title: Association between red cell transfusions and necrotizing enterocolitis.
abstract: OBJECTIVE
  Several case reports and retrospective studies have reported a temporal association between red blood cell (RBC) transfusions and necrotizing enterocolitis (NEC). In this article, we review the clinical evidence and biological plausibility of the association between RBC transfusions and NEC.
  
  
  METHODS
  A literature search was performed using the databases PubMed, EMBASE, and Scopus, and the electronic archive of abstracts presented at the annual meetings of the Pediatric Academic Societies.
  
  
  RESULTS
  Among all cases of NEC, 25 -40% patients were noted to have received an RBC transfusion within a 48 hour period prior to onset of NEC. Compared to infants who developed NEC unrelated to transfusion, neonates with transfusion-associated NEC were born at an earlier gestation, had lower birth weights, and had a delayed onset at 3-5 weeks of postnatal age.
  
  
  CONCLUSIONS
  Based on current clinical evidence, transfusion-associated NEC appears to be a plausible clinical entity. However, there is a need for cautious interpretation of data because all the studies that have been conducted until date are retrospective, and therefore, susceptible to bias. A large, prospective, multi-center trial is needed to evaluate the association between RBC transfusion and NEC.
authors.affiliation: Department of Pediatrics, Division of Neonatology, University of Illinois at Chicago, Chicago, IL 60612, USA.
authors.forename: Sachin C
authors.initials: SC
authors.lastname: Amin
authors.forename: Juan I
authors.initials: JI
authors.lastname: Remon
authors.forename: Girish C
authors.initials: GC
authors.lastname: Subbarao
authors.forename: Akhil
authors.initials: A
authors.lastname: Maheshwari
mesh_terms: D000740:Anemia / Q000628:therapy; D001793:Blood Preservation / Q000009:adverse effects; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology* / Q000209:etiology*; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D011379:Prognosis