Effect of donor and red blood cells concentrate characteristics on recipient hemoglobin increment following red blood cells transfusion in pediatric patients

Objectives: To determine the effects of donor and red blood cells concentrate characteristics on recipient hemoglobin increment following red blood cells transfusion in pediatric patients. Methods: This cross-sectional study was conducted at The Hematology & Transfusion Medicine Department of The UCHS & The Children's Hospital, Lahore from 23rd December 2020 to 31st July 2021 after Institutional Ethical committee approval. After taking informed consent from parents/guardians, One hundred recipients receiving RBCs unit transfusion studied along with the respective donors. The donor's details were recorded on a pre-designed proforma which included age, gender, Body Mass Index (BMI), CBC analysis (Hemoglobin [Hb] & Hematocrit) and blood group. Components' preparation, storage and modifications details were also recorded. Hb levels of recipient were determined 12 hours prior to transfusion and 12-18 hours after transfusion. The data was analyzed on SPSS version 26. Results: Among recipients, the mean age was 5.25 +/- 3 years and male to female ratio was 1.16:1. The mean pre-transfusion Hb level of patients was 6.48g/dl (SD: 2.15) and mean post transfusion Hb was 8.824 g/dl (SD: 2.03) with a significant raise after transfusion (p<0.001). Majority donors (60%) were between 18 to 30 years of age and mean age was 30.7 years (SD: 9.04). The hemoglobin increment was reduced for transfusion of RBC units from donor with greater age. Post-transfusion Hb rise was more in Rh D positive donations than Rh D negative (p<0.0001). No significance of donors' gender, BMI, Hb and hematocrit was found in relation to Hb increment. Among RBCs concentrate features, washing with normal saline found to have greater Hb increment, particularly in Thalassemia patients (p<0.0001). Conclusion: Donors' age and Rh blood group and red blood cell concentrates' washing accounts for significant rise in recipient's post-transfusion hemoglobin. These factors may be used to predict changes in recipients' hemoglobin before transfusion.