The effects of deferoxamine mesylate on iron elimination after blood transfusion in neonatal foals.

The study investigates the impact of a drug named deferoxamine mesylate on the elimination of iron in neonatal foals (young horses) following a blood transfusion. The findings indicate that deferoxamine can minimize iron accumulation in the liver and boost its elimination through urine after a blood transfusion, potentially reducing the risks of hepatic injury often linked to iron overexposure.

Objective and Methodology

This randomized-controlled trial involved thirteen neonatal foals utilized to determine the impacts of deferoxamine on iron elimination. The foals, aged between 1-3 days, either received 3L of their dam’s packed red blood cells (RBCs) or an equal amount of saline once intravenously. Then, a dose of deferoxamine or saline was administered subcutaneously twice daily for 14 days.

• The foals were classified randomly into three groups: the first group received RBC and deferoxamine, the second one received RBC and saline, serving as a placebo group, and the third group was given saline and acted as the control group.
• Blood and urine samples were taken, and liver biopsies were conducted to monitor hematological changes, biochemical variables, and iron metabolism shifts.

Results

• The study recorded a statistically significant increase in hematocrit, RBC count, and hemoglobin in the foal groups that were transfused with packed RBC in comparison to the control group.
• The biochemical markers and the scores of liver biopsies did not present noticeable differences across all three groups.
• Urine iron concentrations and the fractional excretion of iron were significantly higher in foals treated with deferoxamine.
• Fourteen days post-transfusion, the iron concentration in the liver of deferoxamine-treated foals was significantly lower than that in placebo-treated foals and was similar to the control group.

Conclusions

The research concludes that using deferoxamine can enhance the elimination of iron through urine and decrease the accumulation of iron in the liver following a blood transfusion in foals. These findings can be pivotal for foal health, especially since hepatic failure is a common complication among foals requiring a blood transfusion for neonatal isoerythrolysis treatment—often attributed to iron intoxication.