Bahr Timothy M, Christensen Thomas R, Ilstrup Sarah J, Ohls Robin K, Christensen Robert D
Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA; Women and Newborns Research, Intermountain Health, Murray, UT, USA.
Critical Care Research, Intermountain Health, Murray, UT, USA.
Semin Fetal Neonatal Med. 2025 Mar;30(1):101546. doi: 10.1016/j.siny.2024.101546. Epub 2024 Oct 19.
ELGANs (Extremely-Low-Gestational-Age Neonates; those born before 28 weeks gestation) are at risk for developing significant morbidities including retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and cognitive impairment. The pathogenesis of each of these morbidities is complex, but a growing literature suggests that repeated transfusions of adult donor red blood cells (RBC) conveys a propensity to develop these disorders. The biological rationale for the propensities might vary with each morbidity. For instance, hemoglobin A in adult red cells increases oxygen delivery to the developing retina, potentiating ROP, while a proinflammatory nature of adult donor RBC might potentiate BPD. It is possible that fetal RBC harvested from otherwise discarded umbilical cord blood after healthy term births would be a more physiologically appropriate transfusion product for anemic ELGANs. Such a product might result in a lower incidence or severity of the common morbidities. Herein we review our progress, and that of others, toward testing that theory.
极早早产儿（孕周小于28周出生的新生儿）有发生严重疾病的风险，包括早产儿视网膜病变（ROP）、支气管肺发育不良（BPD）和认知障碍。这些疾病的发病机制都很复杂，但越来越多的文献表明，多次输注成人供血者红细胞（RBC）会增加患这些疾病的倾向。每种疾病倾向的生物学原理可能各不相同。例如，成人红细胞中的血红蛋白A会增加向发育中的视网膜输送的氧气，从而增强ROP，而成人供血者RBC的促炎性质可能会增强BPD。从健康足月儿出生后丢弃的脐带血中采集的胎儿RBC，对于贫血的极早早产儿来说，可能是一种生理上更合适的输血产品。这样一种产品可能会降低常见疾病的发病率或严重程度。在此，我们回顾我们以及其他人在验证该理论方面取得的进展。
