Clinics and Departments

Laboratory Services

Transfusion Services

SURGICAL RED BLOOD CELL ORDERING RECOMMENDATIONS
(AABB published guidelines)
See Listing BLOOD PRODUCTS ON HOLD

T&S = Type and Screen


PROCEDURE	UNITS RBCs	PROCEDURE	UNITS RBCs
Amputation (upper or lower extremity)	1	Gastroschisis repair	T&S-1
Anoplasty	1	Hypospadias repair	T&S
Arthrodesis, hip	1- 2	Ileostomy	T&S
Arteriovenous fistula replacement	T&S	Intestinal resection	1
Bladder tumor excision	1	Knee and distal femur procedures	T&S-1
Burn debridement	T&S	Laminectomy
Cardiac Surgery (includes pump prime)		Limited	T&S-1
Catheterization	1	Fusion with instrumentation	2- 4
Closed procedures	1- 2	Laparotomy	T&S-1
Open procedures Patients <10 Kg	2- 3	Limb salvage, with or without tumor resection	1
Patients >10 Kg	4	Liver biopsy	T&S
Pacemaker insertion	T&S	Liver resection	6
PDA ligation	50 mL/Kg	Lobectomy, lung resection	1- 2
Reoperations	2- 4	Lung biopsy	T&S
Valve replacement	2- 4	Myelomeningocoele repair	T&S-1
Cleft palate repair	T&S	Neck dissection	1- 2
Clitorectomy	1	Nephrectomy	2
Colectomy	1	Neonatal cases, open cavity	20 mL/Kg
Colostomy	T&S	Neurofibroma excision	1
Craniectomy	T&S-1	Nevus removal/scar revision	T&S
Craniofacial repair, complex	2- 4	Osteotomy, long bones or joints	1- 2
Craniosynostosis	1- 3	Pectus excavatum repair	T&S
Craniotomy for tumor	1- 3	Prosthesis (insertion/removal), long bones	1- 2
Cerebrospinal fluid shunts, replacement / revisions	T&S	Pyeloplasty	T&S
Cystectomy, ovarian	T&S	Pyelostomy	T&S
Extracorporeal membrane oxygenation	2- 4	Skin grafts, extensive	1- 2
Encephalocoele repair	1	Thoracotomy	1- 2
Endorectal pull-through	1	Thyroid biopsy or resection	T&S
Enterostomy closure	T&S-1	Tumor resection, long bones	2- 4
Extrahepatic anastomosis (Kasai procedure)	2	Urteroneocystostomy	T&S
Femoral neck repair	1- 2	Vascular malformation	1
Fundoplication (Nissen procedure)	T&S

Platelets (Leukocyte Reduced), Plasma, or Cryoprecipitate

Platelets: May be required for surgery for the following:

Patients with a known or pending qualitative platelet defect (CV bypass, von Willebrand’s, medication induced)
Anticipated massive blood loss (>50% EBV)
Pre-operative platelet count <50,000 (<100,00 for patients <5 Kg).

Plasma: May be required for surgery for the following:

CV bypass at risk for coagulopathy or bleeding
Anticipated massive blood loss (>50% EBV)
Documented coagulopathy with PTT >51 seconds (> 70 seconds in preterm infants <30 days old), and/or an INR >1.4

Cryoprecipitate: May be required for CV bypass surgery, massive volume loss (>50% EBV), or fibrinogen <150 mg/dL

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