Exchange Transfusion in the Netherlands: A Personal View

Abstract

It is four o’clock on a December morning and snow has been falling incessantly the whole night. In a hospital 50 km away an exchange transfusion is planned and fresh heparin blood of group O Rhesus negative is requested. A suitable donor has been called to the Donor Centre and blood was withdrawn by 4.45 a. m. As the blood was put on to an emergency taxi for transport information came that the baby had died. In this case it is unlikely that death could have been prevented and there is no doubt that the baby was acutely ill when first being considered for exchange transfusion. Time is a critical commodity here. The hospital concerned keeps a small stock of group O Rh negative blood which could have been made available within minutes from stock. A vital three-quarters of an hour could have been saved if stored Citrate Phosphate Dextrose (CPD) blood not more than 72 hours old had been acceptable.