In premature infants there is no decrease in 24-hour posttransfusion allogeneic red blood cell recovery after 42 days...

Area of Science:

• Neonatal Medicine
• Transfusion Medicine
• Hematology

Background:

• Critically ill preterm very-low-birthweight (VLBW) neonates often require red blood cell (RBC) transfusions due to anemia.
• Current understanding suggests RBC recovery decreases with storage duration in adults, but data in infants is limited.

Purpose of the Study:

• To investigate if posttransfusion 24-hour RBC recovery (PTR24) of allogeneic RBCs in VLBW newborns decreases with storage duration.
• To compare PTR24 in VLBW newborns with that in healthy adults receiving autologous RBCs.

Main Methods:

• Compared PTR24 of biotin-labeled RBCs in 46 VLBW neonates with 51Cr-labeled RBCs in 76 healthy adults.
• RBCs were stored for up to 42 days at 4°C in AS-3 or AS-5.
• Linear mixed-model analysis assessed PTR24 versus RBC storage duration.

Main Results:

• PTR24 in VLBW newborns did not significantly decrease with storage duration (p=0.18), unlike in adults (p<0.0001).
• The slopes of PTR24 versus storage duration differed significantly between newborns and adults (p=0.04).
• Projected mean PTR24 at 42 days of storage was 95.9% for newborns versus 83.8% for adults (p=0.0002).

Conclusions:

• Storage duration of allogeneic RBCs for neonates can be extended up to 42 days without impacting PTR24.
• Findings support current practices of using up to 42-day stored RBCs for small-volume neonatal transfusions.
• This practice helps minimize donor exposure for VLBW infants.