Placental umbilical cord blood transfusion: A novel method of treatment of patients with malaria in the background of anemia.

Malaria is an annual killer of over one million people globally and its essential co-morbidity is anemia. Cord blood, because of its rich mix of fetal and adult hemoglobin, high platelet and WBC counts, hypo-antigenic nature, altered metabolic profile, high affinity for oxygen and the antimalarial effect of cord blood, is an ideal choice in case of malaria with anemia necessitating blood transfusion. This article presents our experience with 94 units of placental umbilical cord whole blood (52 ml-143 ml, mean 81 ml +/- 6.6 ml SD, median 82 ml, mean packed cell volume 48.9 +/- 4.1 SD, mean percent hemoglobin concentration 16.4 g/dl +/- 1.6 g/dl SD; after collection the blood was immediately preserved in the refrigerator and transfused within 72 hours of collection). It was collected after lower uterine cesarean section (LUCS) from consenting mothers (from 1 April 1999 to April 2005) and transfused to 39 informed, consenting patients (24 males + 15 females, aged 8-72 yrs, mean 39.4 yrs). Twenty-two patients were infected with Plasmodium falciparum and 17 had plasmodium vivax infection. For inclusion in this study, the patient's percent plasma hemoglobin had to be 8 g/dl or less (the pretransfusion hemoglobin in malaria-infected patients in this series varied from 5.4 g/dl to 7.9 g/dl). The rise of hemoglobin within 72 hours after two units of freshly collected cord blood transfusion was .5 g/dl to 1.6 g/dl. Each patient received two to six units of freshly collected cord blood transfusion (two units at a time), depending on availability and compatibility. No clinical, immunological or non-immunological reactions have been encountered so far.