Novel Blood Component Therapies in the Pediatric Setting

Introduction

The dogma of transfusion medicine for the last several decades has been the use of blood component therapy; that is, packed red blood cells (RBCs), platelets, and plasma and cryoprecipitate for the treatment or prevention of anemia, thrombocytopenia and hypocoagulability or bleeding, and hypofibrinogenemia, respectively. Recently there has been a surge in both new preparation techniques to make existing blood components safer, such as pathogen reduction, and the use of adjuvant treatments, such as fibrinogen concentrate, to prevent bleeding and subsequent use of blood components. Although these newer blood products or blood derivatives have been studied and used more often in adult patients, this article reviews these products and the existing literature regarding their safety and efficacy in children because their use is likely to become more common:

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  Whole blood (WB)

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  Solvent/detergent-treated blood products, such as Octoplas

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  Pathogen-reduced (PR) blood products, such as INTERCEPT and Mirasol platelet components

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  Fibrinogen concentrate

Whole blood

WB is not a new product or technique but is the foundation of transfusion medicine that is making a resurgence, especially in trauma resuscitation. ¹ WB was initially described in the early 1990s for use in children undergoing complex cardiac surgery, and additional studies of its use in pediatric trauma and other pediatric surgeries have been recently described 2345 .