Banked term umbilical cord blood to meet the packed red blood cell transfusion needs of extremely-low-gestational-age neonates: a feasibility analysis

Abstract

Objectives

To assess the feasibility of drawing, processing, safety-testing, and banking term umbilical cord blood to meet the packed red blood cell transfusion (RBC Tx) needs of extremely-low-gestational-age neonates (ELGANs).

Design

(1) Retrospectively analyze all ELGANs RBC Tx over the past three years, (2) Estimate local cord blood availability, (3) Assess interest in this project, and implementation barriers, through stakeholder surveys.

Results

In three years we cared for 266 ELGANs; 165 (62%) received ≥1 RBC Tx. Annual RBC Tx averaged 197 (95% CI, 152–243). If 10% of our 10,353 annual term births had cord blood drawn and processed, and half of those tested were acceptable for Tx, collections would exceed the 95th % upper estimate for need by >four-fold. Interest exceeded 97%. Identified barriers included FDA approval, training to collect cord blood, and cost.

Conclusion

RBC Tx needs of ELGANS could be met by local cord blood collection.

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Acknowledgements

The authors thank Dr. Luciana Teofili, Transfusion Medicine, and Dr. Giovanni Vento, Neonatology, Fondazione Policlinico Universitario A. Gemelli-Universita Cattolica del Sacro Cuore, Rome, Italy, Dr. Genny Raffaeli, Neonatology, Granada Ospedale Maggiore Policlinico, Milan, Italy, and Dr. Patrick D. Carroll, St. George Regional Hospital, for helpful discussions and manuscript review. We also thank Lindsey C. Carlson and Ashley Krueger of Intermountain Health Women and Newborns Research for their assistance with the survey and Jeni Walker, University of Utah Neonatology, for the illustration.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA

    Robert D. Christensen, Timothy M. Bahr & Robin K. Ohls

  2. Obstetric and Neonatal Operations, Intermountain Health, Murray, UT, USA

    Robert D. Christensen, Timothy M. Bahr, Jake Krong, Lindsey C. Carlton, Erick Henry, Mark J. Sheffield & Erick Gerday

  3. Clinical Research, Intermountain Health, Murray, UT, USA

    Robert D. Christensen, Timothy M. Bahr, Thomas R. Christensen, Jake Krong & Lindsey C. Carlton

  4. Transfusion Services and Department of Pathology, Intermountain Health, Murray, UT, USA

    Sarah J. Ilstrup

  5. American National Red Cross, Salt Lake City, UT, USA

    Walter E. Kelley

  6. Department of Pathology, University of Arizona College of Medicine, Tucson, AZ, USA

    Walter E. Kelley

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Contributions

RDC and TMB conceived the project. TRC, RKO, JK, LCC, EH, MJS, EG Assisted with data acquisition and analysis. RDC authored the initial draft of the manuscript. All authors reviewed and revised the manuscript, providing important content, and all authors approved the last version.

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Robert D. Christensen.

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The Institutional Review Board of Intermountain Health reviewed the protocol and determined the project was exempt from the need for individual informed consent.

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Christensen, R.D., Bahr, T.M., Christensen, T.R. et al. Banked term umbilical cord blood to meet the packed red blood cell transfusion needs of extremely-low-gestational-age neonates: a feasibility analysis.
J Perinatol (2023). https://doi.org/10.1038/s41372-023-01833-y

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  • Received: 25 September 2023

  • Revised: 06 November 2023

  • Accepted: 15 November 2023

  • Published: 29 November 2023

  • DOI: https://doi.org/10.1038/s41372-023-01833-y

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