Neonatal Hematology and Blood Transfusions

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Hematology".

Deadline for manuscript submissions: closed (30 April 2021) | Viewed by 7959

Special Issue Editors


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Guest Editor
Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
Interests: monochorionic twins; twin–twin transfusion syndrome; twin anaemia polycythaemia sequence; neonatal haematology; anaemia; thrombocytopenia
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Guest Editor
Department of Hematology/Transfusion Medicine, John Radcliffe Hospital, NHS Blood & Transplant/Oxford University Hospitals NHS Trust, Oxford, UK
Interests: clinical indications of blood transfusion components

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Guest Editor
Center for Clinical Transfusion Research, Sanquin/LUMC & Department of Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
Interests: clinical epidemiology; real-world data; comparative effectiveness; transfusion; bleeding

Special Issue Information

Dear Colleagues,

Neonatal hematology is an important field in medicine, as neonates, particularly (extremely) preterm neonates, often suffer from anemia, thrombocytopenia, or clotting disorders. These neonates are subsequently treated with blood transfusions (including red blood cells, platelets, and fresh frozen plasma), but international consensus on the optimal transfusion management is lacking. Over the past few years, a number of studies on this topic have provided a better understanding of the benefits and side-effects of blood products in neonates. However, much remains to be learned.

With this Special Issue, we hope to encourage submissions that discuss the current state-of-the-art in the field of neonatal hematology, address ongoing knowledge gaps, and focus on ongoing controversies related to the prevention of hematologic disorders and the optimization of the use of blood transfusions.

Prof. Dr. Enrico Lopriore
Prof. Simon Stanworth
Prof. Dr. Johanna (Anske) G. van der Bom
Guest Editors

Manuscript Submission Information

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Keywords

  • neonates
  • hematology
  • anemia
  • thrombocytopenia
  • clotting disorders
  • blood transfusion
  • red blood cells
  • platelets
  • fresh frozen plasma

Published Papers (3 papers)

