The scope of the work described in this thesis is to examine whether potential transfusion related and clinical risk factors modulate the risk of alloimmunization in a general, previously not... Show moreThe scope of the work described in this thesis is to examine whether potential transfusion related and clinical risk factors modulate the risk of alloimmunization in a general, previously not transfused, non alloimmunized population of transfusion recipients. In these studies we emphasize the methodological aspects of observational research in clinical transfusion medicine Show less
This thesis focuses on several aspects related to the hematological outcome of infants with hemolytic disease of the fetus and newborn (HDFN) due to red blood cell alloimmunization, including... Show moreThis thesis focuses on several aspects related to the hematological outcome of infants with hemolytic disease of the fetus and newborn (HDFN) due to red blood cell alloimmunization, including pathogenesis and management of the disease. The presence of leukocytopenie and thrombocytopenia support the mechanism of suppression of thrombopoiesis and granulopoiesis in favor of the increased erythropoiesis stimulated by anemia and hypoxia. In addition to the problems caused by a shortage of platelets and white and red blood cells, the excess of the red blood cell metabolites bilirubin and iron also contribute to the morbidity of the disease. This thesis also contains a systematic review that demonstrates that there is lack of high level evidence promoting the use of intravenous immunoglobulin (IVIg) to prevent exchange transfusions in HDFN. Irrespective of the controversy concerning the use of IVIg, this thesis shows that intensive follow-up is indicated in both Rhesus D and non-Rhesus D HDFN and raised awareness about the associated morbidity is of paramount importance. Finally, this thesis also contains future research questions concerning HDFN. Show less
