Which patient groups are recommended to receive irradiated blood products?

• A. Immunocompromised recipients
• B. Intrauterine and very premature neonates
• C. Immunocompromised recipients, intrauterine/very premature neonates, and hematopoietic stem cell transplant recipients
• D. All transfusion recipients

Answer: (C)

Irradiated blood products are used to prevent transfusion-associated graft-versus-host disease by inactivating donor T lymphocytes in the transfused unit. This is crucial for groups whose immune systems can’t reliably control these donor cells. Immunocompromised recipients lack the immune power to suppress donor T cells, so these cells can attack the recipient’s tissues if transfused. Intrauterine and very premature neonates have immature and limited immune responses, making them particularly vulnerable to TA-GVHD. Hematopoietic stem cell transplant recipients are profoundly immunosuppressed and often have donor-derived immune cells that can become aggressive toward the host; irradiating their blood products minimizes this risk.

Because of the potential to prevent a deadly complication, irradiated products are recommended for all of these high-risk groups. Not every patient needs irradiation—routine transfusions in healthy individuals do not require it, and irradiated products are used selectively to balance safety with resource use and product quality.