Khodabux Chantal M, von Lindern Jeannette S, van Hilten Joost A, Scherjon Sicco, Walther Frans J, Brand Anneke
Department of Research and Development, Sanquin Blood Bank, Southwest Division, Leiden, The Netherlands.
Transfusion. 2008 Aug;48(8):1634-43. doi: 10.1111/j.1537-2995.2008.01747.x. Epub 2008 May 23.
The objective was to investigate the use of autologous red blood cells (RBCs) derived from umbilical cord blood (UCB), as an alternative for allogeneic transfusions in premature infants admitted to a tertiary neonatal center.
UCB collection was performed at deliveries of less than 32 weeks of gestation and processed into autologous RBC products. Premature infants requiring a RBC transfusion were randomly assigned to an autologous or allogeneic product. The primary endpoint was an at least 50 percent reduction in allogeneic transfusion needs.
Fifty-seven percent of the collections harvested enough volume (> or =15 mL) for processing. After being processed, autologous products (> or =10 mL/kg) were available for 36 percent of the total study population and for 27 percent of the transfused infants and could cover 58 percent (range, 25%-100%) of the transfusion needs within the 21-day product shelf life. Availability of autologous products depended most on the gestational age. Infants born between 24 and 28 weeks had the lowest availability (17%). All products, however, would be useful in view of their high (87%) transfusion needs. Availability was highest (48%) for the infants born between 28 and 30 weeks. For 42 percent of the infants with transfusion needs in this group, autologous products were available. For the infants born between 30 and 32 weeks, autologous products were available for 36 percent of the infants. Transfusion needs in this group were, however, much lower (19%) compared to the other gestational groups.
Autologous RBCs derived from UCB could not replace 50 percent of allogeneic transfusions due to the low UCB volumes collected and subsequent low product availability.
目的是研究使用源自脐带血（UCB）的自体红细胞（RBC），作为三级新生儿中心收治的早产儿异体输血的替代方法。
在妊娠少于32周分娩时采集脐带血，并加工成自体红细胞制品。需要输注红细胞的早产儿被随机分配接受自体或异体制品。主要终点是异体输血需求至少减少50%。
57%的采集量足够（≥15 mL）用于加工。加工后，自体制品（≥10 mL/kg）可供36%的总研究人群和27%的接受输血的婴儿使用，并且在21天的制品保质期内可满足58%（范围25%-100%）的输血需求。自体制品的可获得性主要取决于胎龄。24至28周出生的婴儿可获得性最低（17%）。然而，鉴于他们的输血需求高（87%），所有制品都会有用。28至30周出生的婴儿可获得性最高（48%）。该组中42%有输血需求的婴儿可获得自体制品。对于30至32周出生的婴儿，36%的婴儿可获得自体制品。然而，该组的输血需求与其他胎龄组相比要低得多（19%）。
由于采集的脐带血体积少以及随后制品可获得性低，源自脐带血的自体红细胞不能替代50%的异体输血。
