Efficacy of leucocyte filters during transfusions in preventing the development of anti-HLA antibodies.

The study was planned to investigate the effectiveness of using leucocyte filters in neonates during exchange and erythrocyte transfusion in preventing the development of anti-HLA antibodies. Twenty-four newborn infants who were admitted to the Neonatology Unit and received either exchange or at least two erythrocyte transfusions were recruited. The study group comprised of 12 infants on whom leucocyte filters were used during transfusions. Control group included the remaining 12 infants who were transfused without using a leucocyte filter. Anti-HLA antibodies in the serum samples were studied using modified Amos technique. Presence of anti-HLA antibodies in post-transfusion sera was detected in 3 (25%) of 12 infants in the study (filter) group, while in 10 (83.33%) of 12 infants in the control (no-filter) group. The difference between two groups was statistically significant (p < 0.05). The study demonstrated that term and preterm neonates were capable of developing anti-HLA antibodies following exchange and erythrocyte transfusions, and use of leucocyte filters could efficiently prevent the formation of anti-HLA antibodies.

Assessment of clinical impact and predisposing factors for neonatal thrombocytopenia.

Thrombocytopenia is a common hemostatic abnormality in the newborn infant. The early diagnosis of thrombocytopenia and the underlying primary pathology process play an important role in reducing the risk of severe complications and mortality. We performed a 2-year prospective study of 643 neonates admitted to our neonatology unit to determine the frequency, predisposing factors, and clinical impact of thrombocytopenia. Thrombocytopenia developed in 18.2% of the preterm neonates and 0.8% of the term neonates. Prematurity, sepsis, hypoxia, intrauterine growth retardation, and disseminated intravascular coagulation were identified as predisposing factors for thrombocytopenia. The incidence of complications and mortality were higher in thrombocytopenic infants. Especially the prognosis was worse in cases who had mucosal hemorrhage, without a relation with the degree of thrombocytopenia. The thrombocytopenia occurred by day 2 in 43% of the infants, and resolved by day 8 in 61%. The platelet count nadir occurred by day 2. Since thrombocytopenic infants are at greater risk for bleeding, and the thrombocytopenia itself may have contributed to the high mortality, predisposing factors such as prematurity, infections, hypoxia must be eliminated by providing better care, giving adequate hygiene of both mother and the baby during the prenatal, natal, and neonatal period.