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

Robert D Christensen; Timothy M Bahr; Thomas R Christensen; Robin K Ohls; Jake Krong; Lindsey C Carlton; Erick Henry; Mark J Sheffield; Erick Gerday; Sarah J Ilstrup; Walter E Kelley

doi:10.1038/s41372-023-01833-y

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. 2024 Jun;44(6):873-879. doi: 10.1038/s41372-023-01833-y. Epub 2023 Nov 29.

Authors

Robert D Christensen^{1

2

3}, Timothy M Bahr^{4

5

6}, Thomas R Christensen⁶, Robin K Ohls⁴, Jake Krong^{5

6}, Lindsey C Carlton^{5

6}, Erick Henry⁵, Mark J Sheffield⁵, Erick Gerday⁵, Sarah J Ilstrup⁷, Walter E Kelley^{8

9}

Affiliations

¹ Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA. [email protected].
² Obstetric and Neonatal Operations, Intermountain Health, Murray, UT, USA. [email protected].
³ Clinical Research, Intermountain Health, Murray, UT, USA. [email protected].
⁴ Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.
⁵ Obstetric and Neonatal Operations, Intermountain Health, Murray, UT, USA.
⁶ Clinical Research, Intermountain Health, Murray, UT, USA.
⁷ Transfusion Services and Department of Pathology, Intermountain Health, Murray, UT, USA.
⁸ American National Red Cross, Salt Lake City, UT, USA.
⁹ Department of Pathology, University of Arizona College of Medicine, Tucson, AZ, USA.

PMID: 38030793
DOI: 10.1038/s41372-023-01833-y

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.

MeSH terms

Blood Banks*
Erythrocyte Transfusion* / methods
Feasibility Studies*
Female
Fetal Blood*
Gestational Age
Humans
Infant, Newborn
Male
Retrospective Studies