EXPERIENCE REPORT OF BLOOD COMPONENTS IRRADIATION IN THE RADIOTHERAPY SERVICE OF A PUBLIC UNIVERSITY HOSPITAL

Introduction: ANVISA gives a high priority to making sure that patients receive irradiated blood, during blood transfusion, in order to prevent Transfusion- Associated Graft-Versus-Host Disease (TA-GVHD). Such a fatal immune complication in 90% of cases is caused when T lymphocytes, found in red blood cell and platelet concentrate, begin to multiply and attack receptor cells. In the mechanism of bag irradiation, such complication can be prevented by eliminating T-cells from Blood Components before undergoing the transfusion. This irradiation step is performed daily at the UFTM Clinical Hospital, in the Radiotherapy Service, where, through a CLINAC 600 Linear Accelerator, with 6MV energy, the technical team performs the irradiation of Blood Components with a dose of 25 grays, varying accordingly with the volume of bags received on the day. Objective: To describe the process of blood component irradiation in the routine of the Radiotherapy Service of the UFTM Clinical Hospital, using the CLINAC 600 Linear Accelerator, radiation emitter, applying the calculated dose. Methodology: Blood Component irradiation activity occurs daily in the morning or afternoon, according to the demand of the hospital blood center. Blood Component bags are delivered to the Radiotherapy Service in a thermal box to the radiotherapy technician or technologist of the service. The bags are nestled in a 30x30x14cm acrylic box with lid; which contains a ruler that will determine the volume inside the box for later dose calculation with 25 grays. According to the pouch limit, the dose is calculated, with an anterior-AP exposure (Gantry 0º) and another posterior-PA exposure (Gantry 180º), with an average duration of 20 minutes. Results: From January 2018 to June 2019, bags were irradiated with Red Blood Cell Components (CH), Platelets (PQ) and Aphereses, totaling 13,759 Blood Components. The process allowed the referral of blood bags to hospitals connected to the micro-region of Uberaba, and for immediate use in patients who, for various reasons, had indications of transfusions of different Blood Components. Conclusion: It is noteworthy the need and importance of a single process for the irradiation of Blood Components in order to favor the prevention of complications of TA-GVHD, resulting from possible blood transfusions.