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Single blood donor exposure programme for preterm infants: a large open study and an analysis of the risk factors to
O Baud1, T Lacaze-Masmonteil, A Monsaingeon-Lion
1Service de Réanimation et Pédiatrie Néonatales, Hôpital Antoine Béclère, Clamart, France.
Insights
A single blood donor program for very preterm infants reduced donor exposure by 55%. High-risk infants, born before 28 weeks gestation or with intrauterine growth retardation, faced higher risks of multiple donor exposure.
Area of Science:
- Neonatal Medicine
- Pediatric Hematology
- Transfusion Medicine
Background:
- Very preterm infants require frequent blood transfusions.
- Minimizing exposure to multiple donors and reducing blood wastage are critical clinical goals.
Purpose of the Study:
- To assess the efficacy of a single blood donor exposure program in very preterm infants.
- To identify risk factors for multiple donor exposure within this program.
Main Methods:
- An open study involving 142 neonates in a single donor exposure program with 35-day expiry blood units.
- Analysis of 114 neonates alive post-first unit to determine risk factors for multiple donors.
Main Results:
- A 55% reduction in the total number of required donors was achieved.
- No increase in the overall number of transfusions was observed.
- Infants born before 28 weeks' gestation or with intrauterine growth retardation (IUGR) below the 10th percentile showed the highest transfusion needs.
Conclusions:
- Very preterm infants born before 28 weeks' gestation are at high risk for multiple donor exposure.
- Infants born between 28-31 weeks' gestation with IUGR below the 10th percentile also face a significantly increased risk of multiple donor exposure.
Unlabelled:
As the need for blood transfusions of very preterm infants remains considerable, various strategies are considered to minimize exposure to multiple blood donors along with blood wastage. In a large population of very preterm infants born between 24 and 31 weeks' gestation, we undertook an open study to assess the efficacy of a single blood donor exposure programme and to determine, among the population enrolled in this programme, the risk factors for exposure to multiple donors. One hundred and forty-two neonates were included in a single donor exposure programme with a 35-day expiry date blood unit. Though no inflation in the total number of transfusions was noticed, there was a 55% overall reduction in the total number of required donors. To determine the risk factors for exposure to multiple donors in this population, 114 neonates alive after the expiry date of the first unit of packed red blood cells were selected. The greatest and the most extending transfusion requirements were observed in very preterm infants born before 28 weeks' gestation and in those born after but with an intra-uterine growth retardation below the 10th percentile. Indeed, 70% of those high-risk infants were exposed to a second blood donor and more than 85% of the group exposed to a second donor belonged to this high-risk population.
Conclusion:
Neonates with a very high risk of a more-than-one donor exposure were born before 28 weeks' gestation or between 28 and 31 weeks but with an intra-uterine growth retardation below the 10th percentile.