[Programmed autologous blood transfusion in children. Results of a national survey]

The Role of Hemapheresis in Autotransfusion

Hemapheresis is a commonly used technique for single donor procedures of cell and/or plasma collection. In our blood center a new protocol was carried out to study the application of Hemonetics MCS3p to autotransfusion. PES and TAE protocols were applied: 40 patients for ‘each branch and 40 as controls completed the protocol. In the TAE protocol, 2 units of red cell concentrate were collected at day 0, in the PES protocol 300 ml of plasma were added, while in the control group 400 ml of whole blood were collected. Complete blood cell count, clotting parameters, and the EPO level were tested. The two protocols (TAE and PES) prove effective and safe: no significant change was shown for the clotting time and factors, other hematological and plasma values were controlled:; the endogenous EPO doubles its value 24-h after the procedure and the difference compared to controls is highly significant.

[Pediatric transfusion practices: A single-center retrospective study]

OBJECTIVES

This study aimed to describe the professional practices in pediatric transfusion to assess the accuracy of transfusion guidelines in children.

METHODS

The study retrospectively analyzed the characteristics of all the pediatric transfusions prescribed in the Clermont-Ferrand (France) university hospital center over 1 year and determined whether they conformed to the national guidelines.

RESULTS

One thousand six hundred and seven blood products were delivered to 233 children (806 red cell units, 670 platelet units, and 131 plasma units), accounting for 5.3% of the center's whole blood products. Transfusions were mainly prescribed by the oncohematology unit (68.2%), the intensive care unit (15.4%), and for surgery (10.2%). Ten adverse events were reported in eight patients (0.6% of transfusions). The prescription conformed to the national guidelines in 35.9%, 41.6%, and 80.9% of the red blood cell, platelet, and plasma unit transfusions, respectively. Nonconformity was mainly due to abusive irradiation and "cytomegalovirus seronegative" specifications.

CONCLUSION

Malignancies, intensive care, and surgery are the main indications for transfusion in children. Substantial discrepancy between recommendations and actual practices was observed. This illustrates the variability of risk evaluation. This should be made simpler by the use of photochemical pathogen inactivation techniques.