We agree that association between packed red blood cell (PRBC) transfusion and necrotizing enterocolitis (NEC) has been reported multiple times over the past 20 years but investigators are still hard-pressed to provide a cause-and-effect relationship between the two entities. During the publication process, several revisions of our data were made, and somehow surgical NEC data and blood group data were omitted from our final published results. In our study, out of 26 transfusion-associated NEC cases, 10 (39%) had stage 2a + 2b NEC and 16 (61%) had stage 3a + 3b cases (P = 0.04), while from control (non-transfusion related NEC) group 45 (61.6%) had stage 2 NEC and 28 cases were of stage 3a + 3b NEC, which was statistically significant. B+ blood group was present in 31% of transfusion-associated NEC and only in 9% of non-transfusion associated NEC cases. This relationship did not reach statistical significance (P=0.07).

The mortality rate mentioned in the abstract section has been adjusted for gestational age, birthweight and gender. After rechecking our data, the number of males in the transfusion associated NEC group were 15 instead of 5, which was not statistically significant. We agree with your contention that association between NEC and blood transfusion should be studied in prospective multi-center randomized trials with control of all confounders.