Intravenous immune globulin reduces the need for exchange transfusions in Rhesus and AB0 incompatibility

Acta Paediatr. 2008 Oct;97(10):1362-5. doi: 10.1111/j.1651-2227.2008.00915.x. Epub 2008 Jul 9.

Abstract

Aim: To conduct a quality control review of a single institution experience with intravenous immune globulin in the treatment of Rhesus and AB0 incompatibility.

Methods: Intravenous immune globulin as treatment for Rhesus and AB0 incompatibility was introduced in our hospital in 1998. We performed a chart review of 176 infants with Rhesus or AB0 incompatibility treated in our hospital between 1993 and 2003, divided into a historical control group (1993-1998) and a treatment group (1999-2003). The project was approved through institutional ethics procedures.

Results: The use of exchange transfusion as a therapeutic modality was significantly reduced in the cohort treated with intravenous immune globulin (OR 0.11; 95% CI 0.046-0.26, p < 0.001). We found no difference between the intravenous immune globulin group and the infants receiving only exchange transfusion as far as the duration of phototherapy. Infants with Rhesus incompatibility had a higher need for top-up transfusions than those with AB0 incompatibility.

Conclusion: This study supports the evidence from previous studies suggesting that intravenous immune globulin significantly reduces the need for exchange transfusion in infants with Rhesus and AB0 incompatibility.

MeSH terms

  • ABO Blood-Group System / blood*
  • Bilirubin / blood*
  • Blood Group Incompatibility / therapy*
  • Confidence Intervals
  • Exchange Transfusion, Whole Blood*
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage
  • Immunoglobulins, Intravenous / therapeutic use*
  • Intensive Care Units, Neonatal
  • Medical Records
  • Norway
  • Odds Ratio
  • Phototherapy
  • Quality Control*
  • Retrospective Studies
  • Rh Isoimmunization / therapy*
  • Time Factors

Substances

  • ABO Blood-Group System
  • Immunoglobulins, Intravenous
  • Bilirubin