Banked term umbilical cord blood to meet the packed red blood cell transfusion needs of extremely-low-gestational-age neonates: A feasibility analysis

Abstract

OBJECTIVES: To assess the feasibility of drawing, processing, safety-testing, and banking term umbilical cord blood to meet the packed red blood cell transfusion (RBC Tx) needs of extremely-low-gestational-age neonates (ELGANs). DESIGN: 1) Retrospectively analyze all ELGANs RBC Tx over the past three years, 2) Estimate local cord blood availability, 3) Assess interest in this project, and implementation barriers, through stakeholder surveys. RESULTS: In three years we cared for 266 ELGANs; 165 (62%) received ≥1 RBC Tx. Annual RBC Tx averaged 197 (95% CI, 152 - 243). If 10% of our 10,353 annual term births had cord blood drawn and processed, and half of those tested were acceptable for Tx, collections would exceed the 95th % upper estimate for need by >four-fold. Interest exceeded 97%. Identified barriers included FDA approval, training to collect cord blood, and cost. CONCLUSION: RBC Tx needs of ELGANS could be met by local cord blood collection.