Usefulness of cord-blood harvesting for autologous transfusion in surgical newborns with antenatal diagnosis of congenital anomalies.
OBJECTIVE
The risks of homologous transfusion and the effectiveness of predeposit autologous transfusion have been described. The authors examined the clinical usefulness of cord-blood harvesting for autologous transfusion in newborns who had congenital anomalies antenatally diagnosed that would require surgical intervention at or near the time of delivery.


METHODS
Of 112 cases of antenatal diagnosis of congenital anomalies, 50 mothers gave informed consent and enrolled in this study. Cord-blood was withdrawn immediately after clamping of the umbilical cord and was used for autologous transfusion in newborns within the first 3 days postpartum.


RESULTS
A mean of 72 +/- 54 mL of cord-blood was harvested (27 +/- 18 mL/kg). While preserving cord-blood for 3 days at 4 degrees C, no signs of clot formation or hemolysis were observed. The harvested cord-blood included plasma-free Hb ranging from 1 to 68 (13 +/- 18) mg/dL and thrombin-antithrombin III complex ranging from 2 to 273 (18 +/- 50) ng/mL. Bacteriologic examination of the stored cord-blood showed negative cultures, except for samples from 3 newborns after vaginal delivery. A mean of 46 +/- 34 mL of cord-blood was used in 26 patients for autologous transfusion. No significant complications related to cord-blood transfusion were recognized clinically.


CONCLUSIONS
Autologous cord-blood transfusion has the potential to be a useful alternative to homologous transfusion in newborns requiring surgery. Adequate collection and storage techniques for cord-blood must be developed. J Pediatr Surg 36:851-854.
Imura
K
K
Division of Pediatric Surgery and Obstetrics, Osaka Medical Center for Maternal and Child Health and Research Institute, Osaka, Japan.
Kawahara
H
H
Kitayama
Y
Y
Yoneda
A
A
Yagi
M
M
Suehara
N
N
D001793:Blood Preservation; D001804:Blood Transfusion, Autologous; D000013:Congenital Abnormalities / Q000601:surgery*; D005312:Fetal Blood; D006801:Humans; D007231:Infant, Newborn; D019990:Perioperative Care; D011296:Prenatal Diagnosis; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome