Umbilical cord blood (UCB) may be a viable transfusion option for patients with hemolytic disease of the fetus and newborn (HDFN), according to new research published recently in the Indian Journal of Hematology and Blood Transfusion.
This research confirmed UCB’s safety and quality immediately after birth. Scientists in South India found that cord blood closely matched adult blood in terms of key quality measures, and all samples remained sterile after two weeks of testing.
“This study was exclusively done to determine the quality parameters in UCB so that it can be substituted for adult allogenic red cells for transfusion purposes as well,” explained this study’s authors.
The prospective observational study analyzed 65 UCB units collected after normal vaginal deliveries. Researchers tested each unit for volume, clotting, hemolysis, potassium levels, blood counts, and sterility. Initial results showed no signs of hemolysis and potassium levels within the normal range, supporting the idea that UCB could be safely transfused shortly after collection.
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Importantly, the samples remained free of bacterial growth even after 14 days. Sterility testing was done using MacConkey agar, blood agar, and brain heart infusion liquid media. All UCB cultures remained negative at every time point, unlike adult blood samples tested during the same period, which showed contamination in 2 of 60 cases.
Hemoglobin levels, platelet counts and total leukocyte counts of the UCB were within acceptable ranges. Most UCB samples (86.2%) showed no clots. Blood group antigens were well expressed, with over 90% showing strong ABO and Rh typing, which is critical for compatibility in transfusions, especially in conditions such as HDFN.
“Our study has shown that in comparison of UCB and adult blood, there is no hemolysis, and neither potassium is high on day one, whereas both are significantly affected on day 30 after storage,” stated the authors. They continued, “However, large cohort studies may be required to validate our results.”
Though potassium and plasma hemoglobin levels rose over a 30-day storage period—suggesting degradation over time—the immediate post-birth quality remained high. On day one, nearly all potassium levels were below seven mmol/L, a standard marker of safety. By day 30, however, over 70% of the samples had either elevated potassium or contamination, underscoring the importance of early use.
For patients with HDFN, a condition where maternal antibodies attack fetal red blood cells, UCB may offer a safe, readily available transfusion source—if used promptly. This study adds to the growing evidence that cord blood, often discarded as medical waste, holds untapped potential in neonatal and transfusion medicine.
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