Cord blood as a source of autologous RBCs for transfusion to preterm infants

Eichler, Hermann; Schaible, Thomas; Richter, Ekkehard; Zieger, W.; Voller, Katrin; Leveringhaus, A; Goldmann, S. F.

doi:10.1046/j.1537-2995.2000.40091111.x

Cited by 72 publications

(92 citation statements)

References 10 publications

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“…Autologous blood transfusions have been shown to be safe in both adult and pediatric patients (17,21,25). Umbilical/placental cord blood is autologous blood from a neonate (20), and the use of autologous umbilical cord blood (UCB) has long been discussed among neonatologists (5,6,9,10,29). Owing to the increasing utilization of UCB for the transplantation of hematopoietic stem cells, significant progress has been made in developing safer and more efficient collection techniques for UCB (12,14).…”

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confidence: 99%

Comparison of the Bactec 9240 and BacT/Alert Blood Culture Systems for Evaluation of Placental Cord Blood for Transfusion in Neonates

et al. 2009

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The Bactec 9240 and the BacT/Alert blood culture systems were compared as a means for detection of bacterial contaminants in whole blood, concentrated red cells, and plasma preparations prepared from umbilical cord blood (UCB) samples. Ninety-two UCB units seeded with low levels of various bacteria were evaluated. In more than 50% of cases, growth was not detected in plasma using either system (P < 0.001). When concentrated red cells and whole blood were compared, the Bactec system detected bacterial growth consistently sooner than the BacT/Alert system in all seeded bacteria except Staphylococcus species in whole blood. The median lengths of time to detection (LTD) for whole blood and concentrated cells in BacT/Alert were 18.7 h and 18.5 h, respectively. The median LTD for the same blood fractions using the Bactec system were 16.05 h and 15.64 h. These differences in LTD by blood culture system and sample type were statistically significant (whole blood, P ‫؍‬ 0.0449; concentrated cells, P ‫؍‬ 0.0037). Based on the results of our study, we recommend the use of either concentrated red cells or whole blood for sterility testing in UCB samples. In our laboratory, the Bactec system compared to the BacT/Alert system was the superior method for rapid detection of bacterial contaminants in cord blood.While all neonates experience a decline in their circulating red blood cells immediately after birth, anemia is a more common complication for premature neonates (27,28). Annually in the United States, an estimated 130,000 anemic, critically ill infants receive approximately one million red blood cell transfusions (31). Autologous blood transfusions have been shown to be safe in both adult and pediatric patients (17,21,25). Umbilical/placental cord blood is autologous blood from a neonate (20), and the use of autologous umbilical cord blood (UCB) has long been discussed among neonatologists (5,6,9,10,29). Owing to the increasing utilization of UCB for the transplantation of hematopoietic stem cells, significant progress has been made in developing safer and more efficient collection techniques for UCB (12,14). In neonates, bacterial contamination has been described as the third most common cause of transfusion-related fatality, with most fatalities occurring in gram-negative sepsis (13). Unfortunately, many cases of transfusion-transmitted bacterial infection remain unrecognized and underreported (4, 18, 30). While much experience exists now regarding the efficacy, recovery, and safety of UCB, only few studies investigated the prevalence of bacterial contamination of cord blood. These studies report variable bacterial contamination rates of between 1.85 and 12% (3,7,8,10,14). Bacterial contamination consists predominantly of organisms known as typical skin contaminants similar to those described in adult blood culture collections. Organisms of the vaginal flora have been described as an additional and important component of contaminants in UCB. The American Association of Blood Banks (AABB) standards require that a small ...

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Comparison of the Bactec 9240 and BacT/Alert Blood Culture Systems for Evaluation of Placental Cord Blood for Transfusion in Neonates

et al. 2009

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“…Approximately 20 mL of CB/kg of body weight can be recovered, and a linear association has been found between collected CB volume and birth weight, with a greater relative CB volume from placentas of smaller newborns. 30 Correspondingly, we could collect a mean volume of 20 mL/kg of body weight for infants younger than 28 weeks of gestational age, although a linear correlation between the collected CB volume and birth weight or gestational age was not identified. These results are similar to those obtained by Brune and associates, who collected approximately 20 mL of CB/kg of body weight, irrespective of birth weight.…”

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confidence: 92%

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2015

Exp Clin Transplant

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Objectives: This is a preliminary, single-center, prospective study in the field of autologous cord blood transplant. We investigated the feasibility, safety, and tolerability of autologous whole cord blood transplant in extremely premature infants as a potential therapeutic modality to prevent developing complications related to prematurity. Materials and Methods: This preliminary prospective study (ClinicalTrials.gov identifier NCT02050971) included preterm infants born at less than 32 weeks of gestational age who developed anemia because of prematurity. Infants were assigned to 2 groups: (1) those receiving an autologous cord blood transfusion within 5 days postpartum (n = 5) and (2) those who obtained only an allogeneic red blood cell transfusion when necessary (n = 9; control group). Vital measurements were performed during and after transfusion, and peripheral blood pH, hematocrit, glucose, and calcium and potassium ion levels were measured over the next 4 days. Results: Oxygen saturation was significantly increased throughout the cord blood transfusion and in the subsequent 48 hours. No significant differences were found in vital measurements, such as arterial blood pressure (mean, systolic, and diastolic) or heart rate over the first 48 hours posttransfusion. Similarly, no significant differences were found in biochemical analyses of blood with the exception of pH level. We found initial pH level to be significantly augmented in the cord blood recipient group by the first day after transplant, which remained significantly higher for next 24 hours compared with that shown in the control group. Conclusions: Collection, preparation, and short-term storage of unfrozen cord blood are feasible for clinical use. Our results showed general safety and tolerability of the procedure of whole autologous cord blood transplant in recruited preterm newborns. However, because our study group was small, these results need to be confirmed in further investigations with a larger patient cohort.

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“…Umbilical cord blood (UCB) has been suggested as a source for autologous transfusions 1,5,6 . Placental vessels contain a quarter to a third of the newborn blood volume, and the fetal blood left in the placental vessels may serve as a source of autologous blood 7,8 .…”

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“…Placental vessels contain a quarter to a third of the newborn blood volume, and the fetal blood left in the placental vessels may serve as a source of autologous blood 7,8 . Although studies have shown that the collection and the storage of UCB are feasible for transfusion in newborn infants, the use of UCB for transfusion in preterm infants is reported in few studies 5,[8][9][10][11][12] . We previously tested the safety and feasibility of the collection and storage method of the autologous blood 13 .…”

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confidence: 99%

“…Recently, the use of UCB for transfusion purposes has gained clinical interest. Several studies have shown that it is technically feasible to process and store autologous placental blood like allogeneic blood 5,6,8,11,[18][19][20] . Cord blood transfusion has some advantages such as to have immediate availability and to include high levels of hematopoietic progenitor cells.…”

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