Abstract
Background and aims: To compare the in-vivo efficacy and safety of red cell(RC) concentrates derived from cord blood and banked adult blood in very low-birth-weight premature newborns.
Methods: A prospective, randomized, blind-controlled study was conducted between March 2008-September 2009. Thirty-nine premature born before 32nd gestation weeks(GW) and/or with birth weight less than 1500g were included. RC concentrate bags were prepared from the cord blood, labelled and stored in blood bank. Premature infants requiring blood transfusion were randomly assigned to an autologous or allogeneic product. If an autologous source had been consumed, allogeneic product was used. When patients were discharged, transfusion types were resumed. Two randomized groups were compared on the 14, 28, 35th days and >35 days with respect to hemoglobin levels, transfusion numbers, transfusion and phlebotomy volumes, and to hemoglobin, reticulocyte counts and erythropoietin levels in the postnatal 36th and 40th GW.
Results: Among 39 newborns, 16 received autologous transfusion(Group-1), 15 received allogeneic transfusion(Group-2) and 8 did not receive any transfusion(Group-3). Group-3 had higher birth weight and gestational week(p< 0.05), and RDS, clinical sepsis doubt and phlebotomy volumes were less(p< 0.05). The reticulocyte counts and erythropoietin levels in the postnatal 36th and 40th GW were lower in Group-1(p< 0.05). The other variables did not differ between Group-1 and 2. The autologous source decreased allogeneic transfusion 28% in Group-1.
Conclusions: Autologous cord blood had the same efficacy and safety with RC concentrates derived from banked adult blood. Careful monitorization of phelobotomy losses, implementing more restrictive transfusion guidelines may increase the efficacy of autologous cord blood.
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Altaş, B., Arsan, S., Okulu, E. et al. 295 Evaluation of the Efficacy and Safety of Autologous Cord Blood Transfusions in Very Low-Birth-Weight Premature Newborns. Pediatr Res 68 (Suppl 1), 152 (2010). https://doi.org/10.1203/00006450-201011001-00295
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DOI: https://doi.org/10.1203/00006450-201011001-00295
