Document Detail


Donor blood glucose 6-phosphate dehydrogenase deficiency reduces the efficacy of exchange transfusion in neonatal hyperbilirubinemia.
MedLine Citation:
PMID:  19103674     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Acute intravascular hemolysis after exchange transfusion with glucose 6-phosphate dehydrogenase-deficient blood has been reported; however, it is not routine to screen donor blood for glucose 6-phosphate dehydrogenase deficiency while performing exchange transfusion. We hypothesized that exchange transfusion with glucose 6-phosphate dehydrogenase-deficient blood would lead to a less-than-expected decrease in total serum bilirubin. The objective of this study was to evaluate the effect of exchange transfusion with glucose 6-phosphate dehydrogenase-deficient blood in neonates with idiopathic hyperbilirubinemia on postexchange total serum bilirubin levels, duration of phototherapy, and need for repeat exchange transfusions. METHODS: All neonates who were undergoing exchange transfusion for idiopathic hyperbilirubinemia were enrolled. A sample of donor blood was collected at the time of exchange transfusion for a glucose 6-phosphate dehydrogenase assay. The standard criteria for starting and stopping phototherapy and exchange transfusion were applied. RESULTS: During the 1-year study period, 21 infants underwent exchange with glucose 6-phosphate dehydrogenase-deficient blood, and 114 neonates with similar baseline characteristics underwent exchange transfusion with glucose 6-phosphate dehydrogenase-normal blood. From 6 to 60 hours after exchange transfusion, there was a significantly lesser drop in total serum bilirubin in the recipients of glucose 6-phosphate dehydrogenase-deficient donor blood compared with recipients of glucose 6-phosphate dehydrogenase-normal blood. The mean duration of phototherapy in the postexchange period and number of infants who underwent repeat exchange transfusions were significantly higher in recipients of glucose 6-phosphate dehydrogenase-deficient donor blood in comparison with control subjects. Concurrently, there was a significantly higher drop in hematocrit and rise in plasma hemoglobin in the glucose 6-phosphate dehydrogenase-deficient donor group. CONCLUSIONS: Exchange transfusion with glucose 6-phosphate dehydrogenase-deficient donor blood leads to a lesser drop in postexchange total serum bilirubin. It prolongs the duration of phototherapy and increases the need for repeat exchange transfusions.
Authors:
Sandip Samanta; Praveen Kumar; Sai Sunil Kishore; Gurjeewan Garewal; Anil Narang
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-12-22
Journal Detail:
Title:  Pediatrics     Volume:  123     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-01     Completed Date:  2009-02-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e96-e100     Citation Subset:  AIM; IM    
Affiliation:
Neonatal Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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MeSH Terms
Descriptor/Qualifier:
Bilirubin / blood
Exchange Transfusion, Whole Blood / adverse effects,  methods*
Female
Glucosephosphate Dehydrogenase / adverse effects,  blood*
Glucosephosphate Dehydrogenase Deficiency / blood*
Hemolysis / physiology
Humans
Hyperbilirubinemia / blood*,  enzymology,  therapy*
Infant, Newborn
Male
Chemical
Reg. No./Substance:
635-65-4/Bilirubin; EC 1.1.1.49/Glucosephosphate Dehydrogenase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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