Advertisement

Evaluation of hematologic factors and bilirubin following exchange transfusion in neonatal hyperbilirubinemia

      Abstract

      Introduction

      Exchange transfusion (ECT) is one of effective treatments for rapid reduction of the bilirubin serum levels. The main purpose of this study was to offer greater insights into the effects of ECT on the hematologic factors and bilirubin in neonatal hyperbilirubinemia.

      Methods

      This cross-sectional study was performed on 380 neonates over 35 gestational weeks, and 2–14 days old with a bilirubin of above 17 mg/dl who had undergone ECT at Ghaem Hospital of Mashhad in Iran from 2011 to 2021. Blood samples were examined before, immediately after, 6 h and 60 h after ECT for complete blood cell count (CBC), platelet count and bilirubin serum level analysis.

      Results

      In this study, the mean age of neonates was 5.21 ± 3.55 days with a mean birth weight of 2810 ± 710 gr. The mean platelet count (PLT), white blood cell (WBC) and the serum level of bilirubin were estimated at 260,000/mm2, 12,400/mm2, 23 mg/dl before ECT and 97,000/mm2, 7370//mm2 and 12.6 mg/dl immediately after ECT, respectively (P-value <0.001).

      Conclusion

      The results indicated that the mean serum levels of bilirubin, platelets, and leukocytes dropped to 55%, 30%, and 60% of their baseline levels before ECT, respectively, but they all spiked after ECT.

      Abbreviations:

      RBC (Red Blood Cell), ECT (Exchange Transfusions), WBCs (White Blood Cells), pRBC (packed Red Blood Cells), FFP (Fresh Frozen Plasma)

