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Appropriate transfusion of fetal and paediatric patients of all ages is vital in order to balance transfusion benefits against risks. These risks include transfusion of an incorrect blood component due to errors such as mistaken patient identity, or unpredictable acute transfusion reactions (Stainsby et al, 2008). Recent studies suggest that a significant percentage of paediatric transfusion recipients receive only one transfusion during their admission (Slonim et al, 2008; New et al, 2014), raising the possibility that some may be avoidable. Specialised components are available for transfusion to different paediatric patient groups and for different clinical indications.

Plasma components have been imported for all patients born on or after 1st Jan 1996 in order to reduce the risk of transfusion transmission of variant Creutzfeldt–Jakob disease (vCJD; see section 7). Additional component safety measures are applied for fetal and neonatal patients, who are particularly vulnerable recipients because of their small size and developmental immaturity and who also have the longest potential lifespan. The clinical section focuses largely on aspects relating to transfusion indications and administration, whereas the laboratory section contains most of the information relating to pre-transfusion testing and component selection.

Declaration of Interests

The BSH paid the expenses incurred during the writing of this guidance. None of the authors had conflicts of interest to declare. All authors have made a declaration of interests to the BSH and Task Force Chairs which may be viewed on request.