Granulocyte collection and transfusion

Granulocytes can be collected by apheresis but because of the relatively low concentration of granulocytes in the circulation it is necessary to increase the level of circulating cells to collect an adequate dose for transfusion. This chapter discusses the current technology of granulocyte collection and provides a critical assessment of the potential for the use of therapeutic and prophylactic granulocyte transfusions (GTXs). Donor granulocyte concentrates must be ABO and Rh compatible with the patient because of the red cell content found within the final GTX product. Donor stimulation with properly timed corticosteroids increases the number of circulating granulocytes by releasing those that were adhering to the vascular walls. One approach is the use of GTX as prophylaxis to prevent infection. There are few publications on the use of GTX in pediatric patients, and no randomized controlled trials have been performed.