In the immediate post bone marrow transplant period, what is the red cell product of choice for a patient with a hematocrit of 21%?

In the immediate post bone marrow transplant period, the selection of red cell products must prioritize the patient's safety and the potential for complications related to transfusion. The appropriate choice in this situation is irradiated red cell products.

Irradiation of blood products is performed to prevent transfusion-associated graft-versus-host disease (TA-GvHD), a serious and often fatal complication that can arise when transfused donor lymphocytes attack the recipient’s tissues. This risk is significantly heightened in patients who are immunocompromised, such as those undergoing bone marrow transplants. Administering irradiated red cell products eliminates viable lymphocytes, thereby reducing the risk of TA-GvHD.

While packed red blood cells (or other types of red cell products) can be transfused, without irradiation, they pose a higher risk for patients in this vulnerable state. Saline washed red cells are typically used to remove plasma proteins and potential allergens but do not address the risk of TA-GvHD. Microaggregate filtering also serves a purpose, primarily to reduce the risk of febrile reactions and transfusion-related acute lung injury (TRALI), but it does not mitigate the risk of TA-GvHD.

Thus, considering the immediate post-transplant period's unique challenges