title: The efficacy of autologous cord-blood transfusions in neonatal surgical patients.
abstract: OBJECTIVE
  Allogenic blood transfusions have a risk of infection owing to unknown organisms, graft-versus-host reaction, and immunosupression; however, the use of autologous blood has been reported to be safe. Cord blood has been reported to be useful as a source of stem cell transplantation for the treatment of leukemia and genetic disease. Furthermore, autologous cord-blood transfusions (ACBT) have been reported to be effective for the treatment of anemia in premature infants. The authors examined the efficacy of ACBT in neonatal surgical patients.
  
  
  METHODS
  Autologous cord-blood was stored from 12 infants at delivery, including 2 transvaginal and 10 cesarean section deliveries, from 1998 to 2001. All infants had surgically correctable malformations diagnosed antenatally. The mean gestational age was 37.2 +/- 1.6 weeks, and the birth weight was 2,597 +/- 1.6 g. The results of the blood count, serum electrolyte, and liver function tests of the patients who underwent ACBT only (group 1, n = 7) were compared with those of the 7 neonates who underwent an allogenic transfusion during the same period (group 2, n = 7).
  
  
  RESULTS
  The mean volume of the stored blood was 64 +/- 35.6 g (range, 20 to 100). Eleven of the 12 patients underwent transfusions. Ten of 11 patients received autologous cord blood. A mean of 44.1 +/- 37.3 g of cord blood was used. Three of 10 cases also required an allotransfusion because of ECMO circuit preparation and a shortage of the stored blood. One patient underwent allotransfusion only. As a result, 7 of 11 babies (64%) who required transfusion were able to avoid an allotransfusion. The blood potassium levels were lower in group 1 than in group 2. No significant complications were recognized clinically.
  
  
  CONCLUSIONS
  ACBT is considered beneficial because it enables neonatal surgical patients to avoid allotransfusions. Therefore, autologous cord-blood storage should be considered in the patients antenatally diagnosed to have surgical malformations. However, the storage volume varies for each case. Improved techniques to obtain an adequate amount of blood also should be developed.
authors.affiliation: Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University and The Transfusion Service, Kyushu University Hospital, Fukuoka, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Taguchi
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Suita
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Nakamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamanouchi
authors.forename: Keiko
authors.initials: K
authors.lastname: Ogita
authors.forename: Shohei
authors.initials: S
authors.lastname: Taguchi
authors.forename: Toru
authors.initials: T
authors.lastname: Uesugi
authors.forename: Hitoo
authors.initials: H
authors.lastname: Nakano
authors.forename: Shoichi
authors.initials: S
authors.lastname: Inaba
mesh_terms: D016063:Blood Loss, Surgical; D001793:Blood Preservation; D001804:Blood Transfusion, Autologous; D000013:Congenital Abnormalities / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery*; D015199:Extracorporeal Membrane Oxygenation; D005312:Fetal Blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
chemical_list: D006454:Hemoglobins