TERAPI TRANSFUSI DARAH LEUKODEPLETED PADA PASIEN THALASSEMIA

Bobby Rojas, Irza Wahid

Abstract


Thalassemia merupakan gangguan sintesis hemoglobin (Hb), khususnya rantai globin, yang diturunkan.  Data Pusat Thalassemia, Departemen Ilmu Kesehatan Anak, FKUI-RSCM, sampai dengan bulan Mei 2014 terdapat 1.723 pasien dengan rentang usia terbanyak antara 11-14 tahun.1,  Pengobatan penyakit thalassemia sampai saat ini belum sampai pada tingkat penyembuhan. Di seluruh dunia tata laksana thalassemia bersifat simptomatik berupa transfusi darah seumur hidup. Dahulu target Hb pra transfusi darah 6gr% dan pasca transfusi 8-10gr%, namun sekarang target Hb pra transfusi adalah 9-10gr% dan pasca transfusi adalah 12gr% pada wanita dan 13gr% pada pria.3,4 Transfusi darah merupakan tindakan transplantasi organ yang sederhana, tetapi mengandung banyak risiko, seperti reaksi transfusi dan tertularnya penyakit akibat tercemarnya darah donor oleh virus seperti hepatitis B, C, Human Immunodeficiency Virus (HIV), dan human t-cell leukemia virus (HTLV). Baru pada akhir tahun 2011 pasien thalassemia di RS tertentu bisa mendapatkan packed red cells (PRC) rendah leukosit dengan menggunakan skrining nucleic acid test (NAT), namun tidak rutin tersedia. Selain risiko tertular penyakit infeksi, pasien yang mendapatkan transfusi berulang juga dapat mengalami reaksi transfusi mulai dari ringan seperti menggigil, urtikaria, sampai berat seperti syok anafilaksis. Penggunaan bedside filter saat pemberian transfusi darah non leukodeplesi pada saat transfusi belum rutin dilakukan, karena akan menambah biaya.

Keywords


Thalassemia, hemoglobin, leukodeplesi

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DOI: http://dx.doi.org/10.32883/hcj.v5i2.756

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