Background: From 1994, an increasing number of parents volunteered their own blood as direct donations (DD), citing worries of infectious risks. In June 1996, we began a policy offering collection of parental blood, for later transfusion to their infants. We have reviewed our experience to October 1997, of offering DD to newborns in an NICU.

Objectives: The objectives were to diminish the rate of allogeneic transfusion.

Methods: Prospective cohort data collection. In 16 months, there were requests for DD for 126 infants (10 sets of twins); 164 individuals were tested for acceptability to donate (85 mothers; 79 fathers). Of these, 60 were rejected because of: ABO incompatibility (20); Rh incompatibility (16); both ABO and Rh incompatibility (3); anemia (17); failure to meet other donor criteria (4). Of the 104 acceptable donors, 73 (26 mothers; 47 fathers) donated 123 units of blood for 80 infants. Allogeneic blood exposure was compared in 80 infants forming the DD group (DDG); and 46 infants whose parents requested DD but failed to meet criteria or chose not to donate(control).

Results: Birthweights [mean (SD)]: control 1353g (754), DDG 1005g (518) (p=0.0086); Length of Stay [mean (SD)] control 36.1 (26.4) Days v DDG 60.0 (41.7) (p=0.0003). Each donation provides 3 aliquots of red cells, all three aliquots were transfused in 33% (41/123) of donated units: 2 aliquots in 15.4% (19/123); 1 aliquot in 26.8% (33/123); and 30 units of blood(24%) were not transfused. Frequencies of non-transfusion were 37% controls v 19% DDG (p=0.04). In the DDG, 37.5% (30/80) received allogeneic blood compared to 63% (29/46) in the control group (p=0.01). Examining allogeneic red cell transfusions only, the total donor exposure was 32/80 in DDG versus 38/46 for controls (p<0.0001). Mean exposures were to 0.4 donors in DDG & to 0.8 donors in controls.

Conclusion: A directed donation program decreases the frequency of allogeneic blood exposure, and reduces the number of donors of red cells to which the infant is exposed. This reduction is seen despite these DDG infants being smaller, requiring them to be in hospital longer and potentially placing them at a higher likelihood of transfusion.