Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.
Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy.
Blood Transfus. 2021 Sep;19(5):435-444. doi: 10.2450/2020.0138-20. Epub 2020 Nov 3.
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.
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.
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.
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.
对于新生儿和早产儿等需要输注小剂量血液的患者，使用脐血来源的红细胞似乎是可行的。然而，脐血红细胞的分离和质量控制参数的鉴定与评估仍有待标准化。
我们描述了为输血目的从脐血中获得红细胞的过程，包括用于评估分离性能和储存效果的质量控制。在分离当天以及 7 天和 14 天（储存结束时），向添加 SAG-M 的脐血红细胞中添加 SAG-M，并采样以测量全血细胞计数、生化参数和残留白细胞。我们还评估了微生物污染情况。
共评估了 279 个脐血单位的数据。采集时的中位胎龄为 40 周（四分位间距[IQR]39.1-40.7），中位体积为 90 毫升（IQR81-103）。使用 Compomat 进行自动分离，将浓缩的红细胞悬浮在 SAG-M 溶液中。SAG-M 悬浮单位的中位体积为 31 毫升（IQR24.0-38.1），中位红细胞压积为 54.2%（IQR49.4-59.5）。经白细胞减少处理后的中位体积为 22 毫升（IQR17-28），在处理前（n=75）或处理后（n=204）储存的单位中，体积减少情况相似。白细胞减少单位的红细胞压积高于去白细胞单位。在 2-6°C 下储存 14 天会导致钾水平和溶血百分比增加。采集的单位中，有 2.9%的微生物培养呈阳性。
整个脐血的分离可以提供与成人来源的单位具有相似基线特征的红细胞浓缩物。尽管采集体积变化很大，但单位的输血剂量和质量似乎安全且适合新生儿临床使用，具有令人满意的红细胞压积和残留白细胞含量。
