Practical issues in neonatal transfusion practice.

Small premature infants frequently require transfusions of blood components, particularly red blood cells (RBCs), during the first weeks of life. Although great efforts have been made during the past few years to optimize the transfusion of blood components to these tiny patients, several questions have not been definitively answered. Accordingly, transfusion practices vary among neonatologists. The purpose of this article was to assess the available data critically. The findings indicated that stored RBCs can be transfused safely into premature infants to diminish donor exposures. It was also found that leukocyte-reduced blood components can be used to prevent the transmission of cytomegalovirus; thus, cellular components do not need to be obtained exclusively from donors negative for antibodies to cytomegalovirus. However, gamma-irradiation of cellular blood components cannot be justified for all neonatal transfusions. Obviously, as new information is reported, these findings may require revision.