A clinical study on the feasibility of autologous cord blood transfusion for anemia of prematurity.
BACKGROUND
The objective was to investigate the use of autologous red blood cells (RBCs) derived from umbilical cord blood (UCB), as an alternative for allogeneic transfusions in premature infants admitted to a tertiary neonatal center.


METHODS
UCB collection was performed at deliveries of less than 32 weeks of gestation and processed into autologous RBC products. Premature infants requiring a RBC transfusion were randomly assigned to an autologous or allogeneic product. The primary endpoint was an at least 50 percent reduction in allogeneic transfusion needs.


RESULTS
Fifty-seven percent of the collections harvested enough volume (> or =15 mL) for processing. After being processed, autologous products (> or =10 mL/kg) were available for 36 percent of the total study population and for 27 percent of the transfused infants and could cover 58 percent (range, 25%-100%) of the transfusion needs within the 21-day product shelf life. Availability of autologous products depended most on the gestational age. Infants born between 24 and 28 weeks had the lowest availability (17%). All products, however, would be useful in view of their high (87%) transfusion needs. Availability was highest (48%) for the infants born between 28 and 30 weeks. For 42 percent of the infants with transfusion needs in this group, autologous products were available. For the infants born between 30 and 32 weeks, autologous products were available for 36 percent of the infants. Transfusion needs in this group were, however, much lower (19%) compared to the other gestational groups.


CONCLUSIONS
Autologous RBCs derived from UCB could not replace 50 percent of allogeneic transfusions due to the low UCB volumes collected and subsequent low product availability.
Department of Research and Development, Sanquin Blood Bank, Southwest Division, Leiden, The Netherlands. c.khodabux@sanquin.nl
Chantal M
CM
Khodabux
Jeannette S
JS
von Lindern
Joost A
JA
van Hilten
Sicco
S
Scherjon
Frans J
FJ
Walther
Anneke
A
Brand
D000740:Anemia / Q000097:blood / Q000628:therapy*; D001804:Blood Transfusion, Autologous / Q000191:economics / Q000379:methods*; D001810:Blood Volume; D017707:Erythrocyte Transfusion / Q000191:economics / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005312:Fetal Blood; D005865:Gestational Age; D017048:Health Care Costs; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011247:Pregnancy; D016896:Treatment Outcome