A preliminary report of 123 units of placental umbilical cord whole blood transfusion in HIV-positive patients with anemia and emaciation.
Cord blood, because of its rich mix of fetal and adult hemoglobin, high platelet and WBC counts, and a plasma filled with cytokine and growth factors, as well as its hypo antigenic nature and altered metabolic profile, has all the potential of a real and safe alternative to adult blood transfusion. Our team's experience (from 1st April 1999 to 1st July 2005) with 123 units of placental umbilical cord whole blood (62 ml-154 ml mean 85 ml +/- 8.4 ml SD, median 82 ml, mean packed cell volume 48.8 +/- 4.2 SD, mean percent hemoglobin concentration 16.3 g/dl +/- 1.6 g/dl SD; after collection the blood was immediately preserved in a refrigerator and transfused within 72 hours of collection) collected after lower uterine cesarean section (LUCS), and the transfusion to 16 consenting HIV-positive patients (12 cases had full blown AIDS) with anemia and emaciation is presented here. On the basis of our preliminary experience of cord blood transfusion, we are of the opinion that umbilical cord whole blood transfusion is safe in HIV-positive patients. This blood has the potential to carry more oxygen than adult blood and it does not trigger any clinical, immunological or non-immunological reaction after its transfusion to an adult host with a HIV-positive status. Apart from the correction of anemia, there was also definite improvement in the energy and fatigue levels in individuals with HIV, i.e., physical functioning, a sense of well-being and weight gain from two to five pounds, within three to ten months of the commencement of transfusion. There was also an immediate rise in CD34 levels of peripheral blood in the HLA-randomized host after transfusion, without any clinical graft vs host reaction.
Bhattacharya
N
N
Bijoygarh State Hospital, Calcutta, and Moore Avenue Specialist Polyclinic, Calcutta, India.
D000328:Adult; D000740:Anemia / Q000453:epidemiology / Q000628:therapy*; D018952:Antigens, CD34 / Q000378:metabolism; D001803:Blood Transfusion / Q000379:methods*; D003906:Developing Countries; D004614:Emaciation / Q000453:epidemiology; D005260:Female; D005312:Fetal Blood / Q000637:transplantation*; D005434:Flow Cytometry; D015658:HIV Infections / Q000453:epidemiology*; D006412:Hematopoietic Stem Cells / Q000378:metabolism; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D010920:Placenta / Q000098:blood supply*; D011203:Poverty; D014470:Umbilical Cord / Q000098:blood supply*
D018952:Antigens, CD34