Autologous Infant and Allogeneic Adult Red Cells Demonstrate Similar Concurrent Post-Transfusion Survival in Very Low Birth Weight Neonates.

Autor: Widness JA; Department of Pediatrics, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA. Electronic address: john-widness@uiowa.edu., Kuruvilla DJ; Department of Pharmaceutical Sciences and Experimental Therapeutics, University of Iowa College of Pharmacy, Iowa City, IA., Mock DM; Department of Biochemistry and Molecular Biology and the Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR., Matthews NI; Department of Biochemistry and Molecular Biology and the Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR., Nalbant D; Department of Pediatrics, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA., Cress GA; Department of Pediatrics, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA., Schmidt RL; Department of Pediatrics, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA., Strauss RG; Department of Pediatrics, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA; Department of Pathology, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA., Zimmerman MB; Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA., Veng-Pedersen P; Department of Pharmaceutical Sciences and Experimental Therapeutics, University of Iowa College of Pharmacy, Iowa City, IA.
Jazyk: angličtina
Zdroj: The Journal of pediatrics [J Pediatr] 2015 Nov; Vol. 167 (5), pp. 1001-6. Date of Electronic Publication: 2015 Sep 09.
DOI: 10.1016/j.jpeds.2015.08.028
Abstrakt: Objective: Based on the hypothesis that neonatal autologous red blood cell (RBC) survival (RCS) is substantially shorter than adult RBC, we concurrently tracked the survival of transfused biotin-labeled autologous neonatal and allogeneic adult RBC into ventilated, very low birth weight infants.
Study Design: RBC aliquots from the first clinically ordered, allogeneic adult RBC transfusion and from autologous infant blood were labeled at separate biotin densities (biotin-labeled RBC [BioRBC]) and transfused. Survival of these BioRBCs populations were concurrently followed over weeks by flow cytometric enumeration using leftover blood. Relative tracking of infant autologous and adult allogeneic BioRBC was analyzed by linear mixed modeling of batched weekly data. When possible, Kidd antigen (Jka and Jkb) mismatches between infant and donor RBCs were also used to track these 2 populations.
Results: Contrary to our hypothesis, concurrent tracking curves of RCS of neonatal and adult BioRBC in 15 study infants did not differ until week 7, after which neonatal RCS became shortened to 59%-79% of adult enumeration values for uncertain reasons. Analysis of mismatched Kidd antigen RBC showed similar results, thus, confirming that BioRBC tracking is not perturbed by biotin RBC labeling.
Conclusions: This study illustrates the utility of multidensity BioRBC labeling for concurrent measurement of RCS of multiple RBC populations in vivo. The similar RCS results observed for neonatal and adult BioRBCs transfused into very low birth weight infants provides strong evidence that the circulatory environment of the newborn infant, not intrinsic infant-adult RBC differences, is the primary determinant of erythrocyte survival.
Trial Registration: Clinicaltrials.gov: NCT00731588.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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