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Transfusion and Apheresis Science
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ansong-Assoku B.
        • Shah S.D.
        • Adnan M.
        • et al.
        Neonatal jaundice.
        StatPearls. StatPearls Publishing, Treasure Island (FL)2022
        • Boskabadi H.
        • Maamouri G.
        • Bagheri S.
        Significant neonatal weight loss related to idiopathic neonatal hyperbilirubinemia.
        Int J Pediatr. 2014; 2: 225-231
        • Sgro M.
        • Campbell D.
        • Shah V.
        Incidence and causes of severe neonatal hyperbilirubinemia in Canada.
        Can Med Assoc J. 2006; 175: 587-590
        • Boskabadi H.
        • Ashrafzadeh F.
        • Azarkish F.
        • Khakshour A.
        Complications of neonatal jaundice and the predisposing factors in‎ newborns.
        J Babol Univ Med Sci. 2015; 17: 7-13
        • Ebbesen F.
        • Andersson C.
        • Verder H.
        • Grytter C.
        • Pedersen‐bjergaard L.
        • Petersen J.
        • et al.
        Extreme hyperbilirubinaemia in term and near-term infants in Denmark.
        Acta Paediatr. 2005; 94: 59-64
        • Sabzehei M.K.
        • Basiri B.
        • Shokouhi M.
        • Torabian S.
        Complications of exchange transfusion in hospitalized neonates in two neonatal centers in Hamadan, a five-year experience.
        J Compr Pediatr. 2015; 6: 1-5
        • Olusanya B.O.
        • Imam Z.O.
        • Emokpae A.A.
        • Iskander I.F.
        Revisiting the criteria for exchange transfusion for severe neonatal hyperbilirubinemia in resource-limited settings.
        Neonatology. 2016; 109: 97-104
        • Shapiro S.M.
        Chronic bilirubin encephalopathy: diagnosis and outcome.
        Semin Fetal Neonatal Med. 2010;
        • Thayyil S.
        • Milligan D.
        Single versus double volume exchange transfusion in jaundiced newborn infants.
        Cochrane Database Syst Rev. 2006; 4: 1-11
        • Boskabadi H.
        • Sezavar M.
        • Zakerihamidi M.
        Evaluation of neonatal jaundice based on the severity of hyperbilirubinemia.
        J Clin Neonatol. 2020; 9: 46-51
        • Eghbalian F.
        Evaluation the complications of exchange transfusion in hospitalized neonates.
        Avicenna J Clin Med. 2007; 14: 23-27
        • Behjati S.
        • Sagheb S.
        • Aryasepehr S.
        • Yaghmai B.
        Adverse events associated with neonatal exchange transfusion for hyperbilirubinemia.
        Indian J Pediatr. 2009; 76: 83-85
        • Bülbül A.
        • Okan F.F.
        • Ünsür E.K.
        • Nuhoğlu A.
        Adverse events associated with exchange transfusion and etiology of severe hyperbilirubinemia in near-term and term newborns.
        Turk J Med Sci. 2011; 41: 93-100
        • Badiee Z.
        Exchange transfusion in neonatal hyperbilirubinaemia: experience in Isfahan, Iran.
        Singap Med J. 2007; 48: 421-423
        • Davutoğlu M.
        • Garipardiç M.
        • Güler E.
        • Karabiber H.
        • Erhan D.
        The etiology of severe neonatal hyperbilirubinemia and complications of exchange transfusion.
        Turk J Pediatr. 2010; 52: 163-166
        • Yigit S.
        • Gursoy T.
        • Kanra T.
        • Aydin M.
        • Erdem G.
        • Tekinalp G.
        • et al.
        Whole blood versus red cells and plasma for exchange transfusion in ABO haemolytic disease.
        Transfus Med. 2005; 15: 313-318
        • Sakha S.H.
        • Gharehbaghi M.M.
        Exchange transfusion in severe hyperbilirubinemia: an experience in northwest Iran.
        Turk J Pediatr. 2010; 52: 367-371
        • Brown A.K.
        • Zuelzer W.W.
        • Robinson A.R.
        • Woodcock L.
        Studies in hyperbilirubinemia: II. Clearance of bilirubin from plasma and extravascular space in newborn infants during exchange transfusion.
        AMA J Dis Child. 1957; 93: 274-286
        • Boskabadi H.
        • Mir M.
        Evaluation of the severity and duration of thrombocytopenia following exchange transfusion in neonatal hyperbilirubinemia.
        Iran J Pediatr Hematol Oncol. 2019; 52: 367-371
        • Chen H.-N.
        • Lee M.-L.
        • Tsao L.-Y.
        Exchange transfusion using peripheral vessels is safe and effective in newborn infants.
        Pediatrics. 2008; 122 (e905-e10)
        • Bhat A.W.
        • Churoo B.
        • Iqbal Q.
        • Sheikh M.
        • Iqbal J.
        • Aziz R.
        Complication of exchange transfusion at a tertiary care hospital.
        Seizure. 2011; 15: 97-99
        • Patra K.
        • Storfer-Isser A.
        • Siner B.
        • Moore J.
        • Hack M.
        Adverse events associated with neonatal exchange transfusion in the 1990s.
        J Pediatr. 2004; 144: 626-631
        • Esmaeilivand M.
        • Asadian S.
        • Siavashi V.
        • Mohammadi M.
        • Siavashi A.
        Comparison of the transfusion complications in term and preterm neonates with jaundice.
        J Babol Univ Med Sci. 2016; 18: 49-55
        • Smits-Wintjens V.E.
        • Rath M.E.
        • Van Zwet E.W.
        • Oepkes D.
        • Brand A.
        • Walther F.J.
        • et al.
        Neonatal morbidity after exchange transfusion for red cell alloimmune hemolytic disease.
        Neonatology. 2013; 103: 141-147
        • Phibbs R.
        Response of newborn infants to leukocyte depletion during exchange transfusions.
        Neonatology. 1970; 15: 112-122
        • Xanthou M.
        • Nicolopoulos D.
        • Gizas A.
        • Matsaniotis N.
        The response of leukocytes in the peripheral blood during and following exchange transfusion in the newborn.
        Pediatrics. 1973; 51: 570-574