Bacteriologic assessment of autologous cord blood for neonatal transfusion

Golden, Stephen M.; Petit, Nancy; Mapes, Toby; Davis, S. Edward; Monaghan, W. Patrick

doi:10.1016/0002-9378(84)90616-1

Cited by 11 publications

(8 citation statements)

References 2 publications

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“…Various studies have reported microbial contamination rates of between 0 and 9% [17,18,20,23,32]. More recent examination methods have revealed that iatrogenic bacterial contamination during blood removal deserves less attention than contamination caused by bacteraemia already existing in the newborn due to an amnion infection syndrome [31,32]. In the present study, children with a suspected amnion infection syndrome were excluded.…”

Section: Discussionmentioning

confidence: 96%

Autologous Placental Blood Transfusion for the Therapy of Anaemic Neonates

Brune¹,

Garritsen

Witteler³

et al. 2002

Neonatology

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Almost 65% of all premature neonates with a birth weight <1,500 g receive at least one erythrocyte transfusion during their first weeks of life. In the present study, we examined the feasibility of autologous transfusions in neonates, using placental blood. Placental blood was obtained from 131 of 141 preterm and term infants using a special placental blood collecting system. Approximately 20 ml of placental blood per kilogram body weight could be harvested, irrespective of birth weight. One placental blood sample was contaminated with maternal erythrocytes; aerobe or anaerobe contamination was observed in any of the stored placental blood products (n = 119) after 35 days of storage. 19 of the 141 newborns needed allogeneic erythrocyte transfusions during the first 12 weeks of life. In 5 of these 19 patients, the amount of placental blood collected would have been enough to dispense with further allogeneic blood transfusions. After completion of the preclinical study, we transfused a total of 22 children, using autologous placental blood. 8 of the 10 infants with a birth weight between 1,000 and 2,000 g and 3 of 5 infants requiring surgical intervention directly after birth needed no further allogeneic blood transfusions. We, therefore, conclude that the collection and preparation of placental blood is feasible for clinical use. The target groups of neonates who are most likely to benefit are infants with a birth weight between 1,000 and 2,000 g and neonates requiring surgical intervention directly after birth.

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Section: Discussionmentioning

confidence: 96%

Autologous Placental Blood Transfusion for the Therapy of Anaemic Neonates

Brune¹,

Garritsen

Witteler³

et al. 2002

Neonatology

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“…Autologous fetal blood from the placenta has been used for volume resuscitation of the newborn in the delivery room (16)(17)(18). Paxson (16) and Golden et al (17,18) demonstrated that placental blood could be collected into heparinized containers for use within the first 12 h of life.…”

Section: Discussionmentioning

confidence: 99%

“…Paxson (16) and Golden et al (17,18) demonstrated that placental blood could be collected into heparinized containers for use within the first 12 h of life. Other investigators have extended these observations to demonstrate the feasibility of the short-term storage of placental blood (19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Collection and 28-Day Storage of Human Placental Blood

et al. 1994

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Placental blood was harvested using a novel collection system into packs containing citrate-phosphate-dextroseadenine and then stored for 28 d. Before and during storage, sterility, adequacy of anticoagulation, blood chemistry, and red cell viability were assessed weekly. The average volume of blood collected was 65 mL (range 30-110 mL) with a 0.42 hemocrit once diluted in anticoagulant. All blood culture specimens were sterile at collection and during storage. In the United States, more than 40 000 VLBW infants are born each year, many of whom are critically ill and require care in neonatal intensive care facilities. The majority of these infants will require one or more homologous blood transfusions during the first month of life. These transfusions are given to replace losses due to diagnostic sampling and to treat the physiologic decline in H b concentration designated the anemia of prematurity (1-3). Studies have shown that VLBW infants will receive approximately 50 mL of blood per kg from as many as eight to 10 adult donors during the first month of life (1, 3, 4). However, recent data suggest that changes in transfusion practices for neonates may reduce donor exposure (5, 6). Although red cell transfusion is a valuable part of care, the use of adult donor blood poses risks for these infants including the transmission of viral agents such as non-A and non-B hepatitis, cytomegalovirus, and human immunodeficiency virus (1,7,8). Furthermore, graft versus host disease has been reported after homologous transfusions in neonates (8-1 1). were >90 s, presumably because of the decline in labile clotting factors after 24 h of storage. Hematocrit, red cell ATP, and red cell shape were maintained during storage. As expected, red cell 2,3-diphosphoglycerate declined and potassium levels rose significantly but were not different than levels reported for adult cells similarly preserved. Based on our results, it appears that placental blood represents a potential source of autologous transfusion for the sick neonate over the first month of life. (Pediatr Res 36: W94, 1994)

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“…The idea of salvaging this blood for autologous transfusions for small or sick neonates seems highly reasonable, as this would obviate the issues of introducing foreign antigens or infectious agents with donor blood 93–95. Indeed, the process of harvesting cord blood from term pregnancies for stem cell transplantation has been a successful and popular endeavour 96.…”

Section: New Methods Aimed At Reducing the Need For Transfusionmentioning

confidence: 99%

“…Reports from Japan101 and Germany102 describe successful cord/placental blood transfusion for neonates with surgical problems. Earlier studies by Golden et al demonstrated bacteriologic safety of this practice when the blood is used within 4 h of delivery 94 95. We predict that as better means are developed for harvesting and administering autologous fetal blood from extremely preterm deliveries, the benefits of using this blood, rather than donor blood, for early transfusions will outweigh the risks,103–106 and that this will become one of a number of means of reducing the need for donor blood for certain VLBW neonates.…”

Section: New Methods Aimed At Reducing the Need For Transfusionmentioning

confidence: 99%