PROSPECTIVE, RANDOMIZED TRIAL OF THE SAFETY AND EFFICACY OF A LIMITEDDONOR EXPOSURE TRANSFUSION PROGRAM FOR PREMATURE NEONATES

We investigated the safety and efficacy of using a single unit of pack ed red blood cells until its expiration date (35 days) to meet the tra nsfusion needs of infants weighing <1.5 kg. Unit concentration of pota ssium and infants' hematocrit value, K+ level, pH, and base excess wer e measured before and after transfusion. Compared with control infants , study infants had similar transfusion needs, but received blood from significantly fewer donors. The age of the blood received by study in fants was significantly older and had a higher plasma K+ level. Howeve r, the change in infants' serum K+ levels before and after a transfusi on was not significantly different in the two groups, and no adverse e ffects from transfusion of older blood were observed. We conclude that a protocol that allows use of an assigned unit of packed red blood ce lls preserved with citrate-phosphate-dextrose-adenine anticoagulant un til its expiration date is safe, minimizes donor exposures, and meets the transfusion needs of low birth weight neonates.