Abstrakt

Placental Umbilical Cord Whole Blood Transfusion in an Emergency When the Hemoglobin Concentration Is Less Than 8gm Percent in Pediatric to the Geriatric Age Group From 1999

Niranjan Bhattacharya

We conducted over 1260 cord blood transfusions in consented volunteers with anemic (Hemoglobin less than 8gm/100ml) from 1999 till date in children and adults for various indications of transfusion-caused by Cancer to Malaria, Leprosy, HIV, Rheumatoid arthritis, Tuberculosis, Thalassaemia only to name a few. Not a single case of immediate or delayed graft vs host or other immunological or nonimmunological reaction was noted in any of the patients. Stem cells (0.01% nucleated cells) is used for stem cell transplantation purposes only, while the rest, i.e., 99.99% is discarded. But the discarded part has many potential uses in resource-restricted countries for transfusion purposes, after due screening for the transfusion-transmitted diseases like HIV (1&2) or Hepatitis B/C etc. Cord blood is practically unfastened from infection because of the structural or functional integrity of the placental barrier up to 34-35 weeks. This makes the fetal blood practically free from infection other than its intrinsic hypo antigenicity in nature, an altered metabolic profile and, is enriched with growth factors and inflammatory and noninflammatory cytokine stuffed plasma. This blood with 60-70 percentage fetal hemoglobin content which has the potentiality to carry as a minimum 60 percent extra oxygen than grownup and its use can be extremely beneficial in case of tried revival after cardiac arrest. The placental vessel at time period contains approximately 150ml of twine blood. Cord blood carries three types of hemoglobin, HbF (important fraction), HbA (15-40%) and HbA2 (hint amounts). HbF, that's the primary component, has a greater oxygen binding affinity than HbA. The blood volume of a fetus at time period is around 80-85ml/kg.

Keywords: Umbilical Cord Blood (UCB); transfusion; stem cell; cytokines and growth factor