Pediatr Res. 2026 Sep 2. doi: 10.1038/s41390-026-05414-5. Online ahead of print.
ABSTRACT
BACKGROUND: Blood component safety measures implemented by Blood Establishments (BE) specifically for neonates are frequently precautionary rather than evidence based. We conducted a European survey on specifications for neonatal red blood cells, platelet, and plasma transfusions.
METHODS: The survey was sent to transfusion experts in BEs in 38 European countries between May 2023 and January 2024. We received responses from 20/38 countries.
RESULTS: Many BEs provide neonatal components with additional safety features not routinely applied for adults, and we found evidence of significant variation in practice. 12/19 BEs used a shorter shelf life for split units compared to adult components. For neonatal exchange, 12/19 used saline-adenine-glucose-mannitol (SAGM) replaced with FFP prior to issue. Three BEs performed additional donor or component testing for neonatal units, including screening for lead concentrations (1/20).
CONCLUSION: We identified three questions for which we conducted a critical literature review, around use of short-shelf life of red cells, use of additive solutions, and significance of lead concentrations for neonatal components. Although there were relevant articles addressing these questions, we found a lack of definitive evidence for much precautionary practice, and a need for wider study of the impact of lead in neonatal transfusions to inform future strategies.
PMID:42686839 | DOI:10.1038/s41390-026-05414-5
