Neonatal transfusions/RBC unit age

[dcharland]

Presently we assign an infant a unit of RBCs, sterile dock with chatermed syringes and take aliquots off the unit until its used up. Is there anyone out there that has a cutoff date for using these units? 2 weeks, 10 days inorder to give these infants fresher units? I am not advocating fresh <7 days old for all infants but isn't it better to give these premie's blood that isn't at the end of it's life? We have had a couple of premie's recently that had problems with potasiums going up after transfusion and one baby the bili shot up after transfusion.

[shelleyk482]

Our blood bank supports a children's hospital with a large NICU (> 70 beds). For maintenancy transfusions, our policy is to assign a unit < 7days old to a neonate for the first transfusion and then use aliquots from that unit until the unit expires or is used up ("limited donor" units). For large volume transfusions such as for OR, we routinely use RBC's < 7 days old (if "fresh" units are not available, the physician is contacted and given the option to use washed units).

If the neonatologist is concerned about restricting the potassium for the maintenance transfusions, they always have the option to ask us to discontinue using the "limited donor" protocol but this rarely happens. Our neonatologists are routinely more concerned with limiting donor exposures than the age of the unit.

[dcharland]

Thanks Shelly, this is exactly how our neonatologists practice, more concerned with donor exposure...