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Iron homeostasis after blood transfusion in stable preterm infants – an observational study

  • Jacky Herzlich , Ita Litmanovitz , Rivka Regev , Sofia Bauer , Gisela Sirota , Zvi Steiner and Shmuel Arnon EMAIL logo
Published/Copyright: March 18, 2016

Abstract

Aim:

To evaluate the short-term effects of blood transfusion on iron status [hemoglobin, ferritin, soluble transferrin receptor (sTfR), and reticulocyte count], hepcidin, and erythropoietin in stable preterm infants.

Method:

Sixty-three preterm infants treated with red blood cell transfusions (RBCTs) were included. Venous blood samples were collected before and within 24 h after each transfusion.

Results:

Hemoglobin concentration increased after RBCT (7.2±1.2 g/dL vs. 13.7±2.3 g/dL, P=0.02), as well as ferritin [131 (63–110.4) ng/mL vs. 211 (125.7–299.2) ng/mL, P=0.05); reticulocyte count decreased. sTfR did not change. Hepcidin serum levels increased from 37.5 (21.3–84.7) ng/mL to 72.6 (31.3–126.2) ng/mL, (P=0.04) and erythropoietin decreased (48±19 pg/mL vs. 29±17 pg/mL, P=0.06) after RBCT. A positive linear correlation was found (R2=0.76, P=0.0001) between hepcidin and ferritin levels of post-minus-pre RBCT. Hepcidin levels increased significantly in preterm infants who received RBCT after 1 month of age compared to those who received RBCT at <1 month (P=0.03). No correlation was found between gestational age, weight appropriate for age, or length of blood storage and hepcidin levels.

Conclusion:

Preterm infants can control iron levels by regulating hepcidin and decreasing erythropoietin. This ability varies with postnatal age.


Corresponding author: Shmuel Arnon, MD, Department of Neonatology, Meir Medical Center, Kfar Saba 44281, Israel; and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, Tel.: +972-9-7472225, Fax: +972-9-7471189, E-mail:

Acknowledgments

This study was not supported by external funding.

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  1. The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2015-10-23
Accepted: 2016-2-17
Published Online: 2016-3-18
Published in Print: 2016-11-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

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