title: Linear accelerator: a reproducible, efficacious and cost effective alternative for blood irradiation.
abstract: BACKGROUND
  The dedicated devices for blood irradiation are available only at a few centers in developing countries thus the irradiation remains a service with limited availability due to prohibitive cost.
  
  
  OBJECTIVE
  To implement a blood irradiation program at our center using linear accelerator.
  
  
  METHODS
  The study is performed detailing the specific operational and quality assurance measures employed in providing a blood component-irradiation service at tertiary care hospital. X-rays generated from linear accelerator were used to irradiate the blood components. To facilitate and standardize the blood component irradiation, a blood irradiator box was designed and fabricated in acrylic. Using Elekta Precise Linear Accelerator, a dose of 25 Gy was delivered at the centre of the irradiation box. Standardization was done using five units of blood obtained from healthy voluntary blood donors. Each unit was divided to two parts. One aliquot was subjected to irradiation. Biochemical and hematological parameters were analyzed on various days of storage. Cost incurred was analyzed.
  
  
  RESULTS
  Progressive increase in plasma hemoglobin, potassium and lactate dehydrogenase was noted in the irradiated units but all the parameters were within the acceptable range indicating the suitability of the product for transfusion. The irradiation process was completed in less than 30 min. Validation of the radiation dose done using TLD showed less than ± 3% variation.
  
  
  CONCLUSIONS
  This study shows that that the blood component irradiation is within the scope of most of the hospitals in developing countries even in the absence of dedicated blood irradiators at affordable cost.
authors.affiliation: Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal University, Manipal, Karnataka, India. Electronic address: shameegirish@gmail.com.
authors.forename: Shamee
authors.initials: S
authors.lastname: Shastry
authors.forename: B
authors.initials: B
authors.lastname: Ramya
authors.forename: Jefy
authors.initials: J
authors.lastname: Ninan
authors.forename: G C
authors.initials: GC
authors.lastname: Srinidhi
authors.forename: Sudha S
authors.initials: SS
authors.lastname: Bhat
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Fernandes
mesh_terms: D016913:Blood Component Transfusion / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D001803:Blood Transfusion / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D003362:Cost-Benefit Analysis; D006801:Humans; D010315:Particle Accelerators / Q000191:economics / Q000295:instrumentation*
keywords: Blood components; Irradiation; Linear accelerator; Quality control