Changes in Premature Infant Mercury and Lead Blood Levels after Blood Transfusions

Abstract

After receiving blood transfusions, the blood levels of mercury and lead were maintained at the end of the 1st week of life. As there is no evidence of a proportionate increase in excretory amounts of these heavy metals, there is a concern that they are retained and potentially exert toxic effects.

Alterations in Serum Lead Levels Following Packed Red Blood Cells Transfusions to Preterms Admitted to Neonatal Intensive Care Unit at Cairo University Pediatric Hospital

“…This means that PRBCs had a significant load of lead. All transfusions using these packs delivered a lead amount that exceeded the reference dose (6). Another study also exhibited a direct linear relationship between any lead exposure from the PRBCs transfusion aliquot with the subsequent post-transfusion BLL in the transfused neonate (1).…”

“…This can be justified by: First, the progressive improvement in glomerular filtration rate (GFR). Kidney function of low birth weight (LBW) infants in the 1st week of life is associated with increased lead reabsorption (6). Also, preterm neonates metabolize lead differently and the majority of lead is not excreted in the urine at the same rates as in older children (13).…”

“…A large proportion of PRBCs transfusions are given during the early weeks of life, a time when the excretory ability through urine and stool is most limited. Many adverse effects have been associated with receiving PRBCs transfusions such as necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD) (6,7). In addition, pre-existing neonatal critical illnesses and the difficulties in defining adverse transfusion events in neonatal inten-Copyright © 2019, Author(s).…”

Parenteral Nutrition as an Unexpected and Preventable Source of Mercury Exposure in Preterm Infants

“…Preterm infants have increased vulnerability to neurotoxic agents due to an immature blood-brain barrier and ongoing developmental processes. Non-occupational exposure to Hg is primarily dietary in nature via bioaccumulation of MeHg in the aquatic food chain, but iatrogenic exposures in the form of dental amalgam 1-2 , thimerosal-containing vaccines 6 and blood transfusions 7-8 have been reported. We investigated Hg exposures of preterm infants in the Neonatal Intensive Care Unit (NICU) of a tertiary care institution.…”