title: Iron homeostasis after blood transfusion in stable preterm infants - an observational study.
abstract: OBJECTIVE
  To evaluate the short-term effects of blood transfusion on iron status [hemoglobin, ferritin, soluble transferrin receptor (sTfR), and reticulocyte count], hepcidin, and erythropoietin in stable preterm infants.
  
  
  METHODS
  Sixty-three preterm infants treated with red blood cell transfusions (RBCTs) were included. Venous blood samples were collected before and within 24 h after each transfusion.
  
  
  RESULTS
  Hemoglobin concentration increased after RBCT (7.2±1.2 g/dL vs. 13.7±2.3 g/dL, P=0.02), as well as ferritin [131 (63-110.4) ng/mL vs. 211 (125.7-299.2) ng/mL, P=0.05); reticulocyte count decreased. sTfR did not change. Hepcidin serum levels increased from 37.5 (21.3-84.7) ng/mL to 72.6 (31.3-126.2) ng/mL, (P=0.04) and erythropoietin decreased (48±19 pg/mL vs. 29±17 pg/mL, P=0.06) after RBCT. A positive linear correlation was found (R2=0.76, P=0.0001) between hepcidin and ferritin levels of post-minus-pre RBCT. Hepcidin levels increased significantly in preterm infants who received RBCT after 1 month of age compared to those who received RBCT at <1 month (P=0.03). No correlation was found between gestational age, weight appropriate for age, or length of blood storage and hepcidin levels.
  
  
  CONCLUSIONS
  Preterm infants can control iron levels by regulating hepcidin and decreasing erythropoietin. This ability varies with postnatal age.
authors.forename: Jacky
authors.initials: J
authors.lastname: Herzlich
authors.forename: Ita
authors.initials: I
authors.lastname: Litmanovitz
authors.forename: Rivka
authors.initials: R
authors.lastname: Regev
authors.forename: Sofia
authors.initials: S
authors.lastname: Bauer
authors.forename: Gisela
authors.initials: G
authors.lastname: Sirota
authors.forename: Zvi
authors.initials: Z
authors.lastname: Steiner
authors.forename: Shmuel
authors.initials: S
authors.lastname: Arnon
mesh_terms: D000751:Anemia, Neonatal / Q000097:blood* / Q000628:therapy*; D017707:Erythrocyte Transfusion; D004921:Erythropoietin / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism; D064451:Hepcidins / Q000097:blood; D006706:Homeostasis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D007236:Infant, Small for Gestational Age; D007501:Iron / Q000097:blood*; D008297:Male; D011990:Receptors, Transferrin / Q000097:blood; D017701:Reticulocyte Count
chemical_list: C554270:EPO protein, human; D006454:Hemoglobins; D064451:Hepcidins; D011990:Receptors, Transferrin; D004921:Erythropoietin; D005293:Ferritins; D007501:Iron