title: The relationship of red blood cell transfusion to intestinal mucosal injury in premature infants.
abstract: OBJECTIVE
  To determine the incidence of intestinal mucosal injury before and after transfusions in premature infants.
  
  
  METHODS
  Urine was collected throughout the hospital stay of 62 premature infants and specimens obtained within 24h before and after transfusion were assayed for intestinal fatty acid binding protein (iFABP). A urinary iFABP:creatinine ratio (iFABPu:Cru) of 2.0pg/nmol was considered elevated.
  
  
  RESULTS
  Forty-nine infants were transfused. iFABPu:Cru was elevated following 71 (75.6%) of 94 transfusions for which urine was available. In 51 (71.8%) of these, iFABPu:Cru was also elevated prior to the transfusion. Among four cases of transfusion-associated NEC, iFABPuwas elevated following every sentinel transfusion and prior to three of them.
  
  
  CONCLUSIONS
  Subclinical intestinal mucosal injury is frequent following blood transfusions in premature infants and, when present, usually precedes transfusion. This suggests that transfusion may not be a primary mediator of intestinal injury so much as anemia and its associated conditions.
  
  
  METHODS
  Prognosis study/level 3.
authors.affiliation: Department of Surgery, Loma Linda University School of Medicine, Loma Linda, CA, USA.
authors.forename: Nhan
authors.initials: N
authors.lastname: Hyung
authors.affiliation: Department of Surgery, Loma Linda University School of Medicine, Loma Linda, CA, USA.
authors.forename: Insiyah
authors.initials: I
authors.lastname: Campwala
authors.affiliation: Division of Biochemistry, Loma Linda University School of Medicine, Loma Linda, CA, USA.
authors.forename: Danilo S
authors.initials: DS
authors.lastname: Boskovic
authors.affiliation: Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA.
authors.forename: Laurel
authors.initials: L
authors.lastname: Slater
authors.affiliation: Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA.
authors.forename: Yayesh
authors.initials: Y
authors.lastname: Asmerom
authors.affiliation: Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA.
authors.forename: Megan S
authors.initials: MS
authors.lastname: Holden
authors.affiliation: Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA.
authors.forename: Danilyn M
authors.initials: DM
authors.lastname: Angeles
authors.affiliation: Department of Surgery, Rady Children's Hospital, San Diego, CA, USA. Electronic address: ggollin@rchsd.org.
authors.forename: Gerald
authors.initials: G
authors.lastname: Gollin
mesh_terms: D020345:Enterocolitis, Necrotizing / Q000209:etiology / Q000652:urine; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D050556:Fatty Acid-Binding Proteins / Q000652:urine*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D007234:Infant, Premature / Q000652:urine*; D007235:Infant, Premature, Diseases / Q000652:urine; D017713:Platelet Transfusion / Q000009:adverse effects*
chemical_list: D050556:Fatty Acid-Binding Proteins
keywords: Biomarkers; Necrotizing enterocolitis; Prematurity; Transfusion; iFABP