Usefulness of cord-blood harvesting for autologous transfusion in surgicalnewborns with antenatal diagnosis of congenital anomalies

Background/Purpose: The risks of homologous transfusion and the effectivene ss of predeposit autologous transfusion have been described. The authors ex amined the clinical usefulness of cord-blood harvesting for autologous tran sfusion in newborns who had congenital anomalies antenatally diagnosed that would require surgical intervention at or near the time of delivery. Methods: Of 112 cases of antenatal diagnosis of congenital anomalies, 50 mo thers gave informed consent and enrolled in this study. Cord-blood was with drawn immediately after clamping of the umbilical cord and was used for aut ologous transfusion in newborns within the first 3 days postpartum. Results: A mean of 72 +/- 54 mt of cord-blood was harvested (27 +/- 18 mL/k g). While preserving cord-blood for 3 days at 4 degreesC, no signs of clot formation or hemolysis were observed. The harvested cord-blood included pla sma-free Hb ranging from 1 to 68 (13 +/- 18) mg/dL and thrombin-antithrombi n III complex ranging from 2 to 273 (18 +/- 50) ng/mL. Bacteriologic examin ation of the stored cord-blood showed negative cultures, except for samples from 3 newborns after vaginal delivery. A mean of 46 +/- 34 mt of cord-blo od was used in 26 patients for autologous transfusion. No significant compl ications related to cord-blood transfusion were recognized clinically. Conclusions: Autologous cord-blood transfusion has the potential to be a us eful alternative to homologous transfusion in newborns requiring surgery. A dequate collection and storage techniques for cord-blood must be developed. J Pediatr Surg 36:851-854. Copyright (C) 2001 by W.B. Saunders Company.