Introduction & Objective: Exchange transfusion is replacement of blood or main part of RBC mass and plasma of a recipient by compatible RBC or plasma from one or more donors. This study was carried out with the aim of evaluation the rate of complications of exchange transfusion in hospitalized neonates during 2002-2005.

Materials & Methods: This descriptive cross-sectional study was done on 120 neonates with jaundice who had blood exchange. Medical documents of these neonates were then evaluated for complications of exchange transfusion. Complications after exchange transfusion were included hypocalcaemia, hyperkalemia, thrombocytopenia, necrotizing enterocolitis, cardiac arrest, hypoglycemia, hypothermia, seizure, sepsis and mortality. Data extracted were statistically analyzed by SPSS 10.

Results: In 120 evaluated neonates, 64 neonates (53.3%) were boys and 56 cases (46.7%) were girls. The incidence of complications of exchange transfusion was 61.7% (74 cases). The most common complication in these neonates was thrombocytopenia (51.7%). The second common complication was hypocalcaemia (30.8%). Cases of necrotizing enterocolitis were not seen. Mortality rate from exchange transfusion in neonates was 5% (6 cases). The rate of exchange transfusion complications in low birth weight neonates (body weight less than 2500gr) was more than normal weight neonates (p<0.05). The rate of exchange transfusion complications in preterm neonates was also more than term neonates (P<0.05).

Conclusion: This study showed the thrombocytopenia is the most common complication of exchange transfusion. The total rate of incidence of complications, mortality and main complications of exchange transfusion (seizure and cardio-pulmonary arrest) were more prevalent in preterm and low birth weight neonates compared to the term and normal weight neonates.