PEDIATRICS Vol. 79 No. 3 March 1987, pp. 422-425
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Buffy Coat Transfusions in Neonates With Sepsis and Neutrophil Storage Pool Depletion

J. Gary Wheeler MD1, Allen R. Chauvenet MD1, Christine A. Johnson MD1, Steven M. Block MD1, Robert Dillard MD1, and Jon S. Abramson MD1

1 From the Department of Pediatrics, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina

A randomized study was initiated in neonates with neutropenia (absolute peripheral neutrophil count <1,500/µL) and suspected bacterial infection. Twenty infants with proven infection were enrolled, nine of whom had depletion of bone marrow stores of maturing neutrophils (le 7% metamyelocyte, band and mature forms per 100 nucleated cells). These nine were randomized to receive 15 mL/kg of either buffy coat transfusions (group 2) or plasma and blood products (group 3). The remaining 11 (group 1) were observed. Peripheral neutrophil counts were monitored to determine the neutrophil response to transfusions. There were ten of 11 patients in group 1, two of four in group 2, and two of five in group 3 who lived at least seven days. No complications of transfusion were noted. No difference in the rate of peripheral neutrophil increase was found among the three groups. The study was stopped when it became clear that sufficient numbers of patients could not be entered into the study, in a reasonable period of time, to prove or disprove a clinically significant improvement in outcome. Although in vitro testing of the buffy coat preparations showed normal function in three of four cases, the clinical quality of the buffy coats may have been inadequate because of poor availability of whole fresh blood less than 24 hours old. The role of neutrophil transfusions in these patients remains unclear.

Key Words: buffy coat transfusion • neonatal sepsis • neutropenia

Submitted on July 27, 1986
Accepted on October 6, 1986