In premature infants there is no decrease in 24-hour posttransfusion allogeneic red blood cell recovery after 42 days of storage
Demet Nalbant, José A Cancelas, Donald M Mock, Svetlana V Kyosseva, Robert L Schmidt, Gretchen A Cress, M Bridget Zimmerman, Ronald G Strauss, John A Widness, Demet Nalbant, José A Cancelas, Donald M Mock, Svetlana V Kyosseva, Robert L Schmidt, Gretchen A Cress, M Bridget Zimmerman, Ronald G Strauss, John A Widness
Abstract
Background: Critically ill preterm very-low-birthweight (VLBW) neonates (birthweight ≤ 1.5 kg) frequently develop anemia that is treated with red blood cell (RBC) transfusions. Although RBCs transfused to adults demonstrate progressive decreases in posttransfusion 24-hour RBC recovery (PTR24 ) during storage-to a mean of approximately 85% of the Food and Drug Administration-allowed 42-day storage-limited data in infants indicate no decrease in PTR24 with storage.
Study design and methods: We hypothesized that PTR24 of allogeneic RBCs transfused to anemic VLBW newborns: 1) will be greater than PTR24 of autologous RBCs transfused into healthy adults and 2) will not decrease with increasing storage duration. RBCs were stored at 4°C for not more than 42 days in AS-3 or AS-5. PTR24 was determined in 46 VLBW neonates using biotin-labeled RBCs and in 76 healthy adults using 51 Cr-labeled RBCs. Linear mixed-model analysis was used to estimate slopes and intercepts of PTR24 versus duration of RBC storage.
Results: For VLBW newborns, the estimated slope of PTR24 versus storage did not decrease with the duration of storage (p = 0.18) while for adults it did (p < 0.0001). These estimated slopes differed significantly in adults compared to newborns (p = 0.04). At the allowed 42-day storage limit, projected mean neonatal PTR24 was 95.9%; for adults, it was 83.8% (p = 0.0002).
Conclusions: These data provide evidence that storage duration of allogeneic RBCs intended for neonates can be increased without affecting PTR24 . This conclusion supports the practice of transfusing RBCs stored up to 42 days for small-volume neonatal transfusions to limit donor exposure.
Trial registration: ClinicalTrials.gov NCT00731588.
Conflict of interest statement
Conflict of Interest Statements:
Demet Nalbant: Nothing to declare.
Jose A. Cancelas: Nothing to declare.
Donald M Mock: Paid consultant for Medday Pharmaceuticals
Svetlana V. Kyosseva: Nothing to declare.
Robert L. Schmidt: Nothing to declare.
Nell I. Mathews: Nothing to declare.
Gretchen A. Cress: Nothing to declare.
M. Bridget Zimmerman: Nothing to declare.
Ronald G. Strauss: Nothing to declare.
John A. Widness: Has established loan agreement for use of a Sysmex Hematology Analyzer
© 2017 AABB.
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Source: PubMed