A STUDY OF THE EFFECTS OF SELECTED CHILD AND DONOR-BLOOD CHARACTERISTICS ON LATE POST TRANSFUSION HAEMATOCRIT EQUILIBRATION IN POST NEONATAL CHILDREN IN LAGOS, NIGERIA

Abstract

Blood transfusion is a common and important intervention in the treatment of anaemia.
Knowledge of the optimal time required for packed cell volume (PCV) equilibration post
transfusion is important in order to know the most appropriate time for PCV determination post
transfusion PCV. However, there has been no consensus on the optimal time to equilibration and
thus the most appropriate time for the determination of post-transfusion PCV. In particular, the
degree of equilibration in the late post-transfusion period (6 hours post-transfusion) has been
uncertain. This study was carried out to determine the degree of late post-transfusion
equilibration and the effect of selected child and donor blood factors. involved.
From July 2014 to September 2015 a total of 270 post-neonatal infants and children aged >1
month – 15 years who had a blood transfusion at the Lagos University Teaching Hospital, Lagos,
had their PCVs measured before transfusion and at 6, 12, 18, 24 and 48 hours post-transfusion.
The children were also assessed clinically. The results were analysed in relation to age, type of
blood product (packed red blood cells versus whole blood), age of donor blood and associated
illness. Multiple means were compared between groups using analysis of variance (ANOVA)
while the level of statistical significance was set at p<0.05.
The male: female ratio was 1.5:1 and 57.4% were aged <5 years. Infection (bacteria sepsis and
malaria) was the leading associated illness found among the study Subjects. Bacteria sepsis
ranked higher than malaria in causing severe anaemia in all the age groups. The PCV
equilibration was influenced by age and the associated illness in the subjects but type of blood
transfusion did not influence PCV equilibration. The duration of storage of donor blood
influenced PCV equilibration only at 48 hours post-transfusion in Subjects who received >14
days old blood. None of the factors affected the difference between mean PCV at 6 and 48 hours
but the magnitude of the difference was clinically significant.
It was concluded that, late post-transfusion haematocrit equilibration in post-neonatal children at
the Lagos University Teaching Hospital depended on age, duration of storage of donor blood and
associated illness but not on the type of blood transfusion given. And also that, there was a
clinically significant decrease in post-transfusion haematocrit between 6 and 48 hours.
Considering the significant influence of the associated illness on PCV equilibration it is
recommended that post transfusion PCV values should be checked at 48 hours or later and after
the Subjects have completed treatment for such illnesses. Also, considering the lower increment
in PCV seen at 48 hours in Subjects who received donor blood >14 days old, it is recommended
that children should only receive donor blood <14 days old.

A STUDY OF THE EFFECTS OF SELECTED CHILD AND DONOR-BLOOD CHARACTERISTICS ON LATE POST TRANSFUSION HAEMATOCRIT EQUILIBRATION IN POST NEONATAL CHILDREN IN LAGOS, NIGERIA