Which apheresis platelets product should be irradiated?

Irradiation of apheresis platelets is primarily performed to prevent transfusion-associated graft-versus-host disease (TA-GvHD), a rare but serious complication that can arise when immune cells from the transfused platelets attack the recipient’s tissues. The correct choice is the directed donation given by a mother for her son, which should be irradiated due to the close genetic relationship between the donor and the recipient.

In cases of direct donations from a family member, such as a mother to her son, there is a higher risk for TA-GvHD because of the compatibility of genetic markers. By irradiating the platelets, the donor's T-cells, which can cause the condition, are inactivated, significantly reducing the risk of this adverse effect.

In contrast, autologous units collected prior to surgery do not require irradiation since the cells are from the recipient, thus eliminating the risk of graft-versus-host disease. Random stock units, while used for patients with conditions like disseminated intravascular coagulation (DIC), do not necessitate irradiation unless there are other patient-specific risk factors. Similarly, the directed donation from an unrelated family friend does not carry the same risks as familial donations, thus not requiring routine irradiation