Collection and 28-Day Storage of Human Placental Blood

Abstract

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)

Autologous Placental Blood Transfusion for the Therapy of Anaemic Neonates

“…Various studies have reported microbial contamination rates of between 0 and 9% [17,18,20,23,32]. More recent examination methods have revealed that iatrogenic bacterial contamination during blood removal deserves less attention than contamination caused by bacteraemia already existing in the newborn due to an amnion infection syndrome [31,32].…”

Comparison of the Bactec 9240 and BacT/Alert Blood Culture Systems for Evaluation of Placental Cord Blood for Transfusion in Neonates

“…Autologous blood transfusions have been shown to be safe in both adult and pediatric patients (17,21,25). Umbilical/placental cord blood is autologous blood from a neonate (20), and the use of autologous umbilical cord blood (UCB) has long been discussed among neonatologists (5,6,9,10,29). Owing to the increasing utilization of UCB for the transplantation of hematopoietic stem cells, significant progress has been made in developing safer and more efficient collection techniques for UCB (12,14).…”

Cord Blood Banking and Transplantation – Fetal, Maternal and Perinatal Issues

“…Even at cesarean section, intraoperative autologous blood collection and transfusion has shown to be a safe procedure [69]. Umbilical cord blood obtained at delivery after cord clamping has been suggested as a source of autologous blood for transfusion in neonates [70]. In preterm newborns, but also in term newborns with serious congenital conditions which have to be surgically corrected soon after birth (e.g.…”

“…Later, interest came up to collect and store cord blood for later autologous use [74]. Because concern arised [75] from studies with open syringetype collection systems revealing significant bacterial contamination in stored cord blood samples [76], recent studies used closed systems to collect cord blood into anticoagulantcontaining bags [70]; some autologous cord blood samples have been transfused in preterm neonates [77][78][79]. We ourselves performed a prospective study to determine the feasibility of cord blood collection for autologous transfusion in preterm neonates [80].…”