Granulocyte transfusion in very premature infants with sepsis: 18

In premature infants with sepsis several defects of PMN function have been documented, suggesting that these infants can be equated to neutropenic patients. We, therefore, evaluated the effectiveness of PMN transfusion in 11 very premature newborn infants with sepsis (b.w.820-1200 g; g.a. 25-29 wks). The diagnosis of sepsis was established according to clinical signs and to blood picture, and was always confirmed by blood cultures. Transfusion of packed PMNs (0.5 × 1010cells in 20 ml, obtained by leukafiltration of ABO/R h compatible blood) was given after sepsis was ascertained and repeated in the subsequent days. Group A (6 cases) received a mean of 1 unit per 2.2 symptomatic days, whereas Group B (5 cases) received a mean of 1 unit per 6 symptomatic days. The mortality rate was significantly lower in Group A than in Group B (17% vs. 100%; p <0.02). No side effect was observed. The present results suggest that PMN transfusion may represent a substantial improvement in the treatment of these infants. Adverse effect of the treatment needs further evaluation, but at present possible risks seem to be reasonably low. ( CNR grant no. 78.00563.83).