Kerry Quinn1, Maureen Quinn1, Christina Moreno1, Esther Soundar2, Jun Teruya1,2, Shiu-Ki Hui1,2. 1. Division of Transfusion Medicine and Coagulation, Texas Children's Hospital, Houston, United States of America. 2. Department of Pathology and Immunology, Baylor College of Medicine, Houston, United States of America.
Abstract
BACKGROUND: Data on age of blood and its impact on donor exposure and inventory in the paediatric setting are lacking. The standard of practice of reserving a specific red blood cell (RBC) unit for neonates who may require repeat transfusions is unique to the paediatric setting. Requiring transfusion of fresher RBC units may increase the exposure of neonates to multiple units and negatively affect the supply of fresh RBC. We constructed a transfusion model based on a 6 months of retrospective neonatal transfusion data at our institution. MATERIALS AND METHODS: All neonates (≤4 months old) at Texas Children's Hospital who received a RBC transfusion from June to November 2011 were included and RBC transfusion data were compiled. The age of blood at the time of each RBC transfusion was recorded. These data were reviewed to calculate exposure and inventory impact if each transfusion had been restricted to RBC either ≤7 or ≤14 days old at transfusion. RESULTS: A total of 216 neonates received 938 RBC transfusions. Of these, 393 (42%) were fresh RBC (≤14 days old), even without a required age guideline. Requiring fresh (≤14 days) RBC for all transfusions in this period would have resulted in 70 additional fresh units and one or more additional exposures in 44 patients. Requiring fresher (≤7 days old) RBC would have resulted in an additional 147 units and. one or more additional exposures in 54 patients. DISCUSSION: The more conservative model of fresh (≤7 days old) RBC would greatly increase fresh RBC inventory requirements, and 25% of transfused neonates would require additional RBC exposure. Based on retrospective data and the two transfusion models, it can be concluded that requiring RBC ≤14 days old for neonatal transfusion would best balance the use of fresher RBC with the smallest increase in patient exposure (20%) and minimum impact on the RBC inventory.
BACKGROUND: Data on age of blood and its impact on donor exposure and inventory in the paediatric setting are lacking. The standard of practice of reserving a specific red blood cell (RBC) unit for neonates who may require repeat transfusions is unique to the paediatric setting. Requiring transfusion of fresher RBC units may increase the exposure of neonates to multiple units and negatively affect the supply of fresh RBC. We constructed a transfusion model based on a 6 months of retrospective neonatal transfusion data at our institution. MATERIALS AND METHODS: All neonates (≤4 months old) at Texas Children's Hospital who received a RBC transfusion from June to November 2011 were included and RBC transfusion data were compiled. The age of blood at the time of each RBC transfusion was recorded. These data were reviewed to calculate exposure and inventory impact if each transfusion had been restricted to RBC either ≤7 or ≤14 days old at transfusion. RESULTS: A total of 216 neonates received 938 RBC transfusions. Of these, 393 (42%) were fresh RBC (≤14 days old), even without a required age guideline. Requiring fresh (≤14 days) RBC for all transfusions in this period would have resulted in 70 additional fresh units and one or more additional exposures in 44 patients. Requiring fresher (≤7 days old) RBC would have resulted in an additional 147 units and. one or more additional exposures in 54 patients. DISCUSSION: The more conservative model of fresh (≤7 days old) RBC would greatly increase fresh RBC inventory requirements, and 25% of transfused neonates would require additional RBC exposure. Based on retrospective data and the two transfusion models, it can be concluded that requiring RBC ≤14 days old for neonatal transfusion would best balance the use of fresher RBC with the smallest increase in patient exposure (20%) and minimum impact on the RBC inventory.
Authors: Eldad A Hod; Ning Zhang; Set A Sokol; Boguslaw S Wojczyk; Richard O Francis; Daniel Ansaldi; Kevin P Francis; Phyllis Della-Latta; Susan Whittier; Sujit Sheth; Jeanne E Hendrickson; James C Zimring; Gary M Brittenham; Steven L Spitalnik Journal: Blood Date: 2010-03-18 Impact factor: 22.113
Authors: Ursula Guillén; James J Cummings; Edward F Bell; Shigerharu Hosono; Axel R Frantz; Rolf F Maier; Robin K Whyte; Elaine Boyle; Max Vento; John A Widness; Haresh Kirpalani Journal: Semin Perinatol Date: 2012-08 Impact factor: 3.300
Authors: Angela C Lee; Leila L Reduque; Naomi L C Luban; Paul M Ness; Blair Anton; Eugenie S Heitmiller Journal: Transfusion Date: 2013-04-15 Impact factor: 3.157
Authors: Dean A Fergusson; Paul Hébert; Debora L Hogan; Louise LeBel; Nicole Rouvinez-Bouali; John A Smyth; Koravangattu Sankaran; Alan Tinmouth; Morris A Blajchman; Lajos Kovacs; Christian Lachance; Shoo Lee; C Robin Walker; Brian Hutton; Robin Ducharme; Katelyn Balchin; Tim Ramsay; Jason C Ford; Ashok Kakadekar; Kuppuchipalayam Ramesh; Stan Shapiro Journal: JAMA Date: 2012-10-10 Impact factor: 56.272
Authors: A Wood; N Wilson; P Skacel; R Thomas; E Tidmarsh; C Yale; M de Silva Journal: Arch Dis Child Fetal Neonatal Ed Date: 1995-01 Impact factor: 5.747