IgA deficiency

If a patient is identified as IgA deficient (see also section on transfusion reactions - allergic reactions), they must not receive any blood components containing plasma unless the blood is from IgA deficient donors. PMH does not have any frozen inventory of blood from IgA deficient donors.

Therefore, your choices are as follows:

For RBC requirements:

1. If it's an emergency, take routine compatible RBC units and wash them very thoroughly to remove the most plasma possible.
2. If time allows, you could order IgA deficient components from an outside blood center.
3. Do autologous donation if possible.

For platelet or plasma requirements:

1. If it's an emergency, you're in trouble. You could volume-reduce regular platelets from inventory and heavily premedicate the patient, but the risk of reaction is still high.
2. If time allows, obtain components from IgA-deficient donors through the rare donor network.
3. Use autologous collection if at all possible.

Remember that individuals having severe allergic reactions from IgA antibodies are not always totally lacking in IgA. They may have a selective deficiency but can still have severe problems during transfusion.

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