Blood transfusion: quality and safety issues in thalassemia, basic requirements and new trends

Guidelines for minimizing risks from alloimmunization, other transfusion reactions, and infection risks are presented based on the Thalassemia International Federation (TIF) guidelines. Future developments including pretreatment of the red cell product that may reduce infection risks are discussed. The rationale for guidelines about the transfusion regime that optimizes the balance between over- and undertransfusing patients is discussed. The optimal approach is still debated and may vary with the patient population in question. Because of changes in the preparation of red cell products in recent years, there is variability in iron content of a 'unit' of blood. It is recommended that each center involved in the treatment of thalassemia knows the average hematocrit and volume of the blood product that they are using, as this impacts on response to chelation therapy.