Feasibility of collecting, processing and storing umbilical whole cord blood as a source for neonatal red blood cell transfusions (Whole-Cord).

BACKGROUND AND

OBJECTIVE

The recent BORN trial showed that the transfusion of red blood cells collected from umbilical cord blood (UCB; rich in HbF), represents a physiologically safe option. This study evaluated the feasibility of collecting and storing UCB as whole blood and assessed the hematological and biochemical changes over storage.

MATERIALS AND

METHODS

In this prospective in-vitro study, UCB was collected from term vaginal deliveries (in utero) after 1-minute delayed cord clamping using CPD bags and stored at 2-6°C for 14 days. Volume collected, HbF levels, plasma hemoglobin, supernatant potassium, and sterility (aerobic/anaerobic culture) were evaluated on Day 0 and Day 14 of storage. These parameters were compared with the changes in the adult donor red cell units (routine inventory) with similar storage.

RESULTS

20 cord collections yielded a volume collected of 46.5 ± 13.8 mL. UCB volume showed a non-significant decreasing trend with increasing gravida (p = 0.48). Mean HbF (day 0) was 70.5 ± 5.3% and remained stable. Plasma-free hemoglobin remained stable during storage (p = 0.63). Potassium increased significantly during storage (5.8 ± 2.7-16.3 ± 2.7 mmol/L; p < 0.001) but remained significantly lower than adult red cell units at Day 14 (38.4 ± 4.4 mmol/L; p < 0.001). Two (10%) demonstrated bacterial growth on Day 14 culture.

CONCLUSION

We report that the UCB (whole) can be safely collected and stored for up to 14 days with acceptable hematological and biochemical changes for transfusion. However, further validation of component preparation, modification and optimization protocols is required for regulatory approvals to use UCB for neonatal transfusions in India.