Cytokine load in prestorage leukoreduced PRBC transfusions in premature infants.

OBJECTIVE: Despite the high frequency of packed red blood cell (PRBC) transfusions given to premature neonates, there has been no previous investigation in this population to determine whether small-volume PRBC transfusions using prestorage leukoreduction techniques (1) provide a cytokine load in the transfusate and (2) if there is a load, whether that load alters serum cytokine levels after transfusion. STUDY DESIGN: In all, 27 PRBC units, which were leukoreduced at the time of donation, were followed for cytokine analysis for the duration of the unit's shelf life (1 to 42 days). Infants who received transfusion from these units had cytokines measured pre and post-transfusion.RESULTS:There were no significant levels of interleukin 6 (IL-6), interleukin 10 (IL-10), interleukin 1 beta (IL-1beta), or human tumor necrosis factor alpha (TNF-alpha) detected during the storage time period. Nine premature infants who received transfusions from these units had serum cytokines levels measured pre- vs post-PRBC transfusion, with no evidence of alterations (IL-6 p=0.51, IL-10 p=0.10, IL-1beta p=0.44, TNF-alpha p=0.86). CONCLUSIONS: The determination of a nondetectable or very low level of a cytokine load contained within the PRBC transfusate, combined with the absence of evidence of an in vivo cytokine effect, is important in establishing the safety profile for PRBC blood-banking methods used with premature neonates.