AS-1 red cells for neonatal transfusions: a randomized trial assessing donor exposure and safety.
BACKGROUND
Despite recent optimism about the use of erythropoietin therapy to treat the anemia of prematurity, very-low-birth-weight infants who are severely ill receive multiple red cell (RBC) transfusions. Many physicians transfuse relatively fresh RBCs to newborn infants, exposing them to multiple donors and possibly increasing their risk of acquiring transfusion-transmitted infections.


METHODS
A randomized, single-blind clinical trial was conducted to determine, as the primary endpoint, whether RBCs collected from one dedicated donor and stored for < or = 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 possible adverse clinical and biochemical effects of transfusing AS-1 RBCs stored for < or = 42 days. Control infants received identical nursery care, except they received fresh RBCs stored < or = 7 days in CPDA-1.


RESULTS
Infants transfused with AS-1 RBCs 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 transfusion reactions nor the results of multiple laboratory tests were significantly different in infants who received slow transfusions (15 mL/kg) of AS-1 RBCs stored for < or = 42 days and in infants who received the same volume of CPDA-1 RBCs stored < or = 7 days.


CONCLUSIONS
AS-1 RBCs, usually from only one dedicated donor, can safely supply all RBCs needed by most very-low-birth-weight infants-a practice that decreases donor exposure and likely increases transfusion safety.
Strauss
R G
RG
Department of Pediatrics, University of Iowa College of Medicine, Iowa City, USA.
Burmeister
L F
LF
Johnson
K
K
James
T
T
Miller
J
J
Cordle
D G
DG
Bell
E F
EF
Ludwig
G A
GA
D000225:Adenine; D000751:Anemia, Neonatal / Q000628:therapy*; D001782:Blood Donors; D001793:Blood Preservation / Q000592:standards*; D017707:Erythrocyte Transfusion / Q000592:standards*; D005260:Female; D005947:Glucose; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D008353:Mannitol; D012965:Sodium Chloride
C037839:ADSOL; D008353:Mannitol; D012965:Sodium Chloride; D005947:Glucose; D000225:Adenine