Neonatal and pediatric blood bank practice in the United States: Results from the AABB pediatric transfusion medicine subsection survey

Hollie M Reeves; Erin Goodhue Meyer; Sarah K Harm; Lani Lieberman; Ryan Pyles; Srijana Rajbhandary; Barbee I Whitaker; Meghan Delaney

doi:10.1111/trf.16520

Neonatal and pediatric blood bank practice in the United States: Results from the AABB pediatric transfusion medicine subsection survey

Transfusion. 2021 Aug;61(8):2265-2276. doi: 10.1111/trf.16520. Epub 2021 Jun 10.

Authors

Hollie M Reeves¹, Erin Goodhue Meyer^{2

3}, Sarah K Harm⁴, Lani Lieberman⁵, Ryan Pyles⁶, Srijana Rajbhandary⁷, Barbee I Whitaker⁸, Meghan Delaney^{9

10}

Affiliations

¹ Department of Pathology, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
² American Red Cross Biomedical Services, Columbus, Ohio, USA.
³ Nationwide Children's Hospital, Columbus, Ohio, USA.
⁴ University of Vermont Medical Center, Burlington, Vermont, USA.
⁵ University Health Network, Toronto, Ontario, Canada.
⁶ SSM Health Cardinal Glennon Children's Hospital, Fenton, Missouri, USA.
⁷ AABB, Bethesda, Maryland, USA.
⁸ Center for Biologics Evaluation and Research, Office of Biostatistics and Epidemiology, U.S. Food and Drug Administration, Silver Spring, Maryland, USA.
⁹ Pathology and Laboratory Medicine Division, Children's National Medical Center, Washington, DC, USA.
¹⁰ Pathology and Pediatrics Departments, The George Washington University, Washington, DC, USA.

PMID: 34110629
DOI: 10.1111/trf.16520

Abstract

Background: There are limited standards guiding the selection and processing of blood components specific for neonatal and pediatric transfusions. Therefore, blood banks (BBs) and transfusion services must create their own policies and procedures.

Study design and methods: The American Association of Blood Banks (AABB) Pediatric Transfusion Medicine Subsection Committee developed a 74-question survey to capture neonatal and pediatric BB practices in the United States.

Results: Thirty-five centers completed the survey: a response rate 15.8%. Responses indicated that most carry a mixed inventory of red blood cells (RBCs); 94.2% allow more than one type of RBC product for small-volume (SV) and large-volume (LV) transfusions to neonatal and pediatric patients. Many had storage age thresholds for RBCs transfused to neonates (SV = 60%, LV = 67.7%) but not older pediatric patients. The use of Group O for nonurgent RBC transfusion in neonates was common (74.2%). Responses related to special processing of RBCs and platelets indicated that 100% RBC and platelets are leukocyte-reduced (LR) for neonates and 97% for non-neonates. Irradiation of RBCs and platelets was commonly performed for neonatal transfusion (88.6%). Providing cytomegalovirus (CMV) seronegative products, volume reduction, and washing were variable. All centers transfused single-donor apheresis platelets; 20% allowed pathogen reduction (PR). The majority of centers have strategies limiting the amount of incompatible plasma transfused; however, few titrate ABO isoagglutinins in plasma-containing products (20% for platelets and 9.1% for plasma).

Conclusions: Variability exists in BB practice for neonatal and pediatric transfusion. Future studies are needed to understand and define best BB practices in these patient populations.

Keywords: blood bank; neonatal; pediatric; plasma; platelets; red blood cells; transfusion.

MeSH terms

Blood Banks
Blood Grouping and Crossmatching / methods
Blood Preservation / methods
Blood Transfusion* / methods
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Transfusion Medicine
United States