title: Red blood cell transfusions increase fecal calprotectin levels in premature infants.
abstract: OBJECTIVE
  We hypothesized that red blood cell (RBC) transfusions influence intestinal inflammation in very low birth weight (VLBW) infants. We also suspected that hematocrit (Hct) at transfusions and RBC storage time correlate with intestinal inflammation.
  
  
  METHODS
  VLBW infants, without major congenital defects, intestinal perforation or necrotizing enterocolitis, were enrolled prospectively. Fecal calprotectin (FC) levels were measured from stool samples collected before and after RBC transfusions. Data on Hct and RBC storage time were collected.
  
  
  RESULTS
  Data from 42 RBC transfusions given to 26 infants revealed that FC levels increased faster than baseline after RBC transfusions (P=0.018) and were higher in multiple-transfused infants (0 to 48 and >48 h post transfusion, P=0.007 and P=0.005, respectively). Lower Hct and RBC storage >21 days correlated with higher FC levels (P=0.044 and P=0.013, respectively).
  
  
  CONCLUSIONS
  RBC transfusions, anemia and prolonged RBC storage were associated with an increase in intestinal inflammation.
authors.affiliation: Department of Pediatrics, University of South Florida, Tampa, FL, USA.
authors.forename: T T B
authors.initials: TT
authors.lastname: Ho
authors.affiliation: College of Nursing, University of South Florida, Tampa, FL, USA.
authors.forename: M W
authors.initials: MW
authors.lastname: Groer
authors.affiliation: Department of Pediatrics, University of South Florida, Tampa, FL, USA.
authors.forename: A A
authors.initials: AA
authors.lastname: Luciano
authors.affiliation: Department of Pediatrics, University of Illinois, Chicago, IL, USA.
authors.forename: A
authors.initials: A
authors.lastname: Schwartz
authors.affiliation: College of Nursing, University of South Florida, Tampa, FL, USA.
authors.forename: M
authors.initials: M
authors.lastname: Ji
authors.affiliation: Department of Internal Medicine, University of South Florida, Tampa, FL, USA.
authors.forename: B S
authors.initials: BS
authors.lastname: Miladinovic
authors.affiliation: Department of Pediatrics and Molecular Medicine, University of South Florida, Tampa, FL, USA.
authors.forename: A
authors.identifier: http://orcid.org/0000-0003-1502-7663
authors.initials: A
authors.lastname: Maheshwari
authors.affiliation: Department of Pediatrics, University of South Florida, Tampa, FL, USA.
authors.forename: T L
authors.initials: TL
authors.lastname: Ashmeade
mesh_terms: D000751:Anemia, Neonatal / Q000628:therapy*; D015415:Biomarkers / Q000032:analysis; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005243:Feces / Q000737:chemistry*; D005260:Female; D006400:Hematocrit; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis
chemical_list: D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex