title: Arterial switch operation in the first hours of life using autologous umbilical cord blood.
abstract: BACKGROUND
  In this study, we analyzed our clinical experience performing the arterial switch operation in the first hours of life using autologous umbilical cord blood transfusion (AUCBT). The safety and efficiency of AUCBT was assessed and compared with surgery with the use of homologous blood transfusion.
  
  
  METHODS
  Between September 2009 and February 2011, 61 neonates underwent ASO at our institution. Patients were enrolled and allocated to two groups with different modalities of management strategies for neonates with dextrotransposition of the great arteries.
  
  
  RESULTS
  The groups were similar in diagnoses, birth weight, cardiopulmonary bypass protocol, and surgical technique, excepting timing of surgery and blood management strategy. Preoperative mean hematocrit did not differ significantly between the groups (45% versus 45%). Mean hematocrit was significantly lower in the study group than in the control group during cardiopulmonary bypass (24% versus 31%). The hematocrit progressively increased in the study group to 38% on the first postoperative day. Serum lactate levels were higher in the study group till the second day after surgery. There were no significant differences in postoperative clinical profiles. There were no hospital deaths and no AUCBT-related side effects in our study.
  
  
  CONCLUSIONS
  The arterial switch operation can be performed in the first hours of life with AUCBT. Therefore, AUCBT is a safe and an efficient alternative to homologous blood in neonatal open heart surgery. During the study, we also identified positive economic effects associated with this approach.
authors.affiliation: Department of Perfusiology, Ukrainian Children's Cardiac Center, Kyiv, Ukraine. kchasovskiy82@gmail.com
authors.forename: Kyrylo
authors.initials: K
authors.lastname: Chasovskyi
authors.forename: Oleg
authors.initials: O
authors.lastname: Fedevych
authors.forename: Ganna
authors.initials: G
authors.lastname: Vorobiova
authors.forename: Volodymyr
authors.initials: V
authors.lastname: Zhovnir
authors.forename: Andriy
authors.initials: A
authors.lastname: Maksimenko
authors.forename: Olena
authors.initials: O
authors.lastname: Boychenko
authors.forename: Yuriy
authors.initials: Y
authors.lastname: Lysak
authors.forename: Gordon
authors.initials: G
authors.lastname: Cohen
authors.forename: Illya
authors.initials: I
authors.lastname: Yemets
mesh_terms: D001803:Blood Transfusion / Q000379:methods; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005312:Fetal Blood / Q000637:transplantation*; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D061214:Patient Safety; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014188:Transposition of Great Vessels / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome