Red Cell Transfusion and Thrombotic Risk in Children.

* Abbreviations: RBC — : red blood cell VTE — : venous thromboembolism Venous thromboembolism (VTE) in children who are hospitalized represents an important cause of morbidity and resource use. In the general population, VTE in children is rare, but hospitalization increases this incidence 100- to 1000-fold to 30 to 58 events per 10 000 admissions.1 Pediatric VTE is associated with numerous poor outcomes, including congestive heart failure, limb ischemia, all-cause mortality, and increased length of hospital stay.1–3 For reasons not totally understood, rates of pediatric VTE have been increasing in recent years.1,4 Some risk factors for pediatric VTE are frequently reported in the literature. These include a central venous catheter, infection, age 15 years, illness severity, and sepsis.5–7 In this issue of Pediatrics , Goel et al8 present evidence for another risk factor in the pediatric surgical population: red blood cell (RBC) transfusion. This report parallels other pediatric studies of thrombosis risk associated with transfusion3,7 and a previous adult study by the same group.9 The role of RBCs in coagulation and thrombosis is an … Address correspondence to Brian S. Donahue, MD, PhD, Department of Anesthesiology, Monroe Carell Jr Children’s Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, TN 37232. E-mail: brian.donahue{at}vumc.org