Transfusion and coagulation in the critically ill newborn

Tipologia: Ematologia

Principal Investigator: Dott. Ghirardello Stefano

Our group focus on the risk of developing comorbidities related to red blood cell transfusion from adult donors in critically ill neonates.
We actually investigate if placenta-derived red blood cell (RBC), a new blood product, transfused to preterm newborns is associated with a reduced incidence of retinopathy of prematurity, compared to adult red blood cell (BORN-study). Moreover, we aim to evaluate the effect of placenta-derived RBC transfusion on cerebral oxygenation, by monitoring continuous cerebral near-infrared spectroscopy (NIRS) and plasma circulating pro-inflammatory cytokine in preterm newborns compared to adult RBC transfusions (INCONTRA-study).
Finally our research focus on clinical applications of point-of-care whole blood coagulation tests (thromboelastography) in term and preterm newborns; specifically, after the determination of reference ranges in a cohort of preterm newborns, we aim to explore the role of thromboelastography in reducing plasma transfusion in preterm newborns, compared to standard coagulation tests.

Teofili L, Papacci P, Pellegrino C, Dani C, Cresi F, Remaschi G, Ansaldi G, Giannantonio C, Campagnoli MF, Vania B, Fabbri M, de Vera d' Aragona RP, Molisso A, Beccastrini E, Dragonetti A, Pasciuto T, Gabbriellini S, Baroni S, Serrao F, Purcaro V, Raffaeli G, Villa S, Prati D, Mondello I, Falcone A, Patti ML, Boggini T, Bergamaschi P, Lepore D, Franco FGS, Orazi L, Mozzetta I, Baldascino A, Valentini CG, Locatelli E, Albiani R, Besso FG, Cantone GV, Coscia A, Trimarchi A, Cavallaro G, Ghirardello S, Vento G. Cord red blood cell transfusions for severe retinopathy in preterm neonates in Italy: a multicenter randomized controlled trial. EClinicalMedicine. 2025 Aug 13;87:103426. doi: 10.1016/j.eclinm.2025.
Houben NAM, Lopriore E, Fijnvandraat K, Caram-Deelder C, Carrascosa MA, Beuchée A, Brække K, Cardona F, Debeer A, Domingues S, Ghirardello S, Grizelj R, Hadžimuratović E, Heiring C, Krivec JL, Malý J, Matasova K, Moore CM, Muehlbacher T, Szabó M, Szczapa T, Zaharie G, de Jager J, Reibel-Georgi NJ, New HV, Stanworth SJ, Deschmann E, Roehr CC, Dame C, le Cessie S, van der Bom J, Fustolo-Gunnink S; INSPIRE Study Group. Platelet transfusion in neonatal intensive care units of 22 European countries: a prospective observational study. Lancet Reg Health Eur. 2024 Oct 10; 47:101086.
Chioma R., Ghirardello S., Włodarczyk K. et al. Association between the development of bronchopulmonary dysplasia and platelet transfusion: a protocol for a systematic review and meta-analysis. Frontiers in Pediatrics, 2023.
Fontana C., Raffaeli G., Pesenti N. et al. Red blood cell transfusions in preterm newborns and neurodevelopmental outcomes at 2 and 5 years of age. Blood Transfusion, 2022.
Raffaeli G., Tripodi A., Cavallaro G. et al. Thromboelastographic profiles of healthy very low birthweight infants serially during their first month. Archives of Disease in Childhood. Fetal and Neonatal, 2020.

Laboratory facilities: liquid nitrogen storage; freezer -80° C/ and -20° C; Refrigerate Centrifuge.
Enlight® 2100: tomografo ad impedenza elettrica (EIT) per il monitoraggio regionale continuo ed in tempo reale della funzionalità polmonare dei neonati in culla.
Neolook S2S Accademico: telecamera un'applicazione innovativa progettata per raccogliere dati relativi al comportamento del neonato in culla (es. valutazione del dolore durante le procedure), che può interfacciarsi con versioni sperimentali di intelligenza artificiale.
Tromboelastograph ENTEGRION, VCM analyzer
Automated ELISA immunoassays "ELLA" (Biotechne, CA USA).

BANDO UNITE: NEODATA+ A Multimodal European Health Dataspace for Personalised Neonatal Care.
RF Advancing Neonatal Health: Personalizing Preterm Neonatal Transfusions with Fetal Hemoglobin-Enriched Cord Blood (ANH-PRESTIGE), € 73.100.
RC 08075123 DE 5/DG/988/2023, INCONTRA, € 40.000.
RC 08052624; DE 5/D.G./835/2024, EPLIPS, € 91.500.
RC 08050224 “Determinazione Dirigenziale n.250” 06/06/2025, PAIN, € 60.100.
FUNDS from private donations.
FUNDS from “Aiutami a Crescere, Onlus”, c/o NICU.

Policlinico Universitario Fondazione Agostino Gemelli, Roma. Prof. G. Vento and Prof. L. Teofili;
Policlinico Fondazione IRCCS Ca’ Granda, Milano. Prof. F. Mosca;
University of Parma, Prof.ssa S. Perrone;
Neonatal Transfusion Network (NTN) (Around 130 participants). The European Blood Alliance (EBA), the European Society for Pediatric Research (ESPR), Sanquin Blood Supply Foundation, and the International Haemovigilance Network (IHN) have endorsed the NTN. Dr. Ghirardello coordinate the Italian NICUs participating to the NTN.