Platelet transfusion in an infant leading to formation of anti‐D: implications for immunoprophylaxis

Haspel, Richard L.; Walsh, L. P.; Sloan, Steven R.

doi:10.1111/j.0041-1132.2004.03370.x

Cited by 19 publications

(10 citation statements)

References 14 publications

(37 reference statements)

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“…Exceptions have been described. An Rh‐D negative neonate undergoing cardiac surgery at 17 weeks of age produced anti‐D after 2 PT from D + donors [59]. Three case reports in newborns reported on allo‐anti‐E at the age of 18 days and 11 weeks respectively and one anti‐K detected at the age of 12 weeks [60–62].…”

Section: Special Blood Product Requirementsmentioning

confidence: 99%

Blood transfusions in neonatal cardiac surgery and ECMO

Brand

2009

ISBT Science Series

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Section: Special Blood Product Requirementsmentioning

confidence: 99%

Blood transfusions in neonatal cardiac surgery and ECMO

Brand

2009

ISBT Science Series

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“…Preterm or very‐low‐birth‐weight infants frequently receive transfusions . In contrast to alloimmunization in adults, transfusion‐related alloimmunization in neonates and young children is rare and has been reported only in sporadic cases (Table ) . In agreement with the hypothesized unresponsiveness of the neonatal immune system to RBC antigens, national standards allow limited pretransfusion serologic testing for infants less than 4 months of age.…”

Section: Rbc Alloimmunization In Neonates and Infants Up To 4 Months mentioning

confidence: 99%

“…5 In contrast to alloimmunization in adults, transfusion-related alloimmunization in neonates and young children is rare and has been reported only in sporadic cases (Table 1). [6][7][8][9][10][11][12] In agreement with the hypothesized unresponsiveness of the neonatal immune system to RBC antigens, national standards allow limited pretransfusion serologic testing for infants less than 4 months of age. The British Committee for Standards in Haematology guideline 13 and the AABB standards 14 recommend an initial screening for unexpected RBC antibodies using either plasma or serum from the mother or the infant.…”

mentioning

confidence: 99%

Red blood cell alloimmunization in neonates and children up to 3 years of age

et al. 2017

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BACKGROUND An alloimmune response to red blood cell (RBC) transfusion in neonates is a rare event. Several guidelines recommend limited pretransfusion testing in neonates. The evidence for these recommendations is based on small studies with sample sizes of between 30 and 90 infants. STUDY DESIGN AND METHODS We conducted a retrospective cohort study among consecutive patients who received transfusions at a single university medical center. All non‐alloimmunized patients who had received their first RBC transfusion between 1994 and 2013 and who underwent at least one antibody screening follow‐up visit between 7 and 365 days after transfusion were included. RESULTS The incidence of alloimmunization in the control group of 17,084 adult patients age 45 years or older who had received a median of 5 RBC units (interquartile range, 2‐12 RBC units) was 3.55% (n = 607 alloimmunized patients). After transfusion of 40 RBC units, the cumulative incidence of alloimmunization in adult controls was 10.24% (95% confidence interval, 7.71%‐13.17%). In total, 1641 neonates and children up to age 3 years received a median of 4 RBC units (interquartile range, 2‐7 RBC units) in a median of two RBC transfusion episodes (interquartile range, one to five RBC transfusion episodes). Two children developed anti‐M and anti‐E antibodies post‐transfusion at the ages of 181 and 611 days, respectively. CONCLUSION To our knowledge, this study presents the largest longitudinal cohort study of RBC alloimmunization in neonates. Antibodies against RBC antigens were not detected within the first 6 months of life. Repeat antibody screening and cross‐matching during the first months of life can be safely omitted.

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“…Hence, once it is determined that maternal antibodies are not present in a newborn’s circulation, new antibodies are unlikely to form from transfusions in the first 4 months of life and additional antibody screens are not necessary during a hospital admission (3). The one possible exception is the Rh(D) minor antigen which is very immunogenic (11). Hence, patients who are Rh(D)− should receive Rh(D)− blood components and if such a neonate is exposed to Rh(D)+ RBCs within a platelet component, the patient may be at risk for developing antibodies to Rh(D).…”

Section: Antibodies To Minor Antigensmentioning

confidence: 99%

Neonatal transfusion review

Sloan

2010

Pediatric Anesthesia

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In addition to the issues concerning blood transfusions in general, special considerations apply to transfusing neonates. Young infants' plasma may contain maternal antibodies to ABO blood group antigens instead of the naturally occurring anti-ABO antibodies normally present in older patients. This facilitates the transplant of hearts across ABO boundaries but complicates blood bank testing and selection of appropriate blood components for transfusion. Conversely, blood bank testing is simplified by the fact that neonates do not make antibodies to minor erythrocyte antigens. Cellular blood components may be irradiated to prevent transfusion-associated graft-versus-host disease, a syndrome that can affect immunocompromised patients such as premature infants. However, irradiation accelerates the leakage of potassium out of stored red blood cells (RBCs), increasing the risk or transfusion-induced arrhythmias from hyperkalemia and hypocalcemia. Two other risks of transfusing neonates RBCs include dilutional coagulopathy and potential toxicities from additives used to preserve the stored RBC units.

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Platelet transfusion in an infant leading to formation of anti‐D: implications for immunoprophylaxis

Cited by 19 publications

References 14 publications

Blood transfusions in neonatal cardiac surgery and ECMO

Blood transfusions in neonatal cardiac surgery and ECMO

Red blood cell alloimmunization in neonates and children up to 3 years of age

Neonatal transfusion review

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