SINGLE BLOOD-DONOR EXPOSURE PROGRAM FOR PRETERM INFANTS - A LARGE OPEN STUDY AND AN ANALYSIS OF THE RISK-FACTORS TO MULTIPLE DONOR EXPOSURE

As the need for blood transfusions of very preterm infants remains con siderable, various strategies are considered to minimize exposure to m ultiple blood donors along with blood wastage. In a large population o f very preterm infants born between 24 and 31 weeks' gestation, we und ertook an open study to assess the efficacy of a single blood donor ex posure programme and to determine, among the population enrolled in th is programme, the risk factors for exposure to multiple donors. One hu ndred and forty-two neonates were included in a single donor exposure programme with a 35-day expiry date blood unit. Though no inflation in the total number of transfusions was noticed, there was a 55% overall reduction in the total number of required donors. To determine the ri sk factors for exposure to multiple donors in this population, 114 neo nates alive after the expiry date of the first unit of packed red bloo d cells were selected. The greatest and the most extending transfusion requirements were observed in very preterm infants born before 28 wee ks' gestation and in those born after but with an intra-uterine growth retardation below the 10th percentile. Indeed, 70% of those high-risk infants were exposed to a second blood donor and more than 85% of the group exposed to a second donor belonged to this high-risk population . Conclusion Neonates with a very high risk of a more-than-one donor e xposure were born before 28 weeks' gestation or between 28 and 31 week s but with an intra-uterine retardation below the 10th percentile.