RBC T activation and hemolysis in a neonatal intensive care population: implications for transfusion practice

BORALESSA, H; Modi, Neena; Cockburn, Hazel; Malde, Ranjan; Edwards, Marilyn; Roberts, Irene; Letsky, Elizabeth A.

doi:10.1046/j.1537-2995.2002.00237.x

Cited by 34 publications

(30 citation statements)

References 21 publications

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“…Although T activation has been detected on the RBCs of up to 30% of neonates who have NEC, clinical haemolysis rarely is observed. 15 , 16 Four percent of the patients had haemosiderin and haematuria but without clinical evidence of worsening haemolysis.…”

Section: Discussionmentioning

confidence: 98%

Pattern, indications and review of complications of neonatal blood transfusion in Ibadan, southwest Nigeria

Ayede¹,

Akingbola²

2011

Ann. Ibadan Postgrad. Med.

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Background and objectives:There is a huge need for blood transfusion in the newborn particularly due to the reduced marrow activity in the neonatal period. Despite widely use of blood products in the neonatal period, there is paucity of local data on the pattern, indications and reactions to blood transfusions in Nigerian newborns. This study evaluates the blood transfusion indications and patterns in special care baby unit and C12nd of University College Hospital, Ibadan, Nigeria.Methodology:A cross sectional study was carried on the recruited newborns and structured questionnaires were used to obtain bio data, medical problems, indications for blood transfusion, type of blood products transfused and clinical signs. Urinalysis was performed out before and after the transfusion.Results:A total of 100 neonates were recruited into the study with a male: female ratio of (M: F= 1:1). The age range was 2–34 days and their weight ranged between 0.8kg to 3.6 kg with a mean weight of 1.64 kg. The main indications for transfusion were anaemia from prematurity & neonatal sepsis(NNS) 46%; (red cell replacement), NNS, Disseminated intravascular coagulation(DIC) & anaemia 24%; (partial exchange + top up + Fresh frozen plasma), neonatal jaundice(NNJ) & anaemia 14%; (whole blood), NNJ, NNS + anaemia 6%(Blood transfusion + Fresh frozen plasma), NNS + anaemia 10% (whole blood).Conclusion:Blood transfusion is still frequent in the study area and prematurity, neonatal sepsis and jaundice rank high in the indications. Transfusion reactions are rare in the evaluated neonates.

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Section: Discussionmentioning

confidence: 98%

Pattern, indications and review of complications of neonatal blood transfusion in Ibadan, southwest Nigeria

Ayede¹,

Akingbola²

2011

Ann. Ibadan Postgrad. Med.

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“…Some studies have shown an association of NEC with activation of the Thomsen-Friedenreich cryptic T antigen (T-activation) on RBCs, causing low-grade hemolysis and anemia in multi-transfused patients who have previously received blood from adult donors carrying anti-T antibodies (27). The pathophysiological significance of T-activation in NEC remains unresolved (28), yet a finite possibility remains that some patients with “transfusion-associated” NEC could have had a low-grade smoldering illness prior to the transfusion. Growing preterm infants who are anemic but otherwise stable are usually monitored with an expectation of spontaneous improvement in hematocrits.…”

Section: Discussionmentioning

confidence: 99%

Do Red Cell Transfusions Increase the Risk of Necrotizing Enterocolitis in Premature Infants?

Josephson¹,

Wesolowski²,

Bao³

et al. 2010

The Journal of Pediatrics

119

100

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BACKGROUND Recent studies have detected an association between red blood cell (RBC) transfusions and NEC. We hypothesized that RBC transfusions increase the risk of NEC in premature infants, and investigated whether the risk of ‘transfusion-associated’ NEC is higher in infants with lower hematocrits and advanced postnatal age. METHODS Retrospective comparison of NEC patients and controls born at <34 weeks gestation. RESULTS The frequency of RBC transfusions was similar in NEC patients (47/93, 51%) and controls (52/91, 58%). Late-onset NEC (> 4 weeks of age) was more frequently associated with a history of transfusion(s) than early-onset NEC (adjusted OR=6.7; 95% CI=1.5–31.2; p=0.02). Compared to non-transfused patients, RBC-transfused patients were born at an earlier gestational age, had greater intensive care needs (including at the time of onset of NEC), and longer hospital stay. A history of RBC transfusions within 48-hours prior to NEC onset was noted in 38% of patients, most of whom were extremely low birth weight (ELBW) infants. CONCLUSIONS In most patients, RBC transfusions were temporally unrelated to NEC and may be merely a marker of overall severity of illness. However, the relationship between RBC transfusions and NEC requires further evaluation in ELBW infants using a prospective cohort design.

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“…T-activation can cause hemolysis and anemia in multi-transfused patients who have previously received adult blood containing anti-T antibodies (26, 27). Studies show considerable variation in the frequency of T-activation in NEC, ranging from rare occurrences to up to a third of all patients (6, 28). T-activation is associated with increased morbidity and mortality in NEC.…”

Section: Anemiamentioning

confidence: 99%

Haematological abnormalities in neonatal necrotizing enterocolitis

Song

Subbarao

Maheshwari

2012

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective Necrotizing enterocolitis (NEC) is a leading cause of morbidity and mortality in preterm infants born prior to 32 weeks gestation or with a birth weight less than 1500 grams. In this article, we review hematological abnormalities associated with NEC. Methods A literature search was performed using the databases PubMed, EMBASE, and Scopus, and the electronic archive of abstracts presented at the annual meetings of the Pediatric Academic Societies. Results Thrombocytopenia, disseminated intravascular coagulation, increased or decreased neutrophil counts, and hemolytic anemia are frequent events in NEC. Conclusions NEC is associated with several hematological abnormalities, which may play a direct or indirect role in the pathogenesis of gut mucosal injury. Some of these abnormalities carry important prognostic information.

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RBC T activation and hemolysis in a neonatal intensive care population: implications for transfusion practice

Abstract: T variant activation of RBCs occurs in healthy neonates as well as in infants with NEC and sepsis, but T activation appears rare. Transfusion- associated hemolysis was not seen. The provision of specially prepared blood components for infants with NEC is unnecessary.

Cited by 34 publications

References 21 publications

Pattern, indications and review of complications of neonatal blood transfusion in Ibadan, southwest Nigeria

Pattern, indications and review of complications of neonatal blood transfusion in Ibadan, southwest Nigeria

Do Red Cell Transfusions Increase the Risk of Necrotizing Enterocolitis in Premature Infants?

Haematological abnormalities in neonatal necrotizing enterocolitis

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