Neonatal Nurse Practitioner Practice Exam

When a parent donates blood to their neonate for a transfusion, what is imperative regarding the blood components?

1. Maternal blood donation must be limited to plasma

2. Parental blood components must be irradiated before use

3. The father should be eliminated as a donor if the mother has cytotoxic antibodies

4. Only whole blood should be used

The correct answer is: Parental blood components must be irradiated before use

The necessity for irradiating blood components before use in a transfusion from a parent to a neonate is crucial due to the risk of transfusion-associated graft-versus-host disease (TA-GVHD). This condition occurs when transfused immunocompetent lymphocytes in the blood components attack the recipient's tissues. Neonates, particularly ill ones or those born pre-term, have underdeveloped immune systems that are particularly vulnerable to such complications. Using irradiated blood components helps to inactivate these lymphocytes, reducing the risk of TA-GVHD. This practice is a standard precaution in transfusion medicine, especially when the donor is a close relative, such as a parent, who may share genetic similarities with the newborn. While maternal blood donation can be beneficial, limiting it solely to plasma or using only whole blood would either be insufficient or not applicable, especially in the context of providing necessary red blood cell volume for the neonate. The decision to exclude the father as a donor based on maternal cytotoxic antibodies also encompasses complexities surrounding compatibility that may not be as immediate a concern as preventing TA-GVHD through irradiation.