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Research

11 pages, 237 KiB  
Article
Effectiveness and Safety of Nadroparin Therapy in Preterm and Term Neonates with Venous Thromboembolism
by Jeanine Sol, Marit Boerma, Irene Klaassen, Sinno Simons, Bregje Witjes, Enno Wildschut, Irwin Reiss and Cornelia Heleen van Ommen
J. Clin. Med. 2021, 10(7), 1483; https://doi.org/10.3390/jcm10071483 - 02 Apr 2021
Cited by 5 | Viewed by 1863
Abstract
Introduction: Optimal neonatal nadroparin dosages to treat venous thromboembolism (VTE) are unknown. Objective: To evaluate therapeutic nadroparin dosages to reach therapeutic target ranges (TTR: 0.5–1.0 International Unit (IU)/mL) and the effectiveness and safety of nadroparin in neonatal VTE. Methods: Retrospective study including neonates [...] Read more.
Introduction: Optimal neonatal nadroparin dosages to treat venous thromboembolism (VTE) are unknown. Objective: To evaluate therapeutic nadroparin dosages to reach therapeutic target ranges (TTR: 0.5–1.0 International Unit (IU)/mL) and the effectiveness and safety of nadroparin in neonatal VTE. Methods: Retrospective study including neonates with VTE on nadroparin in a tertiary center between 2007 and 2018. Two groups were distinguished: neonates before (group 1) and after (group 2) switch to higher starting dosages in 2014. Results: Sixty-one neonates (44 preterm, 17 term) with 64 VTEs were included. TTR was reached in 32/64 (50%) VTEs (group 1: 35.7%; group 2: 61.1%). Median nadroparin dosage to reach TTR was 197 (97.9–330.3) IU/kg/12 h. No therapy-related deaths occurred. Recurrent VTE developed in 6 (9.8%) neonates. Complete clot resolution was observed in 31/41 (75.6%) VTEs. TTR was reached in 58.1% VTEs with complete clot resolution. No major bleeding occurred. Non-major clinically relevant bleedings occurred in 3/64 (4.7%) VTEs, consisting of large hematomas due to the use of subcutaneous catheters. Conclusions: High nadroparin dosages are needed to reach TTR in neonates, which seem to be safe. Clot resolution may occur without reaching TTR. Subcutaneous catheters may cause important bleeding complications. Full article
(This article belongs to the Special Issue Neonatal Hematology and Blood Transfusions)
12 pages, 1347 KiB  
Article
High Integrity and Fidelity of Long-Term Cryopreserved Umbilical Cord Blood for Transplantation
by Gee-Hye Kim, Jihye Kwak, Sung Hee Kim, Hee Jung Kim, Hye Kyung Hong, Hye Jin Jin, Soo Jin Choi, Wonil Oh and Soyoun Um
J. Clin. Med. 2021, 10(2), 293; https://doi.org/10.3390/jcm10020293 - 14 Jan 2021
Cited by 6 | Viewed by 2859
Abstract
Umbilical cord blood (UCB) is used as a source of donor cells for hematopoietic stem cell (HSC) transplantation. The success of transplantation is dependent on the quality of cord blood (CB) units for maximizing the chance of engraftment. Improved outcomes following transplantation are [...] Read more.
Umbilical cord blood (UCB) is used as a source of donor cells for hematopoietic stem cell (HSC) transplantation. The success of transplantation is dependent on the quality of cord blood (CB) units for maximizing the chance of engraftment. Improved outcomes following transplantation are associated with certain factors of cryopreserved CB units: total volume and total nucleated cell (TNC) count, mononuclear cell (MNC) count, and CD34+ cell count. The role of the storage period of CB units in determining the viability and counts of cells is less clear and is related to the quality of cryopreserved CB units. Herein, we demonstrate the recovery of viable TNCs and CD34+ cells, as well as the MNC viability in 20-year-old cryopreserved CB units in a CB bank (MEDIPOST Co., Ltd., Seongnam-si, Gyeonggi-do, Korea). In addition, cell populations in CB units were evaluated for future clinical applications. The stable recovery rate of the viability of cryopreserved CB that had been stored for up to 20 years suggested the possibility of uses of the long-term cryopreservation of CB units. Similar relationships were observed in the recovery of TNCs and CD34+ cells in units of cryopreserved and fresh CB. The high-viability recovery of long-term cryopreserved CB suggests that successful hematopoietic stem cell (HSC) transplantation and other clinical applications, which are suitable for treating incurable diseases, may be performed regardless of long-term storage. Full article
(This article belongs to the Special Issue Neonatal Hematology and Blood Transfusions)
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9 pages, 1503 KiB  
Article
Changes in the Use of Fresh-Frozen Plasma Transfusions in Preterm Neonates: A Single Center Experience
by Nina A. M. Houben, Lisanne E. Heeger, Simon J. Stanworth, Helen V. New, Johanna G. van der Bom, Suzanne Fustolo-Gunnink and Enrico Lopriore
J. Clin. Med. 2020, 9(11), 3789; https://doi.org/10.3390/jcm9113789 - 23 Nov 2020
Cited by 9 | Viewed by 2565
Abstract
The aim of this study was to evaluate changes in the use of fresh-frozen plasma (FFP) transfusions and the use of clotting tests in preterm neonates in our center over the past two decades. In this retrospective cohort analysis, we included all consecutive [...] Read more.
The aim of this study was to evaluate changes in the use of fresh-frozen plasma (FFP) transfusions and the use of clotting tests in preterm neonates in our center over the past two decades. In this retrospective cohort analysis, we included all consecutive neonates with a gestational age at birth between 24 + 0 and 31 + 6 weeks admitted to our neonatal intensive care unit (NICU) between 2004 and 2019. We divided all included neonates into three consecutive time epochs according to date of birth: January 2004 to April 2009, May 2009 to August 2014 and September 2014 to December 2019. The main outcomes were the use of FFP transfusion, coagulation testing and the indications for FFP transfusion. The percentage of preterm neonates receiving FFP transfusion decreased from 5.7% (47/824) to 3.7% (30/901) to 2.0% (17/852) from the first epoch to the last epoch (p < 0.001). Additionally, the rate of neonates undergoing coagulation testing decreased from 24.3% (200/824) to 14.5% (131/901) to 8% (68/852) over the epochs (p < 0.001). Most FFP transfusions were prescribed prophylactically based on prolongation of activated partial thromboplastin time (aPTT) or prothrombin time (PT) (56%). In conclusion, both the use of FFP transfusions and the use of coagulation tests decreased significantly over the years. The majority of the FFP transfusions were administrated prophylactically for abnormal coagulation tests. Full article
(This article belongs to the Special Issue Neonatal Hematology and Blood Transfusions)
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