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Graft-versus-host disease following ECMO.
R M Hatley1, M Reynolds, A S Paller
1Department of Surgery, Medical College of Georgia Hospital and Clinics, Augusta, GA 30912-4070.
Journal of Pediatric Surgery
|March 1, 1991
Summary
Extracorporeal membrane oxygenation (ECMO) in newborns can lead to transfusion-associated graft-versus-host disease (GVHD). Irradiating blood products before transfusion is a recommended preventative measure for infants undergoing ECMO.
Area of Science:
- Neonatal care
- Hematology
- Pediatric critical care
Background:
- Extracorporeal membrane oxygenation (ECMO) is a life-saving treatment for neonatal respiratory failure.
- Over 3,000 newborns have received ECMO since 1973.
- ECMO necessitates significant blood product transfusions, including platelets and packed red blood cells.
Observation:
- A rare but serious complication, transfusion-associated graft-versus-host disease (GVHD), was observed in a patient treated with ECMO.
- Newborns on ECMO are exposed to a substantial volume of blood components.
Findings:
- Transfusion-associated GVHD can occur following ECMO treatment in infants.
- Irradiation of blood products effectively prevents GVHD.
Implications:
- Irradiating all blood products before transfusion during ECMO is a crucial safety measure.
- This practice should be adopted by other institutions to protect vulnerable newborns.
- Implementing blood product irradiation can significantly reduce the risk of GVHD in neonates undergoing ECMO.