Effects of exchange transfusion on platelet counts

With the purpose of knowing to what extent thrombocytopenia that occurs in exchange transfusion (ET) can be secondary to the procedure itself or to a generalized infection, blood counts were made in 42 neonates with hyperbilirubinemia due to maternal fetal isoimmunization of the ABO system. Platelets were quantified halfway and immediately after the exchange transfusion procedure as well as 8, 16, 24, 48 and 72 hours after. It was found that prior to ET platelet levels in donor and patient blood was similar and platelet counts were never under 100,000 mm3 (thrombocytopenia). Halfway and at the conclusion of ET, as well as 8 and 16 hours after, a decrease in platelet levels was observed. After 24 hours an increase was observed that reached basal levels prior to ET after 72 hours. In five children thrombocytopenia was observed; in two, halfway of the ET procedure, in one at the end and two more at 8 and 16 hours after ET. From results obtained we can conclude that thrombocytopenia occurring 24 hours after ET can be due to septicemia.