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

Abstract

Background/Purpose: The risks of homologous transfusion and the effectiveness of predeposit autologous transfusion have been described. The authors examined the clinical usefulness of cord-blood harvesting for autologous transfusion 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 mothers gave informed consent and enrolled in this study. Cord-blood was withdrawn immediately after clamping of the umbilical cord and was used for autologous transfusion in newborns within the first 3 days postpartum. Results: A mean of 72 ± 54 mL of cord-blood was harvested (27 ± 18 mL/kg). While preserving cord-blood for 3 days at 4°C, no signs of clot formation or hemolysis were observed. The harvested cord-blood included plasma-free Hb ranging from 1 to 68 (13 ± 18) mg/dL and thrombin-antithrombin III complex ranging from 2 to 273 (18 ± 50) ng/mL. Bacteriologic examination of the stored cord-blood showed negative cultures, except for samples from 3 newborns after vaginal delivery. A mean of 46 ± 34 mL of cord-blood was used in 26 patients for autologous transfusion. No significant complications related to cord-blood transfusion were recognized clinically. Conclusions: Autologous cord-blood transfusion has the potential to be a useful alternative to homologous transfusion in newborns requiring surgery. Adequate collection and storage techniques for cord-blood must be developed. J Pediatr Surg 36:851-854. Copyright © 2001 by W.B. Saunders Company.