AS-1 RED-CELLS FOR NEONATAL TRANSFUSIONS - A RANDOMIZED TRIAL ASSESSING DONOR EXPOSURE AND SAFETY

Background: Despite recent optimism about the use of erythropoietin th erapy to treat the anemia of prematurity. Very-low-birth-weight infant s who are severely ill receive multiple red cell (RBC) transfusions. M any physicians transfuse relatively fresh RBCs to newborn infants, exp osing them to multiple donors and possibly increasing their risk of ac quiring transfusion-transmitted infections. Study Design and Methods: A randomized, single-blind clinical trial was conducted to determine, as the primary endpoint, whether RBCs collected from one dedicated don or and stored for less than or equal to 42 days in AS-1 storage media could safely supply all small-volume RBC transfusions (15 mL/kg/dose) needed by very-low-birth-weight infants (0.6-1.3 kg) during the first 84 days of life. Secondary endpoints were the assessment of the possib le adverse clinical and biochemical effects of transfusing AS-1 RBCs s tored for less than or equal to 42 days. Control infants received iden tical nursery care, except they received fresh RBCs stored less than o r equal to 7 days in CPDA-1. Results: Infants transfused with AS-1 RBC s were exposed to a mean of 1.6 donors, compared with an exposure to 3 .7 donors for infants given CPDA-1 RBCs (p<0.05). Neither clinical tra nsfusion reactions nor the results of multiple laboratory tests were s ignificantly different in infants who received slow transfusions (15 m il kg) of AS-1 RBCs stored for less than or equal to 42 days and in in fants who received the same volume of CPDA-1 RBCs stored less than or equal to 7 days. Conclusion: AS-1 RBCs, usually from only one dedicate d donor, can safely supply all RBCs needed by most very-low-birth-weig ht infants--a practice that decreases donor exposure and likely increa ses transfusion safety.