Feasibility and safety of AS-3 red blood cells for neonatal transfusions.
OBJECTIVE
Most extremely low birth weight (<1 kg) infants receive red blood cell (RBC) transfusions. RBCs stored up to 42 days can be transfused safely in small volumes to preterm infants; however, because the formulation of RBC anticoagulant/preservative solutions differs, clinical studies are required to document the safety of each solution before widespread use. Our goal was to study the feasibility and safety of AS-3 anticoagulant/preservative solution to preterm infants.


METHODS
Two clinical studies were conducted in sequence: (1) a randomized trial to compare RBC transfusions given as stored (< or =42 days) AS-3 RBCs (11 infants) versus fresh (< or = 7 days) citrate, phosphate, dextrose, and adenine RBCs (10 infants) and (2) a subsequent evaluation of the safety of stored AS-3 RBCs in 33 additional preterm infants given 120 AS-3 RBC transfusions.


RESULTS
Results of both the randomized study and the subsequent evaluation documented that AS-3 RBCs stored < or =42 days and transfused in small volumes (15 mL/kg) were safe for RBC transfusions of preterm infants. Donor exposure was significantly reduced, clinical transfusion reactions 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 adenine RBC transfusions were compared.


CONCLUSIONS
AS-3 RBCs can be used safely for small-volume RBC transfusions for preterm infants.
Strauss
R G
RG
Departments of Pediatrics, Preventive Medicine and Environmental Health, and Pathology, The University of Iowa College of Medicine, Iowa City, IA 52242-1182, USA.
Burmeister
L F
LF
Johnson
K
K
Cress
G
G
Cordle
D
D
D000225:Adenine; D000751:Anemia, Neonatal / Q000628:therapy*; D001782:Blood Donors; D001793:Blood Preservation; D017707:Erythrocyte Transfusion; D005240:Feasibility Studies; D005947:Glucose; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008353:Mannitol; D012449:Safety; D016037:Single-Blind Method; D012965:Sodium Chloride; D013997:Time Factors
C037839:ADSOL; D008353:Mannitol; D012965:Sodium Chloride; D005947:Glucose; D000225:Adenine