Tranfusion reactions in newborns

Abstract

The transfusion of blood components is a safe and life-saving procedure. However, it may lead to an adverse outcome. Some of the more frequent acute immunologic transfusion reactions that are seen in older children and adults, such as febrile or allergic reactions, are rarely reported in the newborn. When these reactions do occur, they are usually the result of passively acquired antibodies infused into a relatively small plasma volume, rather than of antibodies produced by the infant. Newborns, on the other hand, may be more vulnerable to metabolic or physiologic complications as a result of the immature nature of their organ systems. The immature development of several organ systems in the premature infant has led to many concerns relating to the infant's ability to efficiently metabolize various compounds present in the anticoagulants and preservatives used for the storage of blood components. The risks for transfusion-related infection from screened donations for hepatitis B virus, hepatitis C virus and human immunodeficiency virus are today very low. Unfortunately, the potential still exists for previously unknown microorganisms to be transmitted via transfusion. All transfusions should be carefully monitored, and adverse reactions to blood components should be appropriately investigated. The decision to transfuse a patient, whether the patient is a newborn, an older child, or an adult, requires considering both the risks and the intended benefits of the transfusion