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Exchange Transfusion for Severe Neonatal Hyperbilirubinemia: 17 Years’ Experience from Vojvodina, Serbia

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Abstract

This study aimed to evaluate the frequency of the main risk factors for severe neonatal hyperbilirubinemia, to determine the incidence of exchange transfusion (ET) in the Autonomous Province of Vojvodina (the northern part of Serbia) and to describe the experience with ET performed in premature and term infants during the past 17 years. We performed a retrospective data analysis of 398 newborn infants who underwent a double volume ET from 1997 to 2013. During the 17 year study period, a decreasing incidence of ET, expressed per thousand newborns, was observed. A total of 468 double volume ET were performed: 328 (82.4 %) infants had one treatment and 70 (17.6 %) had repeated treatments. A total of 262,830 mLs of blood were transfused, an average of 660 mLs per child. There were 221 male and 177 female infants, with a sex ratio 1.25:1. The frequencies of risk factors for developing hyperbilirubinemia were as follows: (1) 38 % RhD incompatibility; (2) 38 % ABO incompatibility (26 % group A infant of group O mother, 12 % group B infant of group O mother); (3) 7 % low birth weight/preterm birth; (4) 17 % other factors. Risk factors for neurotoxicity were identified in 56.3 % of infants. No deaths or complications were reported arising from the treatment. ABO and Rh incompatibilities were found to be the main risk factors for severe neonatal hyperbilirubinemia in Vojvodina. Exchange transfusion, used as therapy for severe hyperbilirubinemia, trended downwards over the period of this study.

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Abbreviations

EBT:

Exchange blood transfusion

HBFN:

Hemolytic disease of the fetus and newborn

RBC:

Red blood cell

BTIV:

Blood Transfusion Institute for Vojvodina

RhD:

Rhesus blood group, D antigen

ABO:

ABO blood group

ISO:

International Organization for Standardization

IAT:

Indirect antiglobulin test

DAT:

Direct antiglobulin test

BW:

Body weight

CPD:

Anticoagulant citrate phosphate dextrose

CPDA1:

Anticoagulant citrate phosphate dextrose adenine

G6PD:

Glucose 6 phosphate dehydrogenase enzyme

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No specific funding was received for this study.

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Authors and Affiliations

  1. The Department of Clinical Transfusion Medicine, Therapeutic Services, Blood and Blood Products Distribution, Blood Transfusion Institute Vojvodina, Hajduk Veljkova 9A, 21000, Novi Sad, Serbia

    Nevenka Bujandric & Jasmina Grujic

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  1. Nevenka Bujandric
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  2. Jasmina Grujic
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Correspondence to Nevenka Bujandric.

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Bujandric, N., Grujic, J. Exchange Transfusion for Severe Neonatal Hyperbilirubinemia: 17 Years’ Experience from Vojvodina, Serbia. Indian J Hematol Blood Transfus 32, 208–214 (2016). https://doi.org/10.1007/s12288-015-0534-1

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  • DOI: https://doi.org/10.1007/s12288-015-0534-1

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