Avoiding Infection From Blood Transfusion in Neonatal Units-Reply

Abstract

In Reply.— Dr Novak is correct in pointing out that technological advances have lagged, and, thus, the ideal reduction in donor exposure has not yet been approached in transfusion practices among premature infants. However, despite my sympathy for the transfusionist who has to balance the competing demands of prompt availability of blood with economy, safety, and so on, I do not think that these issues should cloud appreciation of the lower total disease rates that always follow when any given donor's blood is restricted to fewer recipients. Only in patients with a lifelong need for hundreds of transfusions can it be shown that reduction in donor exposure reaches a point of diminishing returns. The multiplicity of donors used for premature infants is based not only on the limitations in current multibag technology, but also arises because an empirically defined degree of freshness of blood is thought desirable to minimize bilirubin