Cord blood as a source of autologous RBCs for transfusion to preterm infants

BACKGROUND: This prospective study was conducted to gain experience as to w hether it is technically possible to produce autologous RBCs in additive so lution from cord blood (CB), to optimize the blood supply for preterm infan ts. STUDY DESIGN AND METHODS: CB was collected from 47 infants with a mean (+/- SD) birth weight of 1717 (+/- 699) g. Whenever possible, RBC components we re prepared by standard centrifugation using a six-bag system. Ail samples were put in sterility testing quarantine for 5 days, and a maximum storage of 14 days from collection to transfusion was specified. The babies were gi ven either the autologous RBCs or standard allogeneic RBC concentrates, ii autologous blood was not available. RESULTS: In 81 percent of the samples, autologous RBC components could be p rocessed (vol, 7-87 mt; Hct, 31-82%). But within the group of extremely low birth weight infants (body weight <1000 g), a mean CB net volume of only 3 7 mt was collected, and the RBC preparation was successful only in exceptio nal cases. Three CB samples (8.6%) tested positive in sterility testing. Of the 47 infants, 21 were treated with a total of 62 allogeneic and 4 autolo gous RBC transfusions. Most infants with a body weight over 1400 g did not need any RBC transfusion. CONCLUSION: The preparation of autologous RBCs from the CB of preterm infan ts is technically possible in principle. However, major concerns must be ra ised as to whether such preparations are of benefit in ensuring safe care o f neonates with blood components, with respect to the high rate of bacteria l contamination and the limited availability in babies with low birth weigh t.