TITLE:
Efficacy of Whole Blood Reconstituted (WBR) in Exchange Transfusion (ET) in Hemolytic Disease of New Born (HDN) —A Study of 110 Cases
AUTHORS:
Dharmesh Chandra Sharma, Sunita Rai, Sudha Iyengar, Bharat Jain, Satya Sao, Ajay Gaur, Rahul Sapra
KEYWORDS:
Whole Blood Reconstituted (WBR); Hemolytic Disease of Newborn (HDN); Exchange Transfusion (ET); Hyperbilirubinemia; Anemia Correction
JOURNAL NAME:
Open Journal of Blood Diseases,
Vol.3 No.1,
March
29,
2013
ABSTRACT: Aim: This study was aimed to review and establish the
practice of exchange transfusion (ET) with whole blood reconstituted (WBR) in hemolytic disease of newborn (HDN). Objectives: To observe fall in indirect
serum bilirubin, correction of anemia and comparison
with related studies. Background: Hemolytic disease of the Newborn is characterized by presence of IgG antibodies
in maternal circulation, which causes hemolysis in the fetus by crossing the
placenta and sensitizing red cells for destruction by macrophages in the fetal
spleen with consequent hyperbilirubinemia. Exchange transfusion with or without
phototherapy is the method of choice for treating the newborn with on going
hemolysis Methods/Materials: Sample size consisted of 110
neonates in whom 119 exchange transfusions were carried out with WBR. WBR was
prepared by suspending O Rhesus-D (RhD) positive/negative cells (compatible
with neonate’s/ mother’s serum) in AB plasma.
Double volume exchange transfusion(s) were carried out through umbilical vein
by push-pull technique. Results: Out
of 110 cases, 61 (55.5%) were of RhD HDN whereas ABO and other group HDN cases
were 30 (27.3%) and 19 (17.3%) respectively. An average post-ET fall in
indirect serum bilirubin by 54.6% and correction of anemia by3.7 gm/dl were reported in the study. Conclusion: An average post-ET fall in
indirect serum bilirubin and correction of anemia was found to be more
significant when compared to other studies. Hence we recommend exchange transfusion in HDN with WBR to obtain
reasonable fall in indirect serum bilirubin and high average rate of correction
of anemia.