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Red blood cell transfusions can induce proinflammatory cytokines in preterm infants
Author(s) -
Dani Carlo,
Poggi Chiara,
Gozzini Elena,
Leonardi Valentina,
Sereni Alice,
Abbate Rosanna,
Gori Anna Maria
Publication year - 2017
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.14080
Subject(s) - proinflammatory cytokine , medicine , immunology , blood cell , red blood cell transfusion , red blood cell , blood transfusion , intensive care medicine , inflammation
BACKGROUND The risk of developing red blood cell (RBC) transfusion–associated necrotizing enterocolitis (TANEC) in preterm infants has recently been emphasized. Our aim was to assess changes in cytokine serum levels after RBC transfusions in a cohort of very preterm infants to evaluate their possible proinflammatory effect. STUDY DESIGN AND METHODS We carried out a prospective observational study. One transfusion event was studied in infants less than 32 weeks' gestation and more than 7 days old (n = 20) admitted to a tertiary neonatal intensive care unit. Interleukin (IL)−1β, IL‐6, IL‐8, tumor necrosis factor‐α, interferon‐γ (IFN‐γ), IL‐17, monocyte chemoattractant protein‐1 (MCP‐1), interferon‐γ–induced protein 10 (IP‐10), intracellular adhesion molecule‐1 (ICAM‐1), and vascular cell adhesion molecule serum levels were measured in enrolled patients within 120 minutes before (T 0 ) the RBC transfusion and then within 120 minutes (T 1 ), 12 ± 3 hours (T 2 ), 24 ± 6 hours (T 3 ), and 48 ± 6 hours (T 4 ) after the end of RBC transfusion. RESULTS Infants received 19.8 ± 3.0 mL of RBCs at the mean age of 50 ± 18 days. Their hematocrit level increased from 24.1 ± 1.2% to 39.4 ± 2.9%. IL‐1β, IL‐8, IFN‐γ, IL‐17, MCP‐1, IP‐10, and ICAM‐1 increased significantly after RBC transfusions. CONCLUSION Proinflammatory cytokines are increased after RBC transfusion. These findings may contribute to explaining the pathogenesis of TANEC and suggest the opportunity of adopting wise transfusion guidelines that would help to avoid detrimental risks of transfusion‐related immunomodulation and of undertransfusion.