IVIG in the management of Rh and ABO mediated hemolytic disease of the newborn
Why did ICTMG develop a guideline for HDN?
Severe cases of hemolytic disease of the newborn (HDN) can be associated with significant infant morbidity, neurocognitive defects, and mortality. In addition to intensive phototherapy (PT), treatment options may included exchange transfusions (ET) or intravenous immunoglobulin (IVIG). Both ET and IVIG treatments carry risks to the patient.
The ICTMG's guideline provides evidence-based recommendations on the effectiveness and safety of IVIG, in addition to intensive PT, in newborns with RhD or ABO mediated HDN. This guideline also emphasizes the urgent need for additional studies to assess the optimal use of IVIG for patients with HDN.
How to access the ICTMG publication
Lieberman L, Shehata N, Baker JM, Bercovitz RS, Crescenzi E, Crighton G, Christensen RD, Cortey A, de Haas M, Delaney M, Goel R, Hendrickson JE, Jug R, Keir A, La Rocca U, Lemyre B, Maier RF, Muñiz-Diaz E, New NV, Pessoa dos Santos MC, Ramsey G, Wood E, Landry D, Lopriore E. Hemolytic disease of the newborn treated with phototherapy with and without IVIG: a systematic review. PROSPERO: International prospective register of systematic reviews. 2019 CRD42019142072.
ICTMG’s guideline on the use of IVIG in newborns with RhD or ABO mediated HDN was published in the British Journal of Haematology.
Lieberman L, Lopriore E, Baker JM, Bercovitz RS, Christensen RD, Crighton G, Delaney M, Goel R, Hendrickson JE, Keir A, Landry D, La Rocca U, Lemyre B, Maier RF, Muñiz-Diaz E, Nahirniak S, New HV, Pavenski K, Pessoa dos Santos MC, Ramsey G, Shehata S. International guidelines regarding the role of IVIG in the management of Rh- and ABO-mediated haemolytic disease of the newborn. Br J Haematol: April 12, 2022. https://doi.org/10.1111/bjh.18170
Additional resources for physicians
Please use or adapt our presentation for education or training purposes. Download the slide deck here.
Additional resources for patients
Patient Pamphlet #1: Hemolytic disease of the newborn (HDN): ABO incompatibility
This patient pamphlet has been adapted and translated by members of the ICTMG’s HDN Knowledge Mobilization Project.
The ICTMG guideline on the use of IVIG in the management of Rh and ABO mediated hemolytic disease of the newborn provides evidence-based recommendations on the effectiveness and safety of IVIG. Check out how the guideline is being shared, endorsed, and/or implemented by ICTMG's members and partner organizations internationally.
March 2023 - Italian Society of Transfusion medicine and Immunohematology/ Società Italiana di Medicina Trasfusionale e Immunoematologia (SIMTI) – "International guidelines regarding the role of IVIG in the management of Rh- and ABO-mediated haemolytic disease of the newborn” - SIMTI.
March 2023 - Spanish Society of Blood Transfusion/ Sociedad Española de Transfusión Sanguínea (SETS) - SETS - Guides and Publications.
August 2023 - The American Society of Pediatric Hematology/Oncology (ASPHO) endorsed the ICTMG hemolytic disease of the newborn (HDN) guidelines. See ASPHO endorsements here.