Reducing donor exposure in preterm infants requiring multiple blood transfusions

Area of Science:

• Neonatal Medicine
• Transfusion Medicine
• Pediatric Hematology

Background:

• Preterm infants often need multiple blood transfusions.
• Traditional 'fresh' blood policies ( < 7 days old) lead to exposure from numerous donors.
• Reducing donor exposure is crucial for vulnerable preterm infants.

Purpose of the Study:

• To evaluate the impact of a revised transfusion policy on donor exposure in preterm infants.
• To assess the safety and efficacy of using extended-use blood units for top-up transfusions.
• To determine if changes in plasma potassium levels occur with longer blood storage.

Main Methods:

• A retrospective analysis comparing a previous policy (fresh blood) with a new policy (extended-use blood units).
• Data collected on the number of transfusions per infant and the number of unique donors.
• Plasma potassium levels were monitored post-transfusion.

Main Results:

• The mean number of transfusions per infant remained similar between policies (5.6 vs. 5.3).
• Donor exposure per infant significantly decreased from 4.9 to 2.0 under the new policy.
• No significant difference in plasma potassium concentrations was observed, even with blood stored up to 33 days.

Conclusions:

• A simple policy change to utilize extended-use blood units effectively reduces donor exposure in preterm infants requiring multiple transfusions.
• This approach enhances patient safety by minimizing exposure to multiple donors.
• The revised policy is safe and does not compromise transfusion efficacy or lead to adverse potassium level changes.