Alloimmunization in preterm infants after repeated transfusions of WBC-reduced RBCs from the same donor

Ronald G Strauss; Karen Johnson; Gretchen Cress; Delores G Cordle

doi:10.1046/j.1537-2995.2000.40121463.x

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Alloimmunization in preterm infants after repeated transfusions of WBC-reduced RBCs from the same donor

Journal article

Peer reviewed

Alloimmunization in preterm infants after repeated transfusions of WBC-reduced RBCs from the same donor

Ronald G Strauss, Karen Johnson, Gretchen Cress and Delores G Cordle

Transfusion (Philadelphia, Pa.), Vol.40(12), pp.1463-1468

12/2000

DOI: 10.1046/j.1537-2995.2000.40121463.x

PMID: 11134565

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Abstract

BACKGROUND: Preterm infants are among the most heavily transfused of patient groups, yet multiply transfused infants only rarely produce alloantibodies against RBC or WBC antigens. It is not known whether rates of alloimmunization might be increased by repeated exposure to RBCs and WBCs from the same donor, as in limited-donor-exposure programs, or whether infants might benefit from WBC-reduced RBC components as a means of diminishing the risk of possible alloimmunization. STUDY DESIGN AND METHODS: Preterm infants (birth weight 0.6-1.3 kg) received prestorage WBC-reduced RBCs from dedicated donors, collected in AS-3 as a means of limiting donor exposures. Blood samples were collected serially from infants shortly after birth until either discharge or age 6 months and were studied for RBC and WBC antibodies—the latter with reactivity against either HLA class I or neutrophil-specific antigens. RESULTS: Thirty preterm infants received 139 transfusions (mean, 4.6; median, 4 transfusions per infant), with 81 percent of transfusions obtained from one donor per infant. Eighty-four blood samples (mean, 2.7/infant) were studied, and no infant produced RBC antibodies. Twenty-seven percent of infants exhibited WBC antibodies, but only 13 percent actually produced WBC antibodies (passive maternal antibody excluded). Of the WBC antibodies produced by infants, three were against HLA class I and one was against neutrophil-specific antigens; none were linked to adverse effects. CONCLUSIONS: Because infants only rarely produce RBC antibodies, no changes in blood banking practices are necessary for limited-donor-exposure programs. Although the production of WBC antibodies by infants occurs, it seems to be uncommon; thus, the possible benefits, if any, of WBC reduction are uncertain, and further study is required before changes in practice can be justified.

Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy

Biological and medical sciences

Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis

Medical sciences

Transfusions. Complications. Transfusion reactions. Cell and gene therapy

Details

Title: Subtitle: Alloimmunization in preterm infants after repeated transfusions of WBC-reduced RBCs from the same donor
Creators: Ronald G Strauss - University of Iowa
Karen Johnson - University of Iowa
Gretchen Cress - University of Iowa
Delores G Cordle - University of Iowa
Resource Type: Journal article
Publication Details: Transfusion (Philadelphia, Pa.), Vol.40(12), pp.1463-1468
Publisher: Blackwell Publishing
DOI: 10.1046/j.1537-2995.2000.40121463.x
PMID: 11134565
ISSN: 0041-1132
eISSN: 1537-2995
Language: English
Date published: 12/2000
Academic Unit: Stead Family Department of Pediatrics; Pathology; Gastroenterology, Hepatology, Pancreatology, and Nutrition
Record Identifier: 9984622044602771

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