Feasibility and safety of AS-3 red blood cells for neonatal transfusions

Objectives: nest extremely low birth weight (<1 kg) infants receive red blo od cell (RBC) transfusions. RBCs stored up to 42 days can be transfused saf ely in small volumes to preterm infants; however, because the formulation o f RBC anticoagulant/preservative solutions differs, clinical studies are re quired to document the safety of each solution before widespread use. Our: goal was to study the feasibility and safety of AS-3 anticoagulant/preserva tive solution to preterm infants. Study design: Two clinical studies were conducted in sequence: (1) a random ized trial to compare RBC transfusions given as stored (less than or equal to 42 days) AS-3 RBCs (11 infants) versus fresh (less than or equal to 7 da ys) citrate, phosphate, dextrose, and adenine RBCs (10 infants) and (2) a s ubsequent evaluation of the safety of stored AS-3 RBCs in 33 additional pre term infants given 120 AS-3 RBC transfusions. Results: Results of both the randomized study and the subsequent evaluation documented that AS-3 RBCs stored less than or equal to 42 days and transfu sed in small volumes (15 mL/kg) were safe for RBC transfusions of preterm i nfants. Donor exposure was significantly reduced, clinical transfusion reac tions were rare, and post-transfusion blood hematocrit, pH, and plasma Na, K, Ca, lactate, and glucose measurements were similar when AS-3 and citrate , phosphate, dextrose, and aden;ne RBC transfusions were compared. Conclusions: AS-3 RBCs can be used safely for small-volume RBC transfusions for preterm infants.