Centre for Geographic Medicine Research, Kenya Medical Research Institute, Kenya.
Transfusion. 2012 Jul;52(7):1542-51. doi: 10.1111/j.1537-2995.2011.03487.x. Epub 2011 Dec 21.
Severe anemia requiring blood transfusion is common in hospitalized young children in sub-Saharan Africa but blood is often in short supply. Umbilical cord blood may be a useful source of blood if microbiologic safety concerns can be addressed.
Cord blood, donated on the labor ward at the provincial hospital in Mombasa, was cultured soon after collection (screening culture) and after a period of storage (poststorage culture). Conventional blood transfused to children at the hospital was cultured only at the time of issue (poststorage culture). Maternal sera (cord blood) and conventional blood donations were also screened for transfusion-transmitted infection.
At poststorage culture, the overall contamination rate of cord blood was one-third that of conventional blood (13/449 vs. 38/434; odds ratio [OR], 0.31; 95% confidence interval [CI], 0.15-0.61) and for bacteria of high pathogenic potential it was half that of conventional blood (4/449 vs. 7/434; OR, 0.55; 95% CI, 0.12-2.18). Screening cultures were positive in 50% (2/4) of cord blood packs where an organism of high pathogenic potential was isolated at poststorage culture. Cord blood donors had a lower seroreactivity than conventional donors for human immunodeficiency virus (OR, 0.63; 95% CI, 0.29-1.18), hepatitis B virus (OR, 0.32; 95% CI, 0.16-0.59), and hepatitis C virus (OR, 0.20; 95% CI, 0.24-0.76). For syphilis, initial seroreactivity in cord blood donors was 3.8% compared to 1.8% in conventional blood donors (OR, 2.10; 95% CI, 1.15-3.60) but was 0.5% after retesting.
With respect to bacterial contamination and seroreactivity for transfusion-transmitted infection, the safety of cord blood in Mombasa compares favorably with conventional blood. Clinical trials of cord blood transfusion are justified.
在撒哈拉以南非洲的住院幼儿中，严重贫血需要输血是很常见的，但血液往往供应不足。如果能够解决微生物安全问题，脐带血可能是血液的一个有用来源。
在蒙巴萨省医院的产房收集脐带血后，立即进行培养（筛选培养），并在储存一段时间后进行培养（储存后培养）。医院常规输注的血液仅在发放时进行培养（储存后培养）。还对产妇血清（脐带血）和常规献血进行了输血传播感染的筛查。
储存后培养时，脐带血的整体污染率是常规血的三分之一（13/449 比 38/434；比值比 [OR]，0.31；95%置信区间 [CI]，0.15-0.61），高致病性细菌的污染率是常规血的一半（4/449 比 7/434；OR，0.55；95% CI，0.12-2.18）。储存后培养中分离出高致病性病原体的 4 份脐带血中有 2 份（50%）筛选培养阳性。与常规献血者相比，脐带血献血者的人类免疫缺陷病毒（OR，0.63；95% CI，0.29-1.18）、乙型肝炎病毒（OR，0.32；95% CI，0.16-0.59）和丙型肝炎病毒（OR，0.20；95% CI，0.24-0.76）的血清反应性较低。对于梅毒，脐带血献血者的初次血清反应性为 3.8%，而常规血液献血者为 1.8%（OR，2.10；95% CI，1.15-3.60），但再次检测时为 0.5%。
就细菌污染和输血传播感染的血清反应性而言，蒙巴萨的脐带血安全性优于常规血。脐带血输血的临床试验是合理的。
