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- Title
Red blood cell alloimmunization in neonates and children up to 3 years of age.
- Authors
Türkmen, Tugce; Qiu, Dan; Cooper, Nina; Sachs, Ulrich J.; Wößmann, Wilhelm; Schranz, Dietmar; Zimmer, Klaus‐Peter; Ehrhardt, Harald; Hackstein, Holger; Bein, Gregor
- Abstract
<bold>Background: </bold>An alloimmune response to red blood cell (RBC) transfusion in neonates is a rare event. Several guidelines recommend limited pretransfusion testing in neonates. The evidence for these recommendations is based on small studies with sample sizes of between 30 and 90 infants.<bold>Study Design and Methods: </bold>We conducted a retrospective cohort study among consecutive patients who received transfusions at a single university medical center. All non-alloimmunized patients who had received their first RBC transfusion between 1994 and 2013 and who underwent at least one antibody screening follow-up visit between 7 and 365 days after transfusion were included.<bold>Results: </bold>The incidence of alloimmunization in the control group of 17,084 adult patients age 45 years or older who had received a median of 5 RBC units (interquartile range, 2-12 RBC units) was 3.55% (n = 607 alloimmunized patients). After transfusion of 40 RBC units, the cumulative incidence of alloimmunization in adult controls was 10.24% (95% confidence interval, 7.71%-13.17%). In total, 1641 neonates and children up to age 3 years received a median of 4 RBC units (interquartile range, 2-7 RBC units) in a median of two RBC transfusion episodes (interquartile range, one to five RBC transfusion episodes). Two children developed anti-M and anti-E antibodies post-transfusion at the ages of 181 and 611 days, respectively.<bold>Conclusion: </bold>To our knowledge, this study presents the largest longitudinal cohort study of RBC alloimmunization in neonates. Antibodies against RBC antigens were not detected within the first 6 months of life. Repeat antibody screening and cross-matching during the first months of life can be safely omitted.
- Subjects
RED blood cell transfusion; BLOOD transfusion reaction; NEWBORN infant immunology; ANTI-antibodies; IMMUNOGLOBULIN M; IMMUNOGLOBULIN E; ERYTHROCYTES; AGE distribution; BLOOD groups; IMMUNOGLOBULINS; LONGITUDINAL method; MEDICAL protocols; RETROSPECTIVE studies; BLOOD group incompatibility
- Publication
Transfusion, 2017, Vol 57, Issue 11, p2720
- ISSN
0041-1132
- Publication type
journal article
- DOI
10.1111/trf.14273