Pretransfusion blood irradiation: clinical rationale and dosimetric considerations

The irradiation of blood before transfusion into immunosuppressed patients is an increasingly common technique used to prevent graft-versus-host disease. A technical procedure is described for the calibration of blood irradiators, including the determination of absolute dose rate and relative dose distribution over the blood volume. Results of dose rate measurements on commercially available irradiators indicate differences of +5% to -13% with manufacturer-supplied calibrations and variations in the relative dose rate over the irradiation volume from 70% to 180%. The clinical implications of these findings and the need for accurate dosimetry are discussed.