Topic teaching: Paediatric transfusion issues

Presented by

Dr. Sarah Tehseen
Assistant Professor Pediatric Hematology Oncology
Royal University Hospital, Saskatoon

Learning objectives

1. Recognize differences in neonatal hematology compared to adults
2. Outline differences in pre-transfusion testing in neonates
3. Review new evidence for transfusion of blood products in neonates
4. Identify the unique conundrums associated with transfusion
   1. Age of Blood
   2. Plasma transfusion-complications and appropriateness
   3. Alloimmunization
5. Understand large volume hemorrhage in neonates and its resuscitation
6. Unanswered questions and new avenues

References

1. Fresh frozen plasma transfusion in the neonatal population: A systematic review.  Sokou R, Parastatidou S, Konstantinidi A, Tsantes AG, Iacovidou N, Doxani C, Piovani D, Bonovas S, Stefanidis I, Zintzaras E, Tsantes AE.  Blood Rev. 2022 Sep;55:100951. doi: 10.1016/j.blre.2022.100951. Epub 2022 Apr 11.  PMID: 35430103 Review.
2. The role of the calibrated automated thrombogram in neonates: describing mechanisms of neonatal haemostasis and evaluating haemostatic drugs.  Murphy CA, Neary E, O'Reilly DP, Cullivan S, El-Khuffash A, NíAinle F, Maguire PB, McCallion N, Kevane B.  Eur J Pediatr. 2022 Jan;181(1):23-33. doi: 10.1007/s00431-021-04196-8. Epub 2021 Jul 20.  PMID: 34283272 Free PMC article. Review.
3. Effect of High-Dose Erythropoietin on Blood Transfusions in Extremely Low Gestational Age Neonates: Post Hoc Analysis of a Randomized Clinical Trial.  Juul SE, Vu PT, Comstock BA, Wadhawan R, Mayock DE, Courtney SE, Robinson T, Ahmad KA, Bendel-Stenzel E, Baserga M, LaGamma EF, Downey LC, O'Shea M, Rao R, Fahim N, Lampland A, Frantz ID 3rd, Khan J, Weiss M, Gilmore MM, Ohls R, Srinivasan N, Perez JE, McKay V, Heagerty PJ; Preterm Erythropoietin Neuroprotection Trial Consortium.  JAMA Pediatr. 2020 Oct 1;174(10):933-943. doi: 10.1001/jamapediatrics.2020.2271.  PMID: 32804205 Free PMC article. Clinical Trial.
4. A Randomized Trial of Erythropoietin for Neuroprotection in Preterm Infants.  Juul SE, Comstock BA, Wadhawan R, Mayock DE, Courtney SE, Robinson T, Ahmad KA, Bendel-Stenzel E, Baserga M, LaGamma EF, Downey LC, Rao R, Fahim N, Lampland A, Frantz Iii ID, Khan JY, Weiss M, Gilmore MM, Ohls RK, Srinivasan N, Perez JE, McKay V, Vu PT, Lowe J, Kuban K, O'Shea TM, Hartman AL, Heagerty PJ; PENUT Trial Consortium.  N Engl J Med. 2020 Jan 16;382(3):233-243. doi: 10.1056/NEJMoa1907423.  PMID: 31940698 Free PMC article. Clinical Trial.
5. Higher or Lower Hemoglobin Transfusion Thresholds for Preterm Infants.  Kirpalani H, Bell EF, Hintz SR, Tan S, Schmidt B, Chaudhary AS, Johnson KJ, Crawford MM, Newman JE, Vohr BR, Carlo WA, D'Angio CT, Kennedy KA, Ohls RK, Poindexter BB, Schibler K, Whyte RK, Widness JA, Zupancic JAF, Wyckoff MH, Truog WE, Walsh MC, Chock VY, Laptook AR, Sokol GM, Yoder BA, Patel RM, Cotten CM, Carmen MF, Devaskar U, Chawla S, Seabrook R, Higgins RD, Das A; Eunice Kennedy Shriver NICHD Neonatal Research Network.  N Engl J Med. 2020 Dec 31;383(27):2639-2651. doi: 10.1056/NEJMoa2020248.  PMID: 33382931 Free PMC article. Clinical Trial.
6. Clinical Guide to Transfusion, Chapter 13, Neonatal and Paediatric Transfusion.  Lau, W:  https://professionaleducation.blood.ca/en/transfusion/clinical-guide/neonatal-and-pediatric-transfusion

Note: The session is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification program of The Royal College of Physicians and Surgeons of Canada.

Registration  

Closed

Appraisal

Please click here for the Appraisal Link

The survey will close November 4th at 5 p.m. Eastern.

To be added to the distribution list for the LearnTransfusion series, send an email to learn.transfusion@blood.ca  with “Weekly Transfusion Medicine Seminars” in the subject line. Include your name and complete e-mail address in the body of the e-mail and confirm that you would like to be added to the distribution list for the LearnTransfusion series. You will then receive weekly email notifications of upcoming series events with details on how to join the webinars (e.g.,  link to register for the webinar).

The LearnTransfusion series is the seminar component of the Areas of Focused Competency (AFC)-Diploma Program in Transfusion Medicine. The series, organized by Canadian Blood Services, is also open to all practitioners in the field of Transfusion Medicine. Through a series of regular webinars, trainees and practitioners are exposed to various scientific, technical and clinical aspects of transfusion medicine.