Neonatal Blood Transfusion in Africa; Towards Optimizing Scarce Resource
Authors:   Department of Medical Laboratory Science, Faculty of Applied Health Sciences, Edo State University, Uzairue, Edo State, Muhibi MA , Aborisade YO ,   Department of Haematology and Blood Transfusion Science, Osun State University   Teaching Hospital, Osogbo, Osun State, Olaniyan MF ,   Department of Medical Laboratory Science, Faculty of Applied Health Sciences, Edo State University, Uzairue, Edo State, Ademosun AA ,   Department of Haematology and Blood Transfusion Science, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State., Davies-Folorunso TO ,   Department of Medical Laboratory Science, Faculty of Applied Health Sciences, Edo State University, Uzairue, Edo State, Olaniyi OD ,   Department of Medical Laboratory Science, Faculty of Applied Health Sciences, Edo State University, Uzairue, Edo State, Abdulganiy N ,   Department of Medical Laboratory Science, Faculty of Applied Health Sciences, Edo State University, Uzairue, Edo State, Adedapo-Ishmail FA ,   Department of Medical Laboratory Science, Faculty of Applied Health Sciences, Edo State University, Uzairue, Edo State, Kosamat YA ,   Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, Osun State University, Osogbo, Osun State., Alade WA ,   Department of Medical Laboratory Science, Fountain University, Osogbo, Osun State., Lawal SA ,   Department of Haematology, Faculty of Basic Clinical Sciences, University of Ilorin, Kwara State
Published: April 2024

Neonatal transfusion is a common practice in Africa, where many infants are born with low birth weight and require blood transfusions. The use of paediatric packs for neonatal blood transfusions has been recommended. However, the optimal use of these packs in Africa is not clearly understood by some healthcare practitioners. This review aims to provide insights into the optimal use of paediatric packs in neonatal transfusion in Africa.The World Health Organization (WHO) recommends restrictive transfusion practices for paediatric patients, including neonates, based on expert opinion. Transfusion triggers in neonates are controversial and mainly based on expert clinical opinion, although recent randomized controlled trials of ‘liberal’ versus ‘restrictive’ red cell transfusion policies in very low birth weight preterm babies are starting to influence clinical guidelines. Many neonatal red cell transfusions are given to replace losses from frequent blood sampling. This can be reduced by avoiding non-essential tests, using low-volume sample tubes, validated near patient testing, micro-techniques in the laboratory, and non-invasive monitoring where possible.The use of CMV-seronegative blood products for transfusion in low birth weight neonates is not deemed necessary. The primary rationale is that the risk of transfusion-transmitted infections should be reduced by stringent screening of donors, restrictive transfusion practice and certain interventions like irradiation of blood units before transfusion. A recent international survey of transfusion practices for extremely premature infants showed that factors considered “very important” regarding the need to administer blood transfusions included degree of oxygen requirement and need for respiratory support. Donor exposure can also be reduced by allocating single donor units, split into paedipacks, to babies predicted to need more than one transfusion episode within the expiry date of the donation. Implementing a program to improve compliance with neonatal intensive care unit transfusion guidelines was accompanied by a reduction in transfusion rate. The implementation of guidelines to improve compliance with neonatal intensive care unit transfusion guidelines can also reduce the transfusion rate.