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In premature infants there is no decrease in 24-hour posttransfusion allogeneic red blood cell recovery after 42 days of storage
Journal article   Open access   Peer reviewed

In premature infants there is no decrease in 24-hour posttransfusion allogeneic red blood cell recovery after 42 days of storage

Demet Nalbant, José A Cancelas, Donald M Mock, Svetlana V Kyosseva, Robert L Schmidt, Gretchen A Cress, M Bridget Zimmerman, Ronald G Strauss and John A Widness
Transfusion (Philadelphia, Pa.), Vol.58(2), pp.352-358
02/2018
DOI: 10.1111/trf.14396
PMCID: PMC5803343
PMID: 29193118
url
https://doi.org/10.1111/trf.14396View
Published (Version of record) Open Access

Abstract

Critically ill preterm very-low-birthweight (VLBW) neonates (birthweight ≤ 1.5 kg) frequently develop anemia that is treated with red blood cell (RBC) transfusions. Although RBCs transfused to adults demonstrate progressive decreases in posttransfusion 24-hour RBC recovery (PTR ) during storage-to a mean of approximately 85% of the Food and Drug Administration-allowed 42-day storage-limited data in infants indicate no decrease in PTR with storage. We hypothesized that PTR of allogeneic RBCs transfused to anemic VLBW newborns: 1) will be greater than PTR of autologous RBCs transfused into healthy adults and 2) will not decrease with increasing storage duration. RBCs were stored at 4°C for not more than 42 days in AS-3 or AS-5. PTR was determined in 46 VLBW neonates using biotin-labeled RBCs and in 76 healthy adults using Cr-labeled RBCs. Linear mixed-model analysis was used to estimate slopes and intercepts of PTR versus duration of RBC storage. For VLBW newborns, the estimated slope of PTR versus storage did not decrease with the duration of storage (p = 0.18) while for adults it did (p < 0.0001). These estimated slopes differed significantly in adults compared to newborns (p = 0.04). At the allowed 42-day storage limit, projected mean neonatal PTR was 95.9%; for adults, it was 83.8% (p = 0.0002). These data provide evidence that storage duration of allogeneic RBCs intended for neonates can be increased without affecting PTR . This conclusion supports the practice of transfusing RBCs stored up to 42 days for small-volume neonatal transfusions to limit donor exposure.

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