Impact of Exchange Transfusion in Neonatal Hyperbilirubinemia: A Contrast Between Non-blood Group and Blood Group Antibody-induced​

Purpose: Exchange transfusion (ET) is the most rapid and effective intervention for neonatal hyperbilirubinemia. This study examines the impact of blood group antibodies on the efficacy of ET in treating severe hyperbilirubinemia, aiming to inform clinical strategies. Patients and methods: Between March 2011 and July 2024, 273 hyperbilirubinemic newborns underwent ET. They were divided into blood group antibody negative (BGAbN) and positive (BGAbP) groups. Serum total bilirubin (STB), serum indirect bilirubin (SIB), and platelet count (PLT) were assessed before and after ET to compare its effectiveness between the groups. Results: Following ET, a significant decrease in STB, SIB, and PLT levels was noted in both groups (P.05). Gender-based analysis indicated no notable variations in STB, SIB, and PLT levels between the two ET groups in males (P>.05); nevertheless, females in the BGAbN group displayed significantly lower STB and SIB levels post-ET (P<.05). Conclusion: ET stands out as the most immediate and effective treatment for severe neonatal hyperbilirubinemia. The presence of blood group antibodies and neonatal gender impact the efficacy of ET.