Related Experiment Video
Updated: Oct 2, 2025
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Efficacy of packed red blood cell transfusions based on weight versus formula in thalassemic children: An open-label
Mehakdeep Kaur1, Ravneet Kaur2, Tanvi Sood2
1Department of Transfusion Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Insights
A new formula for calculating packed red blood cell (PRBC) transfusions in transfusion-dependent thalassemia (TDT) children significantly reduced donor exposures and annual red cell requirements compared to weight-based calculations.
Area of Science:
- Hematology
- Pediatric Medicine
- Transfusion Medicine
Background:
- Transfusion protocols for transfusion-dependent thalassemia (TDT) children vary globally.
- In India, weight-based calculation of packed red blood cell (PRBC) volume is common.
- This study addresses the need for optimized transfusion strategies in TDT pediatric patients.
Purpose of the Study:
- To compare the efficacy of PRBC transfusions calculated by weight versus a novel formula.
- To evaluate the impact of different calculation methods on patient outcomes.
- To determine the optimal PRBC transfusion strategy for TDT children.
Main Methods:
- Sixty TDT children (3-9 years) were randomized into two groups over 6 months.
- Group A received PRBCs based on weight; Group B received PRBCs calculated using a formula.
- The formula incorporated patient weight, pretransfusion hemoglobin, and PRBC hematocrit.
Main Results:
- Both groups showed similar pretransfusion hemoglobin levels (9 ± 0.4 vs. 8.9 ± 0.4 g/dl).
- Group B (formula-based) had fewer visits (7 ± 1 vs. 8 ± 1) but higher volume per visit (351 ± 78 vs. 287 ± 68 ml).
- Group B demonstrated significantly lower annual PRBC requirements (154 ml/kg/year vs. 178 ml/kg/year) and donor exposures (11 ± 3 vs. 14 ± 3).
Conclusions:
- Formula-based PRBC transfusion calculation is more effective in TDT children.
- This method reduces annual red cell requirements and donor exposure.
- Formula-based transfusions are recommended for optimizing care in TDT pediatric patients.
Background:
Protocols for transfusion therapy in transfusion-dependent thalassemia (TDT) children differ among various medical centers. In India, most centers consider only the patient's weight while calculating the volume of packed red blood cells (PRBCs) to be transfused. This study aimed to compare the efficacy of PRBC transfusions of different volumes calculated either by weight or by a formula using weight and pretransfusion hemoglobin of patient and hematocrit of PRBC.
Study Design And Methods:
Sixty TDT patients in the age group of 3-9 years were enrolled and randomly allocated to two groups. Group A received PRBC transfusion volume based on the patient's weight, and Group B received PRBC volume calculated using a formula for 6 months.
Results:
Average pretransfusion hemoglobin in Group A and Group B (9 ± 0.4 vs. 8.9 ± 0.4 g/dl) was not significantly different (p = .353). Although the average number of visits in 6 months was less for Group A compared to Group B (7 ± 1 vs. 8 ± 1; p = .001); the average volume transfused per visit was more (351 ± 78 vs. 287 ± 68 ml; p = .003). The calculated average annual pure red cell requirement of the patients was 178 ml/kg/year for Group A and 154 ml/kg/year for Group B (p = .000). Total donor exposures were significantly lower in Group B than Group A (11 ± 3 vs. 14 ± 3; p = .006).
Conclusion:
The number of donor exposures and annual pure red cell requirement was significantly lower in the formula-based group. Transfusions based on formula are recommended in TDT patients.
Related Concept Videos
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:15Blood Transfusion
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
01:27Disorders of Erythrocytes
Erythrocyte disorders can be broadly categorized into two main types: anemic and polycythemic conditions.
A low oxygen-carrying capacity of the blood due to the loss, lower production, or destruction of erythrocytes is termed anemia. Hemorrhagic anemia, for example, occurs when bleeding from an external wound or internal ulcer reduces erythrocyte counts.
On the other...