A Preliminary Clinical Report of 183 Units of Placental Umbilical Cord Whole Blood Transfusion in HIV-Positive Patients with Anemia and Emaciation

Abstract

Cord blood, because of its rich mix of fetal and adult hemoglobin, high platelet and white blood cell counts, and a plasma filled with cytokine and growth factors, as well as its hypoantigenic nature and altered metabolic profile, has all the potential of a real and safe alternative to adult blood transfusion. Our team's experience (from April 1, 1999 to date) with 183 units of placental umbilical cord whole blood (72‐150 ml, mean 85 ml ± 8.8 ml SD, median 86 ml, mean packed cell volume 48.8 ± 5.2 SD, mean percentage hemoglobin concentration 17.3 g/dl ± 2.6 g/dl SD; after collection the blood was immediately preserved in a refrigerator and transfused within 72 hours of collection) collected after lower uterine cesarean section, and the transfusion to 46 consenting HIV‐positive patients (16 with a diagnosis of AIDS) with anemia and emaciation is presented here. On the basis of our preliminary experience of cord blood transfusion, we believe that umbilical cord whole blood transfusion is safe in HIV‐positive patients. This blood has the potential to carry more oxygen than adult blood due to its high fetal hemoglobin content, and it does not trigger any clinical, immunological, or nonimmunological reaction after its transfusion to an adult host with a HIV‐positive status. Apart from the correction of anemia, there was also definite improvement in the energy and fatigue levels in individuals with HIV, i.e., physical functioning, a sense of well‐being, and weight gain from 2‐5 pounds, within 3‐10 months of the commencement of transfusion. There was also an immediate rise in CD34 levels of peripheral blood in the HLA‐randomized host after transfusion, without any clinical graft‐versus‐host disease reaction. The structural and functional integrity of the placental barrier and its screening ability of the maternal infection is an added advantage with this fetal blood transfusion in adult patients.