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Chokri Ben Lamine Explains Washed PRBCs!
Jan 5, 2026, 12:55

Chokri Ben Lamine Explains Washed PRBCs!

Chokri Ben Lamine, Adult Hematology and SCT Assistant Consultant at Oncology Center of Excellence at King Faisal Specialist Hospital and Research Center, shared on X:

”Washed PRBC

What are washed PRBCs?

PRBCs washed with saline to remove:

  • Plasma proteins
  • Residual platelets and leukocytes
  • Cytokines / IgA / allergens

Main Indications (Adults):

  1. Severe allergic / anaphylactic transfusion reactions (esp. recurrent)
  2. IgA deficiency with anti-IgA antibodies
  3. History of plasma-mediated reactions despite premedication
  4. Selected neonates (context-specific)

NOT routinely indicated for:
– FNHTR (use leukoreduced blood instead)
– TRALI prevention
– Infection risk reduction
– GVHD prevention (need irradiated blood, not washed)

Practical Limitations / Pearls:

  • Short shelf life after washing (≤24 hours at 1–6°C)
  • Lower RBC recovery → slightly less hematocrit increment
  • Higher contamination risk → use promptly
  • Requires coordination with blood bank

Compare Quickly:
Washed PRBC → removes plasma proteins
Leukoreduced PRBC → removes WBCs (default standard)
Irradiated PRBC → prevents TA-GVHD

MCQ (Perfect Answer)

Q: Best blood product for a patient with IgA deficiency and prior anaphylaxis to transfusion?
A. Standard PRBC
B. Leukoreduced PRBC
C. Irradiated PRBC
D. Washed PRBC

Correct answer: D

OSCE Pearl

Adult with repeated urticaria + hypotension during PRBC transfusion despite antihistamines:

  • Switch to washed PRBC
  • Premedication alone is insufficient

Take-Home:
– Use only when clearly indicated
– Key role in severe allergic reactions and IgA deficiency
– Not a substitute for leukoreduction or irradiation

Reputable Sources:
• AABB Standards for Blood Banks and Transfusion Services

• British Society for Haematology (BSH) Transfusion Guidelines

• UpToDate – Indications for washed red blood cells”

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