Placental umbilical cord whole blood transfusion: a safe and genuine blood substitute for patients of the under-resourced world at emergency

BACKGROUND: Afterbirth or placenta is normally discarded. But placental cord blood, because of its rich mix of fetal and adult hemoglobin, plasma, and high platelet count has the potential to be a safe alternative to adult blood. STUDY DESIGN: We transfused 413 U (range 50 mL to 146 mL; mean 86 mL +/- 7.6 mL SD; median 80 mL; mean packed cell volume 48 +/- 4.1% SD; mean hemoglobin concentration 16.2 g/dL +/- 1.8 g/dL SD) of placental umbilical cord whole blood, after lower uterine cesarean section from consenting mothers, to 129 informed consenting patients, after screening by the institutional ethics committee, from April 1, 1999, until the present. RESULTS: The list of consenting patients included 54 men and 75 women. Patient age varied from 2 years to 86 years. Seventy-three patients (56.58%) suffered from advanced cancer and 56 (43.42%) patients had other diseases like ankylosing spondylitis, lupus erythematosus, rheumatoid arthritis, aplastic anemia, and thalassemia major. We have not encountered a single case of immunologic or nonimmunologic reaction so far. CONCLUSIONS: We suggest that medical institutions could use this gift of nature, which is free from infection, hypoantigenic with altered metabolic profile, filled with growth factor and cytokine-filled plasma, with the potential of higher oxygen-carrying capacity than adult blood, as an emergency source of blood for the management of disaster or crises anywhere in the world. It also may be safely used for the treatment of malignant and nonmalignant disorders. (c) 2005 by the American College of Surgeons.