Thomsen-Friedenreich activation in infants with necrotizing enterocolitis in Taiwan

BACKGROUND: Thomsen‐Friedenreich (T) activation in infants with neonatal necrotizing enterocolitis (NEC) has in some cases led to severe hemolysis after transfusions of plasma‐containing blood components, causing some authors to advise routine screening for T activation in all infants with NEC. However, no data are available on the frequency of T activation in infants with NEC in Taiwan. STUDY DESIGN AND METHODS: We retrospectively reviewed the medical records of 43 infants with NEC managed in our hospital from 2000 to 2007. In all cases, Arachis hypogaea lectin was used to test for T activation. RESULTS: Of the 43 infants, 16 infants (37%) had Stage II and 27 (63%) had Stage III NEC. Four infants had trace T activation, two of whom received transfusions with washed red blood cells (RBCs) and two with unwashed RBCs. None had evidence of hemolysis. The overall mortality in this series was 16% (7/43), but none of the four babies with T activation died. CONCLUSION: In this series of Taiwanese infants with NEC, weak T activation was present in only 9% (4/43) of infants, and RBC transfusion did not result in hemolysis, regardless of whether washed or unwashed cells were administered. We considered routine screening for T activation and provision of prepared blood components in infants with NEC in Taiwan might be unnecessary.