Feasibility and safety of AS-3 red blood cells for neonatal transfusions

Posttransfusion 24‐hour recovery and subsequent survival of allogeneic red blood cells in the bloodstream of newborn infants

“…These results, using biotinylated RBCs to directly measure posttransfusion RBC circulating kinetics in the bloodstream of infants, support the clinical and laboratory observations of earlier reports that stored RBCs are safe and efficacious for neonatal small-volume RBC transfusions. 7,11,12 Our results of PTR 24 document the satisfactory quality of RBCs stored up to 42 days, which, by FDA requirements for approval, must exhibit 75-percent recovery at 42 days of storage. 15,16 Our value of approximately 97 percent agrees with our earlier studies of normal adults 9 and with the value of 97 percent reported for baboons using fresh biotinylated RBCs.…”

“…11 A similar increase in Hct occurred after the transfusion of stored RBCs obtained from biologic parents, 11.6 ± 4.6 percent (paternal) and 11.8 ± 3.9 percent (maternal). 10,11 Nearly identical increases in Hct (12 ± 5% versus 12 ± 4%) were found comparing transfusions of RBCs stored 0 to 21 days versus RBCs stored 22 to 42 days in AS-3 preservative solution. 7 Thus, extensive data support the overall clinical efficacy of stored RBCs and refute the need to use fresh RBCs when small-volume transfusions are given to infants.…”

“…As reported earlier, 10 posttransfusion increases in blood Hct, changes in blood chemistry results, and clinical safety were comparable with RBC units obtained from parents versus units from unrelated donors, and, importantly, results were similar to other studies comparing transfusions of fresh versus stored RBCs collected from standard blood center donors. 7,11,12 For example, the posttransfusion increase in blood Hct (mean ± SD) after a transfusion of 15 mL per kg of fresh RBCs (stored ≤7 days after collection) from unrelated donors was 11.9 ± 5.1 percent versus an increase in Hct of 11.7 ± 4.4 percent from RBCs stored up to 42 days. 11 A similar increase in Hct occurred after the transfusion of stored RBCs obtained from biologic parents, 11.6 ± 4.6 percent (paternal) and 11.8 ± 3.9 percent (maternal).…”

“…7,11,12 For example, the posttransfusion increase in blood Hct (mean ± SD) after a transfusion of 15 mL per kg of fresh RBCs (stored ≤7 days after collection) from unrelated donors was 11.9 ± 5.1 percent versus an increase in Hct of 11.7 ± 4.4 percent from RBCs stored up to 42 days. 11 A similar increase in Hct occurred after the transfusion of stored RBCs obtained from biologic parents, 11.6 ± 4.6 percent (paternal) and 11.8 ± 3.9 percent (maternal). 10,11 Nearly identical increases in Hct (12 ± 5% versus 12 ± 4%) were found comparing transfusions of RBCs stored 0 to 21 days versus RBCs stored 22 to 42 days in AS-3 preservative solution.…”

Effect of Beginning Recombinant Erythropoietin Treatment Within the First Week of Life, Among Very-Low-Birth-Weight Neonates, on “Early” and “Late” Erythrocyte Transfusions: A Meta-Analysis

“…29,30 Thus, perhaps reducing transfusions from one to zero is a much more significant goal than is reducing transfusions from two or more to one. 31 In the present analysis, the number of blood donors to whom neonates were exposed could not be determined, and the entire focus was on the question of whether beginning rEpo treatment in the first week of life would decrease the portion that received any transfusion.…”