Improved Survival of Newborns Receiving Leukocyte Transfusions for Sepsis

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Abstract
To determine the role of polymorphonuclear (PMN) leukocyte transfusions in neonates with sepsis, 23 consecutive newborns were prospectively randomly selected during an 18-month period in a treatment Plan to receive polymorphonuclear leukocyte transfusions with supportive care or supportive care alone. Thirteen neonates received transfusions every 12 hours for a total of five transfusions. Each transfusion consisting of 15 mL/kg of polymorphonuclear leukocytes was subjected to 1,500 rads of radiation. The polymorphonuclear leukocytes were obtained by continuous-flow centrifugation leukapheresis and contained 0.5 to 1.0 x 109 granulocytes per 15 mL with less than 10% lymphocytes. Pretreatment demographic, clinical, and laboratory variables that were found to be insignificant in prognosis between newborns who received transfusions and newborns who did not receive transfusions included weight, gestational and postnatal age, hypoxia, acidosis, hypotension, initial absolute granulocyte count (AGC), initial levels of immunoglobulins (IgA, IgG, and IgM), and total hemolytic complement. Positive findings on blood cultures were obtained in 14/23 patients and even were randomly selected for each treatment group. Absolute granulocyte counts were P < .02). There were no unto-ward effects attributable to the polymorphonuclear leukocyte transfusions during the study or on subsequent follow-up clinic visits. These preliminary data suggest that the use of adult donor polymorphonuclear leukocytes in the early treatment of proven or clinically suspected newborns with sepsis lowers mortality of neonatal sepsis.