BLOOD-TRANSFUSION AND CHRONIC LUNG-DISEASE IN PRETERM INFANTS

Frequent blood transfusions may produce changes in iron status which c an give rise to oxygen-derived free-radical (ODFR) generation and oxid ative injury. Preterm infants developing chronic lung disease (CLD) re ceive significantly more transfusions. A total of 73 very preterm infa nts had weekly estimations of serum iron, transferrin, transferrin sat uration, ferritin, caeruloplasmin, bleomycin detectable ('free') iron (BDI), and thiobarbituric acid reacting substances (TEARS) made over t he first 28 days. Thirty infants remained oxygen dependent at 36 weeks postmenstrual age and were termed as having CLD. They were significan tly lighter and less mature at birth and received more than twice as m any transfusions during the Ist month. They had significantly lower tr ansferrin levels initially but similar total iron and transferrin satu rations as non-CLD infants. Ferritin and caeruloplasmin levels rose to significantly higher levels over the Ist month in CLD infants, and fe rritin levels were significantly related to the number of transfusions given. Infants with higher ferritin levels were more likely to show B DI, although this was not associated with increased lipid peroxidation as evidenced by higher TEARS. Conclusion It is unlikely that oxidativ e injury from ODFRs induced by blood transfusion contributes to the ri sk of developing CLD in preterm infants.