Children and infants that undergo heart surgery react better when receiving fresh whole blood transfusions from a single donor when compared with transfusions from multiple donors, according to a recent research carried at The Children’s Hospital of Philadelphia (CHOP). The findings were published this month in the Annals of Thoracic Surgery.
David R. Jobes, a cardiothoracic anesthesiologist in the Cardiac Center at CHOP that lead the study, said, “Using fresh whole blood for transfusions reduces the number of individual blood donors to which patients are exposed. The risks of transfusion reaction are most significantly linked to donors, so limiting such exposure will benefit patients.” There are several well-recognized risks such as fevers, allergic reactions, transmission of infectious disease and lung injury.
The research enrolled 4,111 children who received heart surgery at CHOP between 1995 and 2010. Of those children, 3,836 received fresh whole blood transfusions while 252 received transfusions of blood components only. CHOP has been providing, since 1995, fresh whole blood to patients who undergo heart surgery, with blood transfusions of components only chosen when the first was not available. Previous experiences evidenced that whole blood in such patients reduced blood loss and the odds of needing extra transfusions.
In this study, the average number of exposures was 2 donors, with increased numbers for younger patients who had complex surgeries. Researchers verified that for pediatric cardiac patients who received blood components the number of exposures for all the subgroups was actually lower than those previously reported in literature. Currently, it is common practice to use transfusions of blood components in pediatric cardiac surgical programs.
“Many congenital heart conditions necessitate multiple surgeries beginning in infancy, and require multiple transfusions over a patient’s lifetime. So limiting donor exposures from the start may reduce long-term complications from blood transfusions. We hope this research encourages officials to re-examine current blood storage practice and make logistical changes to make whole blood more readily available for pediatric heart patients,” said Dr. Jobes.
