Survey of intrauterine red blood cell (RBC) transfusion practices in the United States.

Autor: Bakhtary S; Department of Laboratory Medicine, UCSF, San Francisco, California, USA., Panchalee T; Department of Obstetrics and Gynecology, UCSF, San Francisco, California, USA., Crowe EP; Division of Transfusion Medicine and Pediatric Hematology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Schwab ME; Department of Surgery, UCSF, San Francisco, California, USA., Zakieh A; Division of Transfusion Medicine and Pediatric Hematology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Josephson CD; Department of Oncology and Cancer and Blood Disorders Institute, Johns Hopkins Univ SOM, Baltimore MD and Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA., Sobhani NC; Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, California, USA., Gonzalez-Velez JM; Department of Obstetrics, Gynecology & Reproductive Sciences, UCSF, San Francisco, California, USA., Goel R; Division of Transfusion Medicine and Pediatric Hematology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Jazyk: angličtina
Zdroj: Transfusion [Transfusion] 2022 Dec; Vol. 62 (12), pp. 2449-2453. Date of Electronic Publication: 2022 Oct 04.
DOI: 10.1111/trf.17134
Abstrakt: Background: A paucity of data exists about the current practice of fetal red blood cell (RBC) transfusion in the United States (US). This investigation describes intrauterine transfusion (IUT) RBC product selection and processing practices at different US institutions.
Methods: A transfusion medicine and maternal-fetal medicine (MFM) team designed a survey to interrogate and characterize RBCs utilized for IUT. This survey was distributed to seventy US institutions with fetal treatment centers (October 2020-April 2021) identified through the NAFTNet (North American Fetal Therapy Network).
Results: Thirty-seven institutions responded (response rate 53%, 37/70), but five were excluded for not performing IUTs. Most (84%; 27/32) performed 1-24 IUTs annually; two performed >50 IUTs/year. Group O, Rh(D) negative RBC units were always used by 66% (21/32), and 75% (24/32) provided hemoconcentrated RBCs by washing (17/24) or dry packing (6/24). Overall, 66% (21/32) targeted a hematocrit ≥75%. Fifty percent provided both leukocyte-reduced and CMV-negative RBC units. Irradiation of RBC units was performed within 6 h of issue at 63% (20/32) of sites. Most (81%, 26/32) used RBC units at <7 days of age after collection, 56% (18/32) always provided washed RBC units, while 19% (6/32) issued washed RBC only if fresh units are unavailable. Implicated maternal RBC alloantibodies were matched for 78% (25/32) of the time. The transfused volume was universally determined by the MFMs.
Discussion: Heterogeneity and lack of standardization exist in RBC product selection and special processing steps for IUTs in the US. Hence, the establishment of a consensus to standardize IUT protocols is needed.
(© 2022 AABB.)
Databáze: MEDLINE
Externí odkaz: