{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T03:52:38Z","timestamp":1784173958483,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and objectives<\/jats:title><jats:p>Guidelines and indications for exchange transfusion in haemolytic disease of the foetus and newborn (HDFN) have changed drastically in the past decades, causing a decline in exchange transfusion rate. This study aims to evaluate the incidence of exchange transfusions (ETs) in neonates with Rh\u2010mediated HDFN over the past 20\u00a0years at our centre, and report potentially ET\u2010related complications as well as indicators for bilirubin encephalopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>In this observational study, 438 neonates were included with HDFN, born\u00a0\u2265\u00a035\u00a0weeks gestational age at the Leiden University Medical Centre between January 2000 and July 2020. The incidence of ET and procedure\u2010related complications were assessed in three consecutive time periods determined by changes in guidelines and indications for ET.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of ET in our centre declined from (104\/156) 67% (time period 2000\u20132005), to (39\/181) 22% (2006\u20132015) and to (10\/101) 10% (2015\u20132020, <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00\u00b7001). The maximum bilirubin levels in neonates after birth increased from 13\u00b76\u00a0mg\/dL (or 233\u00a0\u03bcmol\/L), to 15\u00b70\u00a0mg\/dL (257\u00a0\u03bcmol\/L) and to 15\u00b73\u00a0mg\/dL (263\u00a0\u03bcmol\/L). The incidence of complications associated with the use of ET (including sepsis, haematologic disorders and respiratory failure) remained stable throughout the years, and no neonates died during the study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Exchange transfusion incidence declined significantly over the past two decades. Decrease in ET incidence, and concomitant decrease in exposure and expertise, was not associated with an increase in procedure\u2010related complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vox.13090","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T21:00:56Z","timestamp":1616014856000},"page":"990-997","source":"Crossref","is-referenced-by-count":21,"title":["Exchange transfusions in severe Rh\u2010mediated alloimmune haemolytic disease of the foetus and newborn: a 20\u2010year overview on the incidence, associated risks and outcome"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3608-3509","authenticated-orcid":false,"given":"Isabelle M. C.","family":"Ree","sequence":"first","affiliation":[{"name":"Department of Paediatrics Division of Neonatology Leiden University Medical Centre Leiden the Netherlands"},{"name":"Centre for Clinical Transfusion Research Sanquin Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin F. J.","family":"Besuden","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Division of Neonatology Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivianne E. H. J.","family":"Wintjens","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Division of Neonatology Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne (E.) J. T.","family":"Verweij","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Division of Foetal Medicine Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dick","family":"Oepkes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Division of Foetal Medicine Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masja","family":"de Haas","sequence":"additional","affiliation":[{"name":"Centre for Clinical Transfusion Research Sanquin Leiden the Netherlands"},{"name":"Department of Immunohaematology and Blood Transfusion Leiden University Medical Centre Leiden the Netherlands"},{"name":"Department of Immunohematology Diagnostics Sanquin Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Lopriore","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Division of Neonatology Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2017.1331124"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.114.1.297"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.1999.014"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2008.02.005"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2011.02.013"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200102223440807"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12290"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-2910"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2010.01307.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.112970"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/j.0001-6349.2004.00394.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2010.01408.x"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-020-0642-0"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.05.030"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(78)80282-0"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0166-4328(05)80189-5"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000343261"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2008.00915.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/inthealth\/ihy045"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.2147\/JBM.S162191"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0179550"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2013.08.025"},{"key":"e_1_2_6_24_1","first-page":"CD003313","article-title":"Immunoglobulin for alloimmune hemolytic disease in neonates","volume":"3","author":"Zwiers C","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-3242"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2012.03827.x"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07022.x"}],"container-title":["Vox Sanguinis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/vox.13090","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/vox.13090","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/vox.13090","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T16:24:55Z","timestamp":1692635095000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/vox.13090"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,17]]},"references-count":26,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1111\/vox.13090"],"URL":"https:\/\/doi.org\/10.1111\/vox.13090","archive":["Portico"],"relation":{},"ISSN":["0042-9007","1423-0410"],"issn-type":[{"value":"0042-9007","type":"print"},{"value":"1423-0410","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,17]]}}}