Baby born to a mother with SCD requires Hgb S Negative RBC donor unit for top-up transfusion?

[Keith]

A question from one of my staff technolosits:"  If a baby is born to a Sickle mom, should we be testing for Sickledex on the unit we are transfusing to the baby even when we don't know if the baby is Sickle or not?"   Our current policy is that Hemoglobulin S Negative Red Cells will be provided by neonatal exchange transfusion but not for regular top-up transfusion unless the neonate is diagnosed with SCD.

 

I would appreciate if you can share your current practice in your institution.  Thanks.

[Justina]

I'm not sure about babies, but we are looking at making sickle testing on units obsolete for adult patients with SCD.

[Malcolm Needs ☆]

All of the units destined to be transfused to babies in the UK are screened for HbS, whether or not the baby is sickle positive.

[rravkin@aol.com]

_{KEITH, WHEN TRANSFUSING RBC'S TO A NEONATE OUR PRACTICE IS TO TEST FOR HGBS PER STANDARD PROTOCOL, AS WELL AS IRRADIATED, CMV TESTED NEGATIVE, AND LESS THAN 7 DAYS SINCE DONATION. AND READING OVER THE POLICY THAT YOU PRESENT; IT SEEMS INCONSISTANT, WHY WOULD INTERUTERINE TRANSFUSION BE DIFFERENT THAN THE NEONATAL TRANSFUSION, AT LEAST WITH RESPECT TO HGBS TESTING OF THE DONOR UNIT?}

[R1R2]

_{Some transfusion services give HGBS negative if units are dedicated to a baby for "top off" transfusions, however, this is not a requirment as far as I am aware.} 

[Eagle Eye]

_{KEITH, WHEN TRANSFUSING RBC'S TO A NEONATE OUR PRACTICE IS TO TEST FOR HGBS PER STANDARD PROTOCOL, AS WELL AS IRRADIATED, CMV TESTED NEGATIVE, AND LESS THAN 7 DAYS SINCE DONATION. AND READING OVER THE POLICY THAT YOU PRESENT; IT SEEMS INCONSISTANT, WHY WOULD INTERUTERINE TRANSFUSION BE DIFFERENT THAN THE NEONATAL TRANSFUSION, AT LEAST WITH RESPECT TO HGBS TESTING OF THE DONOR UNIT?}

We do exactly same as above.

Edited October 28, 2013 by Eagle Eye

[MAGNUM]

When we transfuse a baby here, we use O Negative, Sickle Negative, CMV Negative, and Irradiated units.  That is for all babies.

[tbostock]

 

I'm not sure about babies, but we are looking at making sickle testing on units obsolete for adult patients with SCD.

 

We were thinking the same thing. Having a hard time getting support to get rid of it though.

[David Saikin]

If the baby is from  a mom with SCD then you know that the child has a least one HgbS gene . . . wherever I worked with neonates we always gave HgbS neg rbcs.  Sometimes you just gotta do the right thing and this seems like one of those times to me.

[Abdulhameed Al-Attas]

 Our current policy is that Hemoglobulin S Negative Red Cells will be provided for IUT,regular top-up transfusion and neonatal exchange transfusion.

Another thing you can NOT dignose a neonate for a Sickle because the hemoglobin they have is HbF at that age you have to wait untill 7 months to do that.

[Malcolm Needs ☆]

 Our current policy is that Hemoglobulin S Negative Red Cells will be provided for IUT,regular top-up transfusion and neonatal exchange transfusion.

Another thing you can NOT dignose a neonate for a Sickle because the hemoglobin they have is HbF at that age you have to wait untill 7 months to do that.

You can, if you use molecular techniques. 

[Abdulhameed Al-Attas]

Yes, Malcolm, you are absolutly right But we in Third countries use ONLY serology Techniques, Molecular is still a dream for us.

[Malcolm Needs ☆]

I understand that.