Authors: Jennifer Stepien, Marie-Hélène Robert
Primary target audiences: Transfusion medicine physicians, non-transfusion medicine physicians, nurses, medical laboratory technologists in a hospital laboratory
NOTE: This FAQ, developed in collaboration with Héma-Québec, provides information for granulocyte concentrate ordering, collection, delivery and reporting requirements. For additional information about granulocyte concentrates, see Héma-Québec's Circular of Information. The Clinical Guide to Transfusion Chapter 20, Granulocyte transfusion therapy, also provides an overview of clinical evidence, indications and recent innovations in manufacturing of granulocyte concentrates.
Granulocyte transfusions may help eliminate infectious bacterial or fungal pathogens in some clinical settings. Granulocyte transfusions are primarily used as a supportive therapy in patients with significant and prolonged neutropenia (less than 0.5 x 109 /L) or documented neutrophil dysfunction and severe bacterial or fungal infection(s) that are not responding to antimicrobials.1
The efficacy of granulocyte transfusions in various clinical settings has not been proven, either as a means to improve survival of patients or to shorten the duration of the infection. This product is not indicated for infection prophylaxis.1
No. Granulocyte concentrates are manufactured and distributed by Héma-Québec and transported directly to the ordering hospital. For hospitals outside the province of Québec, Canadian Blood Services will arrange the transport from Héma-Québec to the ordering hospital. Please refer to Héma-Québec's Circular of Information for additional information about granulocyte concentrates.
The ordering hospital must order granulocyte concentrates from Héma-Québec by completing two order forms provided on the Héma-Québec website. The forms must be retrieved from the Héma-Québec website as only the most recent forms will be accepted.
Complete both Héma-Québec forms ENR-03946 and ENR-03947:
Fax both forms (ENR-03946 and ENR-03947) to Héma-Québec at the number indicated on the bottom of form ENR-03946: 514-904-2522 or 1-866-811-9465.
Two follow up actions must be taken by the ordering hospital:
*Note: Manitoba hospitals will fax both forms to the Canadian Blood Services Winnipeg Centre Diagnostic Services - Crossmatch Laboratory instead.
Canadian Blood Services will make arrangements with the ordering hospital for the delivery of granulocyte concentrates.*
*Note: For Manitoba hospitals, the Canadian Blood Services Winnipeg Diagnostic Services – Crossmatch Laboratory is responsible for issuing granulocyte concentrates and coordinating delivery.
Héma-Québec and Canadian Blood Services will provide the ordering hospital with the granulocyte collection schedule as outlined in the process below:
*Note: Manitoba hospitals receive product directly from the Canadian Blood Services Winnipeg Diagnostic Services – Crossmatch Laboratory, who will also coordinate the delivery.
Héma-Québec is responsible for packing the granulocyte concentrates. Canadian Blood Services is responsible for picking up the granulocyte concentrates from Héma-Québec and shipping to the ordering hospital at room temperature. For hospitals in the Ottawa region, Héma-Québec can arrange to have the boxes shipped back to Héma-Québec; hospitals located outside the Ottawa region can reach out to Héma-Québec to determine if the boxes should be discarded or returned to Héma-Québec.
A copy of the completed forms submitted to Héma-Québec (see question 4) will arrive with each granulocyte concentrate unit. Please refer to Héma-Québec's Circular of Information for additional information.
Granulocyte concentrates are stored at 20°C to 24°C without agitation. Please refer to Héma-Québec's Circular of Information for additional information.
Granulocyte concentrates must be transfused within 24 hours of collection.
Granulocyte units are issued with transmissible disease testing results from the donor’s most recent blood donation (prior to granulocyte donation) and have “analyses en cours” (pending analysis) written on the ISBT label (refer to Figure 1). Blood group (ABO and Rh) information is not included on the granulocyte concentrate label.
Testing is performed on the donor’s granulocyte donation on the day following collection and the updated testing results are provided to the ordering hospital by fax as they become available. Hospitals should refer to this document for blood group and transmissible disease testing information.
The physician signature on form ENR-03947 indicates the hospital is willing to accept granulocyte concentrates before testing results are available.
Granulocyte concentrates are usually collected from frequent donors.
Héma-Québec will forward donor testing results to the ordering hospital at the fax number provided by the hospital on order form ENR-03946. The ordering hospital is responsible for providing the fax number to ensure the results are received.
Testing is done on the weekday following the granulocytes collection. For example, granulocytes collected on Monday will have results available on Tuesday. If the granulocytes collection occurs on a Friday, Saturday, or public holiday, testing will be done on the next weekday.
For quality assurance (QA) purposes, data regarding patient diagnosis and outcome, the number of granulocyte concentrates transfused, and other relevant clinical details will be requested by Héma-Québec following the treatment.
For more information about the QA requirements, please contact the Héma-Québec medical office through hospital customer service at 514-832-5000 ext. 6909 and ask to speak to the on-call MD.
Severe adverse reaction must be reported to Héma-Québec so they can conduct an investigation. The report must be emailed to firstname.lastname@example.org with an accompanying phone call (514-904-2522 or 514-904-8350 or 1-866-811-9465).
Stepien J, Robert M-H. FAQ: Information for health professionals ordering granulocyte concentrates [Internet]. Ottawa: Canadian Blood Services; 2023 MM DD [cited YYYY MM DD]. Available from: FAQ: Information for health professionals ordering granulocyte concentrates | Professional Education (blood.ca)