The safety and efficacy of packed cord red blood cell transfusion for severe anaemia in children in a Kenyan hospital
Blood transfusion services in sub-Saharan Africa continue to struggle to provide adequate quantities of safe blood. Umbilical cord blood, which is usually discarded, is a potential but untested source of blood for transfusion in young children with severe anaemia. In previous studies we have demonstrated the feasibility and microbiological safety of cord blood collection at Coast Provincial General Hospital in Mombasa. Worldwide, there is little experience of allogeneic cord blood transfusion in young children and no experience in Africa. This describes a study in which transfused sedimented* cord red blood cells to closely observed children with severe anaemia. The attached protocol describes a study to provide safety and efficacy data, which will informed the justification for, and design of, a randomised controlled trial of packed cord red blood cell transfusion and adult-donated whole blood. The outcomes of this study are currently in press.
Cord blood was donated at Coast Provincial General Hospital and red cells were produced by sedimentation during refrigerated storage. Children with severe anaemia but without signs of critical illness were recruited at Kilifi District Hospital and received a maximum of two group identical/compatible cord blood units. The primary outcome measure was the frequency and nature of adverse reactions associated with the transfusion and the secondary outcome measures were change in haemoglobin at 24 hours and one month after transfusion. This study has been completed. (Trial registration:ISRCTN66687527)
*in the attached protocol this is referred to as packed cord red blood cells
Please click on the links below to access the study protocol, and the case record forms used for data collection.