| Donor blood glucose 6-phosphate dehydrogenase deficiency reduces the efficacy of exchange transfusion in neonatal hyperbilirubinemia. | |
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MedLine Citation:
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PMID: 19103674 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Sandip Samanta; Praveen Kumar; Sai Sunil Kishore; Gurjeewan Garewal; Anil Narang |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-12-22 |
Journal Detail:
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Title: Pediatrics Volume: 123 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2009-01-01 Completed Date: 2009-02-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: e96-e100 Citation Subset: AIM; IM |
Affiliation:
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Neonatal Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Bilirubin
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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:
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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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