Smit-Sibinga Neonatology and Blood Transfusion

1. Auflage 2010
ISBN: 978-0-387-23600-1
Verlag: Springer US
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, Band 39, 294 Seiten, eBook

Reihe: Developments in Hematology and Immunology

Proceedings of the Twenty-Eighth International Symposium on Blood Transfusion, Groningen, NL, Organized by the Sanquin Division Blood Bank North-East, Groningen.

It is in many ways fitting that the last of these international symposia on blood transfusion should end with neonatal blood transfusion. The most fragile, least well studied and most at risk population requires special care and concern. We need to expand our knowledge of their unique physiology, biochemical pathways and in planning treatment and interventions, always "do no harm."

This proceedings of the last Groningen symposium presents a wealth of information on developmental immunology, the molecular basis of haematopoeisis, physiological basis of bleeding and thrombosis, transfusion risks and benefits and lastly, future therapies. Infants provide us with much to learn but in turn they will be the providers of (through cord blood) and the recipients of (through cellular engineering) the best that science can offer. Translational research, which has been the thrust of these presentations for 28 years, will benefit them in a way that no scientist could have ever predicted.

Zielgruppe

Professional/practitioner

Autoren/Hrsg.

Smit-Sibinga, C. Th.

Smit-Sibinga, C.T.h.

Inhaltsverzeichnis

Foetal and Neonatal Haematology.- Regulation of Developmental Haematopoiesis By Gata Transcription Factors.- Development of The Immune System In The Foetal and Perinatal Period.- Foetal and Neonatal Immunohaematological Responses: Consequences for Practical Management?.- Biology of Thrombopoietin In the Human Foetus and Neonate.- Discussion.- Immunohaematology and Haemostasis.- Management of Red Cell Alloimmunization in Pregnancy.- New Treatment Options in Neonatal Hyperbilirubinaemia.- Consensus and Controversy in Foetal and Neonatal Alloimmune Thrombocytopenia.- The Bleeding Infant.- Discussion.- Blood Transfusion in the Neonate.- Neonatal Thrombosis.- Criteria for Selecting a Red Blood Cell Product to Transfuse Anaemic Infants.- Hazards of Transfusion: GvHD.- Non-Immune, Non-Infectious Complications of Transfusion.- Extracorporeal Membrane Oxygenation in the Neonate with Respiratory Failure.- Discussion.- Cellular Therapies in Neonatology.- Genetic Engineering for the Foetus and Neonate.- Meta-Analysis and Evidence-Based Decision Making in Neonatal Care.- Placental Blood Banking in the Year 2003.- Discussion.- Epilogue.- Epilogue.

Leseproben

"II. IMMUNOHAEMATOLOGY AND HAEMOSTASIS MANAGEMENT OF RED CELL ALLOIMMUNIZATION IN PREGNANCY (p. 68-67)

I.L. van Kamp, H.H.H. Kanhai

History of Red Cell Alloimmunization

Haemolytic disease of the foetus and newborn, also known as erythroblastosis foetalis, used to be one of the main causes of perinatal mortality for many centuries. Although the clinical picture of extremely hydropic and icteric stillborns was already described in the 17 century, the pathogenesis of the disease was not understood until the early 1940s.

Darrow published in 1934 an extensive overview on the clinical picture and etiologic considerations of neonatal haemolytic disease [1]. From the observation that the disease frequently occurred in the offspring in one family, Darrow hypothesized that the placenta may be the means of transmission of a destructive influence from mother to foetus [1]. Subsequently, Levine and Stetson managed to identify an unknown red-cell antigen in the blood of a woman who was delivered from a stillborn hydropic baby [2].

The woman had massive uterine bleeding and appeared to suffer from a life-threatening transfusion reaction, after being transfused with her husbands f blood. As husband and wife both had blood type 0, Levine and Stetson called this unknown phenomenon “intra-group agglutination” [2,3]. Simultaneously, Landsteiner and Weiner discovered an agglutinating factor in th serum of rodents, sensitised with blood from a Macacus Rhesus monkey [4]. As this factor caused agglutination of the blood of 85% of New York’s population, it was f initially assumed to be similar to the human antibody causing erythroblastosis foetalis.

Eventually, the antibody appeared comparable, though not identical to the human antibody, but by that time it had been erroneously called “Rhesus”. t After the discovery of the alloimmune origin of haemolytic disease, more insight and knowledge was gained on this pathological process by several studies [5]. In these years a beneficial effect of maternal and pater f nal ABO incompati- r bility on the severity of haemolytic disease was observed [6].

Neonatal exchange transfusion as a method of treatment of hyperbilirubinaemia was described by Wallerstein in 1946 [7]. This was the first impor tant step in the prevention of kernicterus, the most serious and feared complication of neonatal hyperbilirubinaemia, followed in 1958 by the introduction of fototherapy. However, until the 1960s severe foetal haemolytic disease could neither be diagnosed nor be treated. Elective preterm delivery of a foetus, assumed to be viable, was the policy in most pregnancies complicated by maternal Rhesus (D) alloimmunization, aiming to prevent foetal demise and to be able to start neonatal treatment."