T cryptantigen activation is associated with advanced necrotizing enterocolitis

Background/Purpose: Thomsen-Friedenreich cryptantigen activation (TCA) exposes neonates with necrotizing enterocolitis NEC to the risk of hemolysis after transfusion of blood products. The authors aimed to determine the prevalence of TCA in neonates with NEC and to correlate TCA with severity of dis...

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Bibliographic Details
Published in:	Journal of pediatric surgery Vol. 37; no. 5; pp. 791 - 793
Main Authors:	Hall, N., Ong, E.G.P., Ade-Ajayi, N., Fasoli, L., Ververidis, M., Kiely, E.M., Drake, D.P., Spitz, L., Hann, I., Mok, Q., Pierro, A.
Format:	Journal Article Conference Proceeding
Language:	English
Published:	Philadelphia, PA Elsevier Inc 01-05-2002 Elsevier
Subjects:	Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Antigens, Tumor-Associated, Carbohydrate - immunology Biological and medical sciences Emergency and intensive care: neonates and children. Prematurity. Sudden death Enterocolitis, Necrotizing - immunology Enterocolitis, Necrotizing - mortality Enterocolitis, Necrotizing - surgery Humans Infant, Newborn Intensive care medicine Isoantigens - immunology Medical sciences necrotizing enterocolitis Survival Rate T crypt antigen activation T crypt antigen activation necrotizing enterocolitis Human Hemolysis Thomsen Friedenreich antigen Association Newborn Transfusion Cross sectional study Digestive diseases Intestinal disease Necrotizing enterocolitis Transfusion reaction Activation
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Summary:	Background/Purpose: Thomsen-Friedenreich cryptantigen activation (TCA) exposes neonates with necrotizing enterocolitis NEC to the risk of hemolysis after transfusion of blood products. The authors aimed to determine the prevalence of TCA in neonates with NEC and to correlate TCA with severity of disease and outcome. Methods: One hundred four neonates with NEC were tested for TCA on admission. Patients with TCA requiring transfusion were given packed red cells, low-titer anti-T fresh frozen plasma, and washed platelets to avoid hemolysis. Results: Twenty-three infants had TCA, and 96% of these had stage III disease. The incidence of TCA was significantly higher in infants with stage III disease compared with those with stage II (30% v 4%; P <.01). A total of 91% of infants with TCA required laparotomy compared with 81% of those with no activation. At laparotomy, widespread disease was more common in the TCA group (71% v 55%). TCA did not significantly increase mortality rate (TCA, 39% v no TCA, 28%); this may reflect the transfusion policy of our unit. Conclusions: Twenty-two percent of neonates with NEC referred to our unit had TCA. There is an association between TCA and advanced NEC. Screening of neonates with advanced NEC for TCA is advised to identify those at risk of hematologic complications. J Pediatr Surg 37:791-793. Copyright 2002, Elsevier Science (USA). All rights reserved.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0022-3468 1531-5037
DOI:	10.1053/jpsu.2002.32289