Exchange transfusions and top-up transfusions in neonates with Kell haemolytic disease compared to Rh D haemolytic disease.
OBJECTIVE
To evaluate neonatal outcome in Kell haemolytic disease compared to Rh D haemolytic disease.


METHODS
Retrospective study of all (near)-term neonates with Kell (n=34) and Rh D haemolytic disease (n=157) admitted to our centre between January 2000 and December 2008. We recorded the need for exchange transfusion and top-up transfusions up to 3 months of age.


RESULTS
Neonates in the Kell group required less days of phototherapy than neonates in the Rh D group [2.4 vs. 4.1 days, respectively (P<0.01)]. The percentage of neonates requiring an exchange transfusion was lower in the Kell group than in the Rh D group [6% (2/34) and 62% (98/157), respectively (P<0.01)]. The percentage of neonates in the Kell group and Rh D group requiring a top-up transfusion was 62% (21/34) and 72% (113/157), respectively (P=0.20). The median number of top-up transfusions per neonate in the Kell group and Rh D group was 1 [interquartile range (IQR) 0-2] and 2(IQR 0-2), respectively (P=0.07).


CONCLUSIONS
Neonates with Kell haemolytic disease require less phototherapy and less exchange transfusions compared to neonates with Rh D haemolytic disease, but an equal number of top-up transfusions.
Rath
M E A
ME
Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, the Netherlands.
Smits-Wintjens
V E H J
VE
Lindenburg
I T M
IT
Brand
A
A
van Kamp
I L
IL
Oepkes
D
D
Walther
F J
FJ
Lopriore
E
E
D004899:Erythroblastosis, Fetal / Q000209:etiology / Q000628:therapy*; D005078:Exchange Transfusion, Whole Blood / Q000706:statistics & numerical data*; D006461:Hemolysis; D006801:Humans; D007231:Infant, Newborn; D007626:Kell Blood-Group System / Q000276:immunology*; D010789:Phototherapy / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012204:Rh-Hr Blood-Group System / Q000276:immunology*
D007626:Kell Blood-Group System; D012204:Rh-Hr Blood-Group System