Abstract
Background:
Anemia, a common condition among critically ill premature infants, is affected by red blood cell (RBC) survival (RCS). We hypothesized that transfused allogeneic Kidd antigen–mismatched RBCs would demonstrate the same concurrent RCS tracking as RBCs multilabeled at separate, discrete low densities with biotin (BioRBCs).
Methods:
Allogeneic RBCs from adult donors were labeled at four biotin densities, mixed, and transfused into 17 anemic premature infants. Nine of the donors and neonates were Kidd antigen mismatched. Serial posttransfusion blood samples were assayed for up to 8 wk by flow cytometry to track the survival of the proportions of Kidd antigen–mismatched and Kidd antigen–biotinylated RBCs.
Results:
Using linear mixed modeling to compare results, RCS of the three lowest BioRBC densities was similar to RCS by Kidd antigen mismatch and to one another. RCS of RBCs labeled at the highest BioRBC density was shortened.
Conclusion:
RCS of different populations of RBCs can be tracked concurrently and reliably using the three lowest BioRBC densities. Although comparable RCS results can be achieved using Kidd antigen mismatches, BioRBCs are preferred for investigating neonatal anemia because biotin labeling of both allogeneic and autologous RBCs is possible.
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Acknowledgements
The authors acknowledge the helpful discussions with Robert S. Franco and Peter Veng-Pedersen regarding methodological and theoretical aspects of the present study. We appreciate the many contributions of the clinical laboratory staff led by Mitchell J. Owen and overseen by Matthew D. Krasowski, without which this work would not have been possible. We also acknowledge the many outstanding clinical research contributions of Iowa’s neonatal nurse research team (Karen Johnson, Sara Scott, and Ruthann Schrock) and the research laboratory team (Earl Gingerich and Jessica Goehring). Mark Hart provided valuable editorial and secretarial assistance. The Sysmex XE-2100 automatic hematology analyzer used in this study was generously provided on an on-loan basis from Sysmex, Kobe, Japan. Finally, we appreciate the willingness of the study subject families in allowing their infants to participate. This trial has been registered at www.clinicaltrials.gov (identifier NCT00731588).
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Widness, J., Nalbant, D., Matthews, N. et al. Tracking donor RBC survival in premature infants: agreement of multiple populations of biotin-labeled RBCs with Kidd antigen–mismatched RBCs. Pediatr Res 74, 689–697 (2013). https://doi.org/10.1038/pr.2013.163
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DOI: https://doi.org/10.1038/pr.2013.163
