TY - JOUR
T1 - Use and Waste of Reconstituted Whole Blood Exchange Transfusions
T2 - An 11-year National Observational Study
AU - de Winter, Derek P
AU - Lopriore, Enrico
AU - Hulzebos, Christian V
AU - Lukens, Michaël V
AU - Klinkspoor, J H
AU - van Bohemen, Michaela
AU - Besten, Gijs den
AU - de Vooght, Karen M K
AU - Vrancken, Sabine L A G
AU - Trompenaars, Amanda M P
AU - Hoffmann-Haringsma, Angelique
AU - Péquériaux, N C V
AU - Andriessen, Peter
AU - Gijzen, Karlijn
AU - van Hillegersberg, J L A M
AU - Zant, Janneke C
AU - van Rossem, Maaike C
AU - Gammeren, A J Adriaan van
AU - Weerkamp, Floor
AU - Counsilman, Clare E
AU - Knol, F R
AU - Schiering, I A M
AU - Dubbink-Verheij, Gerdina H
AU - Verweij, E J T Joanne
AU - de Haas, Masja
AU - WISE investigators
PY - 2024/7/31
Y1 - 2024/7/31
N2 - Objectives: To identify indications for exchange transfusions, assess the use and waste of exchange transfusion products (ie, reconstituted whole blood exchange transfusions), and determine nationwide distribution and prevalence of these transfusions in the Netherlands. Study design: All 9 neonatal intensive care units and 15 non-neonatal intensive care unit hospitals participated in this retrospective, observational, cohort study. We retrieved data on the indications for and use of all exchange transfusion products ordered by participating centers over an 11-year period. Results: A total of 574 patients for whom 1265 products were ordered were included for analyses. Severe ABO (32.6%) and non-ABO (25.2%) immune hemolysis and subsequent hyperbilirubinemia were the most frequent indications. Rare indications were severe leukocytosis in Bordetella pertussis (2.1%) and severe anemia (1.5%). Approximately one-half of all ordered products remained unused. In 278 of 574 neonates (48.4%), ≥1 products were not used, of which 229 (82.7%) were due to the resolving of severe hyperbilirubinemia with further intensification of phototherapy. The overall prevalence of neonates who received an exchange transfusion was 14.6:100 000 liveborn neonates. Conclusions: A considerable proportion of products remained unused, and annually a limited number of patients are treated with an exchange transfusion in the Netherlands, highlighting the rarity of the procedure in the Netherlands.
AB - Objectives: To identify indications for exchange transfusions, assess the use and waste of exchange transfusion products (ie, reconstituted whole blood exchange transfusions), and determine nationwide distribution and prevalence of these transfusions in the Netherlands. Study design: All 9 neonatal intensive care units and 15 non-neonatal intensive care unit hospitals participated in this retrospective, observational, cohort study. We retrieved data on the indications for and use of all exchange transfusion products ordered by participating centers over an 11-year period. Results: A total of 574 patients for whom 1265 products were ordered were included for analyses. Severe ABO (32.6%) and non-ABO (25.2%) immune hemolysis and subsequent hyperbilirubinemia were the most frequent indications. Rare indications were severe leukocytosis in Bordetella pertussis (2.1%) and severe anemia (1.5%). Approximately one-half of all ordered products remained unused. In 278 of 574 neonates (48.4%), ≥1 products were not used, of which 229 (82.7%) were due to the resolving of severe hyperbilirubinemia with further intensification of phototherapy. The overall prevalence of neonates who received an exchange transfusion was 14.6:100 000 liveborn neonates. Conclusions: A considerable proportion of products remained unused, and annually a limited number of patients are treated with an exchange transfusion in the Netherlands, highlighting the rarity of the procedure in the Netherlands.
KW - Exchange transfusion
KW - Hyperbilirubinemia
KW - Pertussis
KW - Prevalence
U2 - 10.1016/j.jpeds.2024.114225
DO - 10.1016/j.jpeds.2024.114225
M3 - Article
SN - 0022-3476
VL - 275
JO - The Journal of Pediatrics
JF - The Journal of Pediatrics
M1 - 114225
ER -