Post-transfusion changes in serum hepcidin and iron parameters in preterm infants

BackgroundPacked red blood cell transfusion is common in preterm neonates. Hepcidin acts as a negative feedback iron regulator. Iron parameters such as immature reticulocyte fraction (IRF) and high-light-scatter reticulocytes (HLR) are used to clarify iron metabolism. Very little is known about the regulation of hepcidin in preterm infants because most reports have evaluated prohepcidin. The aim of this study was therefore to evaluate serum hepcidin and establish hematological parameters in preterm infants after transfusion. MethodsThe subjects consisted of 19 newborns (10 boys) with mean gestational age 29.1 2.0 weeks, who had been transfused at the chronological age of 44.84 19.61 days. Blood sample was collected before the transfusion and thereafter at 5days and at 1month. Serum hepcidin and other iron parameters were evaluated. ResultsMean serum hepcidin before and 5days after transfusion was significantly different (5.5 +/- 5.1 vs 10 +/- 7.9 ng/mL respectively, P = 0.005). IRF and % HLR were also decreased significantly, 5days after transfusion (0.4 +/- 0.2 vs 0.2 +/- 0.1, P = 0.009; 1.4 +/- 1.5% vs 0.5 +/- 0.4%, P = 0.012, respectively). Changes in hepcidin 5days after transfusion were correlated significantly with changes in mean corpuscular hemoglobin (, 0.13; SE, 0.05; P = 0.017), total iron binding capacity (, 3.74; SE, 1.56; P = 0.016) and transferrin (, 2.9, SE, 1.4; P = 0.039). ConclusionsSerum hepcidin concentration, along with IRF and HLR, are potentially useful in estimating pre- and post-transfusion iron status. Larger studies are needed to evaluate the sensitivity and specificity of hepcidin compared with ordinary iron parameters in premature infants.