Transfusions of CPDA-1 red blood cells stored for up to 28 days decrease donor exposures in very low-birth-weight...

Area of Science:

• Neonatal Medicine
• Transfusion Medicine
• Pediatric Hematology

Background:

• Premature infants often require multiple red blood cell (RBC) transfusions.
• Reducing donor exposure is crucial to minimize transfusion-related risks in vulnerable neonates.
• Current transfusion practices may involve frequent donor exposures due to shorter storage limits.

Purpose of the Study:

• To evaluate the safety and efficacy of transfusing citrate-phosphate-adenine anticoagulant-preservative (CPDA-1) RBCs stored for up to 28 days in premature infants.
• To determine if longer storage of RBCs can reduce the number of donor exposures in this population.
• To assess clinical and biochemical outcomes associated with transfusing longer-stored RBCs.

Main Methods:

• A prospective randomized two-group study was conducted.
• Very low-birth-weight premature infants receiving at least one RBC transfusion were enrolled.
• Group 1 received CPDA-1 RBCs stored up to 28 days; Group 2 received CPDA-1 RBCs stored up to 3 days.

Main Results:

• Infants in both groups had similar demographics and clinical characteristics.
• The number of donors per infant was significantly reduced by 70.2% in Group 1 (1.5 donors) compared to Group 2 (4.3 donors) (P < 0.001).
• Transfusions of RBCs stored up to 28 days (potassium 29.7 +/- 18.3 mmol/L) did not cause significant clinical or biochemical changes compared to shorter-stored RBCs (potassium 19.8 +/- 12.3 mmol/L).

Conclusions:

• Citrate-phosphate-adenine anticoagulant-preservative (CPDA-1) RBCs stored for up to 28 days can be safely transfused to premature infants.
• Utilizing longer-stored RBCs significantly reduces donor exposures in premature infants.
• This approach offers a viable strategy to enhance transfusion safety and efficiency in neonatal care.