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The life span of erythrocytes transfused to preterm infants
1Department of Pediatrics, University of Montreal, Research Center, Hôpital Sainte-Justine, Quebec, Canada.
Insights
The average lifespan of adult red blood cells transfused to preterm infants is approximately 56 days. Half of these transfused cells remain in circulation for about 30 days in preterm infants.
Area of Science:
- Neonatal Medicine
- Hematology
Background:
- Preterm infants often require blood transfusions due to various medical conditions.
- Understanding the survival of transfused red blood cells is crucial for optimizing transfusion protocols in neonates.
Purpose of the Study:
- To determine the lifespan of adult red blood cells transfused into early preterm infants.
- To establish the duration for which transfused erythrocytes remain viable in the circulation of very preterm neonates.
Main Methods:
- Weekly blood sampling from nineteen very preterm infants post-transfusion.
- High-performance liquid chromatography (HPLC) used to quantify fetal hemoglobin (HbF) levels.
- Red blood cell lifespan calculated by tracking the return of HbF levels to baseline autologous levels.
Main Results:
- The mean lifespan of adult red blood cells transfused to preterm infants was 56.4 +/- 7 days.
- In the studied preterm infants, approximately 50% of transfused adult red blood cells remained in circulation around 30 days post-transfusion.
- Data was collected from 12 out of 19 infants until their baseline HbF levels were re-established.
Conclusions:
- Adult red blood cells have a defined lifespan when transfused to preterm infants.
- The findings suggest that transfused erythrocyte survival in preterm neonates is a critical factor in transfusion management.
- Further research may refine transfusion strategies based on these erythrocyte survival data.
Abstract:
This study was made to determine the life span of adult red cells transfused to early preterm infants. Nineteen very preterm infants (birth weight, 878.7 +/- 221 g; gestational age, 26.8 +/- 1.5 wk at birth) were sampled weekly after their last blood transfusion to determine the level (%) of fetal Hb in their circulation. Two microliters of blood were subjected to reverse phase HPLC to separate the alpha, beta, and gamma globin components of their Hbs. The percent of fetal Hb (HbF) was calculated as gamma/gamma + beta x 100. The life span of the adult erythrocytes transfused was defined as the time interval between the transfusion and when the percentage of HbF in the recipient's circulation returns to the HbF levels that exist in the infant's autologous red cells (the maximum post transfusion HbF level). Twelve of the 19 infants were followed until their autologous HbF levels were reached. Their mean adult red blood cell life span was 56.4 +/- 7 d (range: 46-68 d). The results obtained in this study imply that the number of days after a transfusion at which half the cells infused remain in the circulation in a preterm infant is about 30 d.