Exchange transfusion in neonatal hyperbilirubinaemia: experience in Isfahan, Iran.

INTRODUCTION This study aims to determine the aetiology and complications of exchange transfusion (ET) performed for neonatal hyperbilirubinaemia in Isfahan, Iran. METHODS A retrospective chart review of 68 term and near-term newborns who underwent ET at two perinatal centres in Isfahan, Iran between January 2001 and January 2004, was performed. RESULTS Of the 68 patients who underwent ET, nine (13.2 percent) required more than one ET. The most common causes of ET overall were ABO incompatibility (22.1 percent) and glucose-6-phosphate dehydrogenase deficiency (19.1 percent). The maximum total serum bilirubin concentration was 25.9 +/- 7.5 mg/dL. ET complications occurred in 14 neonates (20.9 percent), the most common being thrombocytopenia (6 percent). One (1.5 percent) of the 68 patients died of complications, probably attributable to ET. CONCLUSION ET causes high morbidity, even in term and near-term newborns. Therefore, it should be initiated only when the benefit of preventing kernicterus outweighs the complications associated with the procedure.