T and Tk antigen activation in XXXX : manifestations, severity of illness, and effectiveness of testing.

@entity1 @entity8 @entity295 @entity520 @entity1964
AIMS: To determine if T or Tk antigen activation is associated with different and more severe manifestations of illness in @entity1 with @entity1964 ( @entity1964 ); and if a policy of testing @entity1 with suspected @entity295 or @entity1964 for T and Tk antigen activation is effective. METHODS: A case-control study of @entity1 with confirmed @entity1964 , born after the introduction of screening, was undertaken:17 activated @entity1 were compared with 28 non-activated controls, matched for gestation and weight. A historical control study compared the outcome of @entity1 before and after the introduction of testing. RESULTS: Of 201 @entity1 with confirmed @entity1964 , 27 were T or Tk antigen activated-10 (9%) before and 17 (19%) after the introduction of testing. T or Tk antigen activated @entity1 had a significantly higher mortality (35% vs 7%); more frequent (71% vs 21%) and severe haemolysis, hyperkalaemia, @entity8 , @entity520 ; and they received more colloid for resuscitation. While only known activated @entity1 in both time periods were managed with the use of low titre T antibody blood products, there was a significant increase in mortality (odds ratios 2.6; 95% CI 1.2, 5.6) and incidence of surgery (OR 2.7; 1.5, 4.9) after the introduction of testing. The increased mortality (OR 2.6; 0.8, 5.2) and incidence of surgery (OR 1.8; 0.9, 3.7) were no longer significant after adjustment for several perinatal risk factors. CONCLUSIONS: In a retrospective case-control study, routine testing of at risk @entity1 increased the detection rate of T and Tk antigen activation. The use of low titre T plasma products in these @entity1 did not reduce mortality compared with historical controls. A randomised controlled trial of testing in at risk @entity1 , or of the use of low titre T plasma products in babies with @entity1964 and T activation, is warranted.
