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Type: Journal article
Title: Plasma cytokines and markers of endothelial activation increase after packed red blood cell transfusion in the preterm infant
Author: Keir, A.
McPhee, A.
Andersen, C.
Stark, M.
Citation: Pediatric Research, 2013; 73(1):75-79
Publisher: Int Pediatric Research Foundation Inc
Issue Date: 2013
ISSN: 0031-3998
Statement of
Amy K. Keir, Andrew J. McPhee, Chad C. Andersen and Michael J. Stark
Abstract: BACKGROUND: Transfusion of packed red blood cells (PRBCs) saves lives in the neonatal critical care setting and is one of the most common interventions in the preterm infant. The number and volume of PRBC transfusions are associated with several major neonatal morbidities, although a direct causal link between transfusion and major neonatal morbidity is still to be proven. Transfusion-related immunomodulation (TRIM) may underlie these adverse outcomes, yet it has received little attention in the high-risk preterm infant. METHODS: One transfusion event was studied in infants ≤28 wk gestation between 2 and 6 wk postnatal age (n = 28). Plasma inflammatory cytokines and markers of endothelial activation were measured in the infants before and 2–4 h after transfusion, as well as in the donor pack. RESULTS: Median (range) age at transfusion was 18 (14–39) days with the pretransfusion hemoglobin level at 9.8 (7.4–10.2) g/dl. Interleukin (IL)-1β (P = 0.01), IL-8 (P = <0.001), tumor necrosis factor-α (P = 0.008), and monocyte chemoattractant protein (P = 0.01) were increased after transfusion. A similar elevation in markers of endothelial activation was seen after transfusion with increased plasma macrophage inhibitory factor (P = 0.005) and soluble intracellular adhesion molecule-1 (P = <0.001). CONCLUSION: Production of inflammatory cytokines and immunoactivation of the endothelium observed after the transfusion of PRBCs in the preterm infant may be a manifestation of TRIM. The implications of this emerging phenomenon within the preterm neonatal population warrant further investigation.
Keywords: Endothelium
Tumor Necrosis Factor-alpha
Plasminogen Activator Inhibitor 1
Monocyte Chemoattractant Proteins
Erythrocyte Transfusion
Statistics, Nonparametric
Infant, Newborn
Fas Ligand Protein
Infant, Extremely Premature
Rights: © 2013 International Pediatric Research Foundation, Inc.
DOI: 10.1038/pr.2012.144
Appears in Collections:Aurora harvest
Paediatrics publications

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