Nationwide, many NICUs continue to use red blood cells less than 10 days old in neonates, despite an increased emphasis on reducing donor exposure because of risk of transfusion (Tx) transmitted diseases. In the past, we have demonstrated that the donor exposure is reduced significantly after instituting a Dedicated Donor Transfusion Program (DDTP) [One unit of red cells is dedicated to each baby for the life of the unit - 35 days] in our NICU.

OBJECTIVE:To see if DDTP has any effect on blood transfusion practices in neonates.

METHODS: We reviewed the blood transfusion data 3 years later, in infants <1500 grams. Group 1 are infants <1000 grams and Group II are infants 1000-1500 grams. We compared the annual donor exposure and number of transfusions in infants in the year of introduction of DDTP and 3 years later. We also reviewed the blood pH, post-transfusion serum potassium and hematocrit.

RESULTS: Table 1) The total number of patients transfused decreased by 13.5% in infants <1500 grams; 2) The donor exposure continued to stay low after 3 years of DDTP; 3) The blood pH and serum potassium did not show any significant change; 4) The rate of rise of hematocrit was as expected.

Table 1 No caption available.
Full size table

CONCLUSION: DDTP has a significant effect in changing blood transfusion practices in our NICU. Presently, the clinical status of the infant determines the need for transfusion. Although average donor exposure per patient stayed unchanged, significantly lesser number of infants <1500 grams were transfused. Since the use of older red blood cells have been shown to be efficacious and safe, more NICUs should be using DDTP, making every effort to reduce the donor exposure in the neonate.