Transfusion and coagulation in the critically ill newborn

Tipologia: Ematologia

Principal Investigator: Ghirardello

Our group focus on the risk of developing comorbidities related to red blood cell transfusion from adult donors in critically-ill neonates.
We actually investigate if placenta-derived red blood cell (RBC), a new blood product, transfused to preterm newborns is associated with a reduced incidence of retinopathy of prematurity, compared to adult red blood cell (BORN-study); moreover, we aim to evaluate the effect of placenta-derived RBC transfusion on cerebral oxygenation and circulating pro-inflammatory cytokine in preterm newborns compared to adult RBC transfusions (INCONTRA-study).
Finally our research focus on clinical applications of point-of-care whole blood coagulation tests (thromboelastography) in term and preterm newborns; specifically, after the determination of reference ranges in a cohort of preterm newborns, we aim to explore the role of thromboelastography in reducing plasma transfusion in preterm newborns, compared to standard coagulation tests.

Chioma R., Ghirardello S., Włodarczyk K. et al. Association between the development of bronchopulmonary dysplasia and platelet transfusion: a protocol for a systematic review and meta-analysis. Frontiers in Pediatrics, 2023;
Teofili L., Papacci P., Orlando N. et al. BORN study: a multicenter randomized trial investigating cord blood red blood cell transfusions to reduce the severity of retinopathy of prematurity in extremely low gestational age neonates. Trials, 2022;
Raffaeli G., Pesenti N., Cavallaro G. et al. Optimizing fresh-frozen plasma transfusion in surgical neonates through thromboelastography: a quality improvement study. European Journal of Pediatrics, 2022;
Fontana C., Raffaeli G., Pesenti N. et al. Red blood cell transfusions in preterm newborns and neurodevelopmental outcomes at 2 and 5 years of age. Blood Transfusion, 2022;
Raffaeli G., Tripodi A., Cavallaro G. et al. Thromboelastographic profiles of healthy very low birthweight infants serially during their first month. Archives of Disease in Childhood. Fetal and Neonatal, 2020.

Laboratory facilities (liquid nitrogen storage; freezer -80° C/-20° C; Refrigerate Centrifuge);
Automated ELISA immunoassays "ELLA" (Biotechne, CA USA).

Ricerca corrente Fondazione Policlinico San Matteo 2023: (RC 08075123 DE 5/DG/988/2023);
Inflammation and cerebral oxygenation in preterm newborns following fetal red blood cell transfusion compared to adult red blood cell transfusion (acronym: INCONTRA, Inflammation and Cerebral Oxygenation in Neonatal TRAnsfusion).

Policlinico Universitario Fondazione Agostino Gemelli, Roma. Prof. G. Vento and Prof. L. Teofili;
Policlinico Fondazione IRCCS Ca’ Granda, Milano. Prof. F. Mosca;
Neonatal Transfusion Network (NTN) (Around 130 participants from different countries are represented in the NTN. The European Blood Alliance (EBA), the European Society for Pediatric Research (ESPR), Sanquin Blood Supply Foundation, and the International Haemovigilance Network (IHN) have endorsed the NTN. Dr. Ghirardello coordinate the Italian NICUs participating to the NTN.