Perinatal, Neonatal, and Pediatric Transfusion—Principles and Practice

The unique challenges of pediatric transfusion medicine include tailoring one’s approach to treatment by taking into account many factors, such as the influence of patients’ age, developmental maturity on physiology and biology, and pathologic conditions involving the immunologic and hematologic systems. The main technical challenges include: (1) working with very small aliquots of blood components because of the inherently greater risk of volume overload and (2) the fact that risk of infection, product preservatives, and product storage breakdown can have an even greater effect in the pediatric population due to their unique physiology and biology. Research and evidence-based medicine in the field of pediatric transfusion is challenging due to the small number of experts and the challenge of designing research for such a vulnerable population. This chapter addresses core concepts in pediatric transfusion medicine, including: guidelines for the administration of blood products and component therapy; the associated relevant principles of immunology and hematology, and special considerations for certain pediatric populations.