# Effect of Platelet Transfusions on Neonatal Intestinal Injury

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2020 · $409,375

## Abstract

ABSTRACT
Necrotizing enterocolitis (NEC) is an idiopathic, inflammatory bowel necrosis of premature infants, and a
leading cause of mortality in neonates born prior to 32 weeks' gestation. Clinical studies show that >90% of
patients with confirmed NEC develop thrombocytopenia, but the underlying mechanisms remain unclear due to
limited investigative attention so far. Because premature infants who develop NEC are also at risk of serious
bleeding complications such as intraventricular hemorrhage, thrombocytopenia in a critically-ill infant with NEC
is usually treated prophylactically with platelet transfusions (to correct the platelet count, not actual bleeding).
There is some evidence to link platelet transfusions with adverse outcomes in NEC, but platelet transfusions
continue to be used widely in these patients because the question remains whether the inferior outcomes of
infants treated with platelet transfusions reflect the adverse effects of the transfused platelets or merely the
confounding effect of the higher severity of illness of these infants. Understanding the pathophysiological role
of platelets in NEC is critical for rational transfusion practices. To investigate these questions, the investigators
have developed murine models of NEC-related thrombocytopenia and generated preliminary data on the
pathophysiological role of platelets and the mechanisms of thrombocytopenia during NEC. Three specific aims
are proposed: (1) Elucidate the mechanisms underlying the development of thrombocytopenia during NEC,
and establish major sites of platelet consumption during NEC; (2) Determine the effect of thrombocytopenia on
intestinal injury during NEC; and (3) Determine the effect of platelet transfusions on intestinal injury during
NEC. In the third aim, the investigators will also compare fresh vs. stored platelets for their inflammatory
effects. Accomplishment of the proposed aims will generate novel insights into the effects of platelet
transfusions on neonatal intestinal injury. Important information on the immunomodulatory effects of platelet
transfusions in neonates will also be obtained. These studies will also provide important reference points for
clinical evaluation of transfusion practices in premature infants and during intestinal injury.

## Key facts

- **NIH application ID:** 9987700
- **Project number:** 5R01HL133022-04
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Mohan Kumar Krishnan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $409,375
- **Award type:** 5
- **Project period:** 2018-08-07 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9987700

## Citation

> US National Institutes of Health, RePORTER application 9987700, Effect of Platelet Transfusions on Neonatal Intestinal Injury (5R01HL133022-04). Retrieved via AI Analytics 2026-06-08 from https://api.ai-analytics.org/grant/nih/9987700. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*