Which measure helps minimize transfusion-related reactions in preterm neonates?

• A. Leukoreduction reduces febrile nonhemolytic transfusion reactions and alloimmunization.
• B. Increases risk of infection.
• C. Eliminates all risks of transfusion.
• D. Is only used in adults.

Answer: (A)

Leukoreduction of blood products, meaning removing white blood cells before transfusion, helps minimize transfusion-related reactions in preterm neonates. Donor white cells can release cytokines that trigger febrile nonhemolytic transfusion reactions, and they can carry antigens that the recipient’s immune system may recognize, leading to alloimmunization. By reducing the number of donor leukocytes, you lower both the fever/inflammatory reaction risk and the chance of antibody formation against donor HLA or HNA antigens, which can affect future transfusion compatibility. It can also reduce CMV transmission since CMV resides in leukocytes. This approach does not eliminate all transfusion risks, and it is used in neonates as well as in adults.