Document Detail


The microbiologic safety of umbilical cord blood transfusion for children with severe anemia in Mombasa, Kenya.
MedLine Citation:
PMID:  22221267     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: 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. STUDY DESIGN AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Authors:
Oliver W Hassall; Johnstone Thitiri; Greg Fegan; Lewa Pole; Salim Mwarumba; Douglas Denje; Kongo Wambua; Brett Lowe; Christopher M Parry; Kishor Mandaliya; Kathryn Maitland; Imelda Bates
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-21
Journal Detail:
Title:  Transfusion     Volume:  -     ISSN:  1537-2995     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-1-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 American Association of Blood Banks.
Affiliation:
From the Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya; the Department of Primary Health Care and the Centre for Clinical Vaccinology & Tropical Medicine, University of Oxford, Oxford, UK; the Coast Provincial General Hospital and the Regional Blood Transfusion Centre, Mombasa, Kenya; Angkor Hospital for Children, Mahidol-Oxford Tropical Medicine Research Unit, Siem Reap, Cambodia; the Department of Paediatrics, Imperial College London, London, UK; and the Liverpool School of Tropical Medicine, Liverpool, UK.
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