title: Red blood cell transfusions in children awaiting heart transplantation.
abstract: In children awaiting heart transplantation, the benefits of RBC transfusion must be weighed against the potential risks of allosensitization. We sought to describe the use of RBC transfusion and erythropoietin in children with heart failure, as well as assess the impact of these measures on allosensitization. Hospitalized patients listed for heart transplantation between 1/03 and 12/10 were included in the analysis. We excluded patients supported by mechanical support or those highly sensitized prior to listing. Sixty-seven subjects (median age of 6.2 yr) met inclusion criteria. The mean waitlist time was 19.5 days. The majority of subjects, 50 (75%), received at least one RBC transfusion while listed. For those who were transfused, the median number of RBC transfusion events was 3, range: 1-8. Erythropoietin was given to 37 (55%) of subjects. Erythropoietin administration was not associated with subsequent need for transfusion (p = 0.61). Of the 50 subjects who received RBC transfusion, none developed significant elevation of serum PRA by the time of transplant. RBC transfusion may be commonly undertaken in hospitalized children awaiting transplantation. The likelihood of allosensitization following leukoreduced RBC transfusion is extremely low. The benefits of routine erythropoietin administration to reduce the need for transfusion remain to be determined.
authors: Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA 30322-1062, USA. wmahle@emory.edu
authors: William T
authors: WT
authors: Mahle
authors: Alexandria M
authors: AM
authors: Berg
authors: Kirk R
authors: KR
authors: Kanter
mesh_terms: D000293:Adolescent; D000740:Anemia / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D017707:Erythrocyte Transfusion / Q000379:methods*; D004912:Erythrocytes / Q000166:cytology*; D004921:Erythropoietin / Q000627:therapeutic use; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D007223:Infant; D015233:Models, Statistical; D012044:Regression Analysis; D012306:Risk; D013997:Time Factors; D014184:Transplantation, Homologous; D014850:Waiting Lists
chemical_list: D004921:Erythropoietin