Maria Bianchi1, Nicoletta Orlando2, Ombretta Barbagallo1, Sabrina Sparnacci1, Caterina Giovanna Valentini1, Brigida Carducci3, Luciana Teofili1,2. 1. Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy. 2. Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy. 3. Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
Abstract
BACKGROUND: For neonates and preterm infants, in whom a transfusion dose is low, the use of red blood cells (RBC) from cord blood appears to be feasible. Standardisation of fractionation and identification and assessment of quality control parameters for such RBC are still lacking. MATERIALS AND METHODS: We describe the process used to obtain RBC from cord blood for transfusion purposes, including quality controls to evaluate fractionation performance and the effects of storage. The cord RBC, to which SAG-M was added, were sampled on the day of fractionation, and 7 and 14 days (end of storage) later in order to measure the complete blood count, biochemical parameters and residual white blood cells. We also assessed microbial contamination. RESULTS: Data relative to 279 cord blood units were evaluated. The median gestational age at collection was 40 weeks (interquartile range [IQR] 39.1-40.7) and the median volume was 90 mL (IQR 81-103). Units were subjected to automated fractionation with Compomat, and packed RBC were suspended in SAG-M solution. The median volume of the SAG-M-suspended units was 31 mL (IQR 24.0-38.1) and the median haematocrit was 54.2% (IQR 49.4-59.5). The median volume after leukoreduction was 22 mL (IQR 17-28), with the volume decrease being similar in units leukoreduced before (n=75) or after (n=204) storage. The haematocrit of leukoreduced units was higher than that of buffy coat-depleted units. Storage at 2-6 °C for 14 days was accompanied by an increase of potassium levels and percentage of haemolysis. Microbial cultures were positive for 2.9% of the collected units. DISCUSSION: Fractionation of whole cord blood can provide RBC concentrates with similar baseline characteristics as units from adults. The transfusion dose and quality of the units appear safe and suitable for clinical use in neonates, with a satisfactory haematocrit and residual white blood cell content, despite a very variable collection volume.
BACKGROUND: For neonates and preterm infants, in whom a transfusion dose is low, the use of red blood cells (RBC) from cord blood appears to be feasible. Standardisation of fractionation and identification and assessment of quality control parameters for such RBC are still lacking. MATERIALS AND METHODS: We describe the process used to obtain RBC from cord blood for transfusion purposes, including quality controls to evaluate fractionation performance and the effects of storage. The cord RBC, to which SAG-M was added, were sampled on the day of fractionation, and 7 and 14 days (end of storage) later in order to measure the complete blood count, biochemical parameters and residual white blood cells. We also assessed microbial contamination. RESULTS: Data relative to 279 cord blood units were evaluated. The median gestational age at collection was 40 weeks (interquartile range [IQR] 39.1-40.7) and the median volume was 90 mL (IQR 81-103). Units were subjected to automated fractionation with Compomat, and packed RBC were suspended in SAG-M solution. The median volume of the SAG-M-suspended units was 31 mL (IQR 24.0-38.1) and the median haematocrit was 54.2% (IQR 49.4-59.5). The median volume after leukoreduction was 22 mL (IQR 17-28), with the volume decrease being similar in units leukoreduced before (n=75) or after (n=204) storage. The haematocrit of leukoreduced units was higher than that of buffy coat-depleted units. Storage at 2-6 °C for 14 days was accompanied by an increase of potassium levels and percentage of haemolysis. Microbial cultures were positive for 2.9% of the collected units. DISCUSSION: Fractionation of whole cord blood can provide RBC concentrates with similar baseline characteristics as units from adults. The transfusion dose and quality of the units appear safe and suitable for clinical use in neonates, with a satisfactory haematocrit and residual white blood cell content, despite a very variable collection volume.
Authors: Marie E Steiner; Paul M Ness; Susan F Assmann; Darrell J Triulzi; Steven R Sloan; Meghan Delaney; Suzanne Granger; Elliott Bennett-Guerrero; Morris A Blajchman; Vincent Scavo; Jeffrey L Carson; Jerrold H Levy; Glenn Whitman; Pamela D'Andrea; Shelley Pulkrabek; Thomas L Ortel; Larissa Bornikova; Thomas Raife; Kathleen E Puca; Richard M Kaufman; Gregory A Nuttall; Pampee P Young; Samuel Youssef; Richard Engelman; Philip E Greilich; Ronald Miles; Cassandra D Josephson; Arthur Bracey; Rhonda Cooke; Jeffrey McCullough; Robert Hunsaker; Lynne Uhl; Janice G McFarland; Yara Park; Melissa M Cushing; Charles T Klodell; Ravindra Karanam; Pamela R Roberts; Cornelius Dyke; Eldad A Hod; Christopher P Stowell Journal: N Engl J Med Date: 2015-04-09 Impact factor: 91.245
Authors: M Kotowski; Z Litwinska; P Klos; E Pius-Sadowska; E Zagrodnik-Ulan; P Ustianowski; J Rudnicki; B Machalinski Journal: J Physiol Pharmacol Date: 2017-12 Impact factor: 3.011
Authors: A Ballin; E Arbel; G Kenet; M Berar; D Kohelet; A Tanay; H Zakut; D Meytes Journal: Arch Dis Child Fetal Neonatal Ed Date: 1995-11 Impact factor: 5.747