior to transfusion, and properly identify antigen-negative RBCs if alloantibodies are present.

          o Patients with alloantibodies require fully crossmatched (ie, anti-immunoglobulin phase) donor units.

          o In ethnic minorities who have received multiple transfusions, testing patients for commonly involved antigens (eg, Rh, Kell, Kidd, Duffy) and using antigen-negative units can significantly reduce the frequency of alloimmunization. However, the cost effectiveness of this approach must be considered because most patients who have received multiple transfusions do not form clinically significant alloantibodies. A more cost-effective approach is to match the ethnic origin of donors and recipients, reserving extensive antigen typing for recipients who have been previously alloimmunized. These patients may also benefit from leukodepleted RBCs because leukoreduction appears to decrease the frequency of alloimmunization to RBC antigens, possibly due to decreased stimulation of TH2 lymphocytes associated with transfusions.

          o If attempting to transfuse Rh-positive units (RBCs, platelets, or granulocytes) into an Rh-negative recipient, prevent alloimmunization to the D antigen by administering intravenous Rh-immunoglobulin (eg, WinRho SD, 10-12 mcg/mL of transfused Rh-positive RBCs). If transfusing a large number of Rh-positive units, reduce the dose of Rh-immunoglobulin after removing the antigen load by RBC exchange.

    * Refractoriness to platelet transfusions
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          o Primary alloimmunization to class I HLA antigens present on platelets involves active donor APCs.

          o Removing leukocytes by filtration or buffy coat removal or deactivating APCs by ultraviolet-B irradiation reduces the frequency of alloimmunization.

          o Leukocyte reduction is indicated in all patients who are expected to be transfused repeatedly, especially candidates for bone marrow transplantation. These patients may also benefit from initial HLA typing and transfusions from crossmatched or HLA-matched platelets.
Andy

All we are saying is give thals a chance.

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Offline mrtariqkhan

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Re: Advantages of using a filter during transfusion
« Reply #12 on: June 25, 2007, 11:46:33 AM »
Hi,

 Thanks everyone for the replies these are of great help....   


    Zaini-  Thanks for the detailed reply iam sad for your daughter, our daughter too was diagnosed with intermedia but she dropped below 6 so we had to transfuse her at 6 months. Now she is totally dependent on the transfusions... best of luck with your daughter. I well definetly let know my wife of your generous advices. thanks a zillion....


    Sajid-  Yes my wife told me about you and mum. My wife was very happy to see you doing so good. she was very impressed.... well the blood transfusion went quite tiresome for us as they gave us in the last. and viens of such a small kid is always very difficult to get... nurses at pims are quite trained in this regard but the blood quality there is not good.... anyhow i hope this process will get easier in future i mean when huda will get older... keep up the good work. btw i am a web developer and have a experince of 2 years plus now. if i can be of any assistance in the site please let me know....


 Andy - Thanks for the conclusive reply to my question i have posted another one would you be kind enough to answer that too....


Again everyone thanks for the welcome and replies.. I appreciate everything...

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Offline Andy Battaglia

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Re: Advantages of using a filter during transfusion
« Reply #13 on: June 25, 2007, 04:46:18 PM »
Yes, the reason for the yellow color and high bilirubin is the excess hemolysis or break down of the transfused red cells. This happens because antibodies in the blood react to the antigens in the donor blood. These antibodies are increased in the blood due to previous transfusions. The more one is transfused, the more one accumulates these antibodies. This is why using a filter or filtered blood is so important. Removing the white cells and the antibodies contained in them is very important in improving the survival of the transfused red cells and also avoiding transfusion reactions. As you suggested, accurate cross matching is also a very important factor in avoiding excessive hemolysis.

If at all possible, use a filter during transfusion. One other thing that may help is using prednisone along with the transfusions. This can help counteract the immediate antibody reaction and lead to longer life for the transfused red cells. Perhaps Sharmin can share her experiences with her son regarding this.
Andy

All we are saying is give thals a chance.

Re: Advantages of using a filter during transfusion
« Reply #14 on: July 22, 2007, 09:51:40 AM »
A-o-A Mr Tariq.
i am agreed with Mr Sajjid and Zaini. i am Mumtaz, my son also having the problem that he always got reaction at the time of transfeusion, so the doctor advise us to use blood after wash, method is, they saparate RBCs from WBCs, and then they washe RBCs by normal Sciline( in our lanugage Glocouse), to remove remainig WBCs from RBCs. Allhumduallah my son is now not frequiently reacted by the blood. so u should talk with ur doctor before adopting this method.
May Allah solve our Problems
Allah Hafiz
Mumtaz
Hi!

     I have recently started reading on the net for my daughter who is a thal major and found this forum pretty useful i have to say people like andy and sajid are doing an awesome job keep it up  :hugfriend.

     Can someone tell me the advantages of using a filter during transfusion and also one of the doctors said that it will lower the amount of iron that goes in due to transfusion (is it true) . In Pakistan it costs around $40, could someone please guide me that spending this amount is really necessary each time.

 

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