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Characteristics and incidence of transfusion-associated necrotizing enterocolitis in the UK.

Authors
  • Faraday, Christopher1
  • Hamad, Sheima1
  • Jones, Kelsey D2
  • Sim, Kathleen3
  • Cherian, Shobha4
  • James, Anitha5
  • Godambe, Sunit2
  • New, Helen V6
  • Kroll, J Simon3
  • Clarke, Paul1, 7
  • 1 Neonatal Unit, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK.
  • 2 Neonatal Unit, Imperial College Healthcare NHS Trust, London, UK.
  • 3 Department of Medicine, Section of Paediatrics, Imperial College, London, UK.
  • 4 Neonatal Unit, University Hospital of Wales, Cardiff, UK.
  • 5 Neonatal Unit, Royal Gwent Hospital, Newport, UK.
  • 6 NHS Blood and Transplant/Department of Haematology, Imperial College, London, UK.
  • 7 Norwich Medical School, University of East Anglia, Norwich, UK.
Type
Published Article
Journal
The Journal of Maternal-Fetal & Neonatal Medicine
Publisher
Informa UK (Taylor & Francis)
Publication Date
Feb 01, 2020
Volume
33
Issue
3
Pages
398–403
Identifiers
DOI: 10.1080/14767058.2018.1494147
PMID: 29945481
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Background and aims: The etiology of necrotizing enterocolitis (NEC) is unclear and postulated as being multifactorial. It has been suggested that one causative factor is the transfusion of packed red blood cells (PRBCs) leading to the disease entity commonly referred to as transfusion-associated NEC (TANEC). TANEC has been reported in North America but its incidence has not been formally investigated in the UK. Our aims were to identify the incidence of NEC and TANEC in tertiary-level UK neonatal units and to describe characteristics of TANEC cases.Materials and methods: Using strict case definitions for NEC and TANEC, we undertook a retrospective review to estimate the incidence of TANEC cases occurring in four UK tertiary-level centers during a 38-month period.Results: Of 8007 consecutive neonatal admissions of all gestations to the four centers, 68 babies went on to develop NEC and all affected infants were of very low birth weight (VLBW); 34 of these had previously received a transfusion of PRBCs but did not fit the diagnostic criteria for TANEC, whereas 15 (22%) of the 68 babies with NEC qualified as TANEC cases. UK cases occurred at an earlier postnatal age than cases reported in multiple large North American series and were of a lower birth weight.Conclusions: We have confirmed the presence of TANEC in the UK VLBW neonatal population. Its incidence lies within the wide range described in previous reports of this phenomenon globally, though with some local variation in characteristics. Further work is needed to clarify causation, pathophysiology, and possible mechanisms of prevention of TANEC.

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