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.
Author(s): C. Th. Smit-Sibinga
Edition: 1
Year: 2006
Language: English
Pages: 294
Neonatology and Blood Transfusion (Developments in Hematology and Immunology)......Page 1
Front-matter......Page 2
Title Page
......Page 4
Copyright Page
......Page 5
INTRODUCTION......Page 7
Table of Contents
......Page 8
MODERATORS AND SPEAKERS......Page 10
OPENING ADDRESS......Page 12
I.
Foetal and Neonatal Haematology......Page 15
Introduction......Page 16
Biology of ‘haematopoietic’ GATA transcription factors......Page 17
GATA transcription factors in the switch from ‘primitive’ to ‘definitive’ haematopoiesis
......Page 20
GATA transcription factors in the switch of the primary site of haematopoiesis
......Page 21
Regulation of the Epo receptor by GATA-1 in haematopoietic progenitor cells
......Page 23
Role of GATA transcription factors in the switch of globin genes during development
......Page 24
GATA transcription factors in the regulation of the switch of primary site of erythropoietin production
......Page 25
GATA transcription factors in congenital or acquired disorders of haematopoiesis
......Page 26
Summary......Page 28
References......Page 29
DEVELOPMENT OF THE IMMUNE SYSTEM IN THE FOETAL AND PERINATAL PERIOD
......Page 37
References......Page 41
Introduction......Page 43
Long-Term Effects of Intraperitoneal Transfusions with Non-Leukocyte Reduced, Non-Irradiated Red Cells
......Page 44
Effects of Maternally Administered High Dose Immunoglobulin (IVIG) and Platelet Transfusions (IUPT) in Infant Hood
......Page 46
Short Term Effects of Intrauterine Erythrocyte Transfusions (despite leukocyte reduction and gamma irradiation)
......Page 47
Premature Infants......Page 50
Conclusion......Page 52
References......Page 53
Cellular biology of thrombopoietin......Page 55
Molecular biology of thrombopoietin......Page 56
Molecular biology of c-mpl, the thrombopoietin receptor......Page 57
Regulation of Tpo......Page 58
Clinical biology of Tpo......Page 59
Biology of thrombopoietin in inherited neonatal thrombocytopenias......Page 60
Biology of thrombopoietin in acquired neonatal thrombocytopenias......Page 62
New aspects of the developmental biology of thrombopoietin......Page 64
Acknowledgement......Page 65
References......Page 66
DISCUSSION......Page 75
II.
Immunohaematology and Haemostasis......Page 81
History of Red Cell Alloimmunization......Page 82
Prevention of Red Cell Immunisation......Page 84
Maternal Serum Testing......Page 86
Paternal Zygosity and Foetal Typing......Page 87
Plasmapheresis......Page 88
Foetal monitoring......Page 89
Intrauterine Transfusion......Page 94
References......Page 102
Introduction......Page 126
Pathophysiology......Page 127
Risk of Severe Hyperbilirubinaemia......Page 128
Treatment of Unconjugated Hyperbilirubinaemia......Page 129
Mechanism of Action......Page 130
Exchange Transfusion......Page 134
Summary......Page 135
References......Page 136
Areas of Consensus......Page 140
Antenatal Management......Page 143
Maternally-administered Intravenous (IV) Gammaglobulin (IVIG)......Page 144
Antenatal Treatment......Page 147
Foetal Platelet Transfusions......Page 149
Management of the Neonate......Page 151
References......Page 152
Introduction......Page 155
Well Infant......Page 156
Vitamin K Deficiency......Page 157
References......Page 158
DISCUSSION......Page 160
III. Blood Transfusion in the Neonate......Page 173
Developmental Haemostasis......Page 174
Risk Factors......Page 175
Arterial TEs......Page 176
Laboratory Testing......Page 177
Treatment......Page 178
References
......Page 179
Introduction......Page 181
Increase in Extracellular Potassium......Page 182
Safety of Additives in Pre1ervative Solutions......Page 183
Clinical Experience Transfusing Stored RBCs......Page 185
References......Page 187
Pathogenesis......Page 189
Diagnosis of TA-GvHD......Page 191
Groups at Risk......Page 192
The Irradiation Process......Page 193
Instrumentation for Irradiation......Page 194
Components to be Irradiated......Page 195
Storage of Red Cells and Platelets after Irradiation......Page 197
Selection of Radiation Dose......Page 199
Confirming that Irradiation Occurred......Page 200
New Methods in the Prevention of TA-GvHD......Page 202
References......Page 203
Introduction......Page 210
Extended Storage/Additive Solutions......Page 211
Metabolic Complications......Page 213
Potential Toxicities of Transfusion......Page 217
References......Page 219
Introduction......Page 222
ECMO Criteria......Page 224
The ECMO Procedure......Page 225
Equipment and Systems......Page 227
Patient Management......Page 228
Daily Medical Management (Figure 5)......Page 229
Outcome Data......Page 231
References......Page 232
DISCUSSION......Page 236
IV.
Cellular Therapies in Neonatology......Page 249
In Utero Haematopoietic Stem Cell Transplantation......Page 250
Human IUHSCTx Clinical Trials......Page 252
Gene Therapy for X-Linked Severe Combined Immune Deficiency......Page 253
SCID Clinical Trials and Leukaemia......Page 254
References......Page 255
Introduction......Page 256
Meta-analysis and Evidence-based Decisions in Neonatology......Page 257
Pathophysiology of Erythropoietin in the Anaemia of Prematurity......Page 258
Meta-Analysis of Clinical Trials Studying rHEPO in the Anaemia of Prematurity
......Page 259
Evidence-Based Medicine beyond Meta-Analysis for Making Medical Decisions
......Page 260
Conclusions......Page 263
References......Page 264
Introduction......Page 266
The Milano Cord Blood Bank......Page 268
Donor Selection and Informed Consent......Page 269
Cord Blood Collection, Transportation and Receipt at the Bank......Page 270
Unit Processing, Characterisation and Quality Control......Page 271
Cord Blood Cryopreservation......Page 273
Cord Blood Unit Validation......Page 274
Mother and Newborn Check Six Months after Delivery......Page 275
References......Page 277
DISCUSSION......Page 279
EPILOGUE
......Page 286
INDEX......Page 287
