Effect of blood transfusion on lipid peroxidation in preterm infants

Objective: To see whether there was a link between blood transfusion and lipid peroxidation as measured by urinary malondialdehyde (MDA) concentration in preterm infants. Methods: Urine samples were collected before and after blood transfusions in preterm infants. Twenty blood transfusion episodes were studied in 12 infants (some infants were studied on more than one occasion). Twenty two infants who had not received a transfusion were used as controls. All infants were preterm and less than 1500 g birth weight. Urinary MDA was measured using a thiobarbituric acid assay and expressed as nmol/mg creatinine. Results: The median (interquartile range) urinary MDA concentration before transfusion was 9.1 (6.4–12.6) nmol/mg, and was not significantly different from that in the 22 non-transfused infants (11.3 (7.3–15.6) nmol/mg). There was a significant increase 24 hours after transfusion to 14.6 (7.3–23.7) nmol/mg, but it decreased to 10.1 (6.6–15.4) nmol/mg when measured a median (range) of 6 (3–9) days later. Conclusions: Blood transfusions were associated with evidence of increased lipid peroxidation. If lipid peroxidation contributes to the pathogenesis of retinopathy of prematurity and chronic lung disease, these results suggest an explanatory mechanism.