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How do I support a pediatric cardiac surgery program utilizing fresh whole blood?

T he hemostatic benefits of transfusing fresh whole blood (FWB) compared to components are controversial for pediatric cardiothoracic (CT) surgical patients as generally reported in the literature. However, of less controversy, a reduction in donor exposure is a uniform finding when FWB is transfused to pediatric CT surgical patients. A pediatric CT program utilizing FWB to reduce transfusion requirements has been in existence since 1995 at The Children’s Hospital of Philadelphia. The combined cooperation of the American Red Cross– Penn Jersey Region in Philadelphia (Red Cross), hospital transfusion service (blood bank), and clinical staff have worked together to sustain this unique program. Furthermore, this Red Cross is the only location of the ARC facilities that currently collects FWB for pediatric CT surgical patients. This collection program has now even extended to hospitals outside our immediate region. This report presents a description of how FWB is requested, obtained, utilized, and monitored in this program.