Placental blood was harvested using a novel collection system into packs containing citrate-phosphate-dextroseadenine and then stored for 28 d. Before and during storage, sterility, adequacy of anticoagulation, blood chemistry, and red cell viability were assessed weekly. The average volume of blood collected was 65 mL (range 30-110 mL) with a 0.42 hemocrit once diluted in anticoagulant. All blood culture specimens were sterile at collection and during storage. In the United States, more than 40 000 VLBW infants are born each year, many of whom are critically ill and require care in neonatal intensive care facilities. The majority of these infants will require one or more homologous blood transfusions during the first month of life. These transfusions are given to replace losses due to diagnostic sampling and to treat the physiologic decline in H b concentration designated the anemia of prematurity (1-3). Studies have shown that VLBW infants will receive approximately 50 mL of blood per kg from as many as eight to 10 adult donors during the first month of life (1, 3, 4). However, recent data suggest that changes in transfusion practices for neonates may reduce donor exposure (5, 6). Although red cell transfusion is a valuable part of care, the use of adult donor blood poses risks for these infants including the transmission of viral agents such as non-A and non-B hepatitis, cytomegalovirus, and human immunodeficiency virus (1,7,8). Furthermore, graft versus host disease has been reported after homologous transfusions in neonates (8-1 1). were >90 s, presumably because of the decline in labile clotting factors after 24 h of storage. Hematocrit, red cell ATP, and red cell shape were maintained during storage. As expected, red cell 2,3-diphosphoglycerate declined and potassium levels rose significantly but were not different than levels reported for adult cells similarly preserved. Based on our results, it appears that placental blood represents a potential source of autologous transfusion for the sick neonate over the first month of life. (Pediatr Res 36: W94, 1994)

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