Red Blood Cell units for exchange transfusion should meet the following criteria:
- ABO and Rh compatible with the infant
- Crossmatch compatible with maternal serum
- Negative for antigens that correspond with maternal antibodies
- Less than 7 days old to minimize potassium and avoid decreased levels of 2,3 DPG
- Irradiated to avoid the risk of TA-GVHD
- Cytomegalovirus (CMV) “safe” (leukoreduced and/or CMV seronegative)
- Negative for HbS to avoid sickling in low O2 tension
RBC units are normally crossmatched with maternal plasma, although the infant's plasma can be used if a maternal blood specimen is unavailable.