新生儿脐血输注的临床应用进展

韩玥,祝华平

中国当代儿科杂志 ›› 2025, Vol. 27 ›› Issue (4) : 487-492.

PDF(507 KB)
PDF(507 KB)
中国当代儿科杂志 ›› 2025, Vol. 27 ›› Issue (4) : 487-492. DOI: 10.7499/j.issn.1008-8830.2409146
综述

新生儿脐血输注的临床应用进展

  • 韩玥
作者信息 +

Progress in the clinical application of cord blood transfusion in neonates

  • HAN Yue
Author information +
文章历史 +

摘要

新生儿输血来源多为异体成人血。异体成人血虽然能够为新生儿提供及时有效的输血支持,但其血红蛋白类型和止血系统与新生儿存在差异,且有一定的感染风险。近年来,脐血输注在新生儿早期手术、贫血中的应用价值逐步凸显。研究表明,输注脐血不仅有助于降低早产儿并发症的发生率,还能为新生儿提供更安全的替代输血来源。然而,脐血输注仍未广泛应用。该文综述了新生儿脐血输注的优势、临床应用进展及意义,以期为脐血输注在临床实践中的广泛应用提供依据。

Abstract

The primary source of blood transfusions for neonates is allogeneic adult blood. While allogeneic adult blood can provide timely and effective transfusion support for neonates, there are differences in hemoglobin types and coagulation systems between adults and neonates, along with potential infection risks. In recent years, the clinical value of cord blood transfusion in early surgical interventions and anemia management for neonates has been increasingly recognized. Studies have shown that cord blood transfusion not only reduces the incidence of complications in preterm infants but also provides a safer alternative transfusion source for neonates. However, cord blood transfusion has not yet been widely adopted. This article reviews the advantages, clinical application progress, and significance of cord blood transfusion in neonates, to provide evidence supporting its broader clinical implementation.

关键词

脐血 / 输血 / 贫血 / 新生儿

Key words

Cord blood / Transfusion / Anemia / Neonate

引用本文

导出引用
韩玥,祝华平. 新生儿脐血输注的临床应用进展[J]. 中国当代儿科杂志. 2025, 27(4): 487-492 https://doi.org/10.7499/j.issn.1008-8830.2409146
HAN Yue,ZHU Hua-Ping. Progress in the clinical application of cord blood transfusion in neonates[J]. Chinese Journal of Contemporary Pediatrics. 2025, 27(4): 487-492 https://doi.org/10.7499/j.issn.1008-8830.2409146

参考文献

1 Villeneuve A, Arsenault V, Lacroix J, et al. Neonatal red blood cell transfusion[J]. Vox Sang, 2021, 116(4): 366-378. PMID: 33245826. DOI: 10.1111/vox.13036.
2 Bianchi M, Orlando N, Barbagallo O, et al. Allogeneic cord blood red blood cells: assessing cord blood unit fractionation and validation[J]. Blood Transfus, 2021, 19(5): 435-444. PMID: 33196415. PMCID: PMC8486608. DOI: 10.2450/2020.0138-20.
3 Barreto Henriksson H, Hellstr?m A, Hesse C, et al. Morphology and biological data in cord blood eryhtrocyte units resembles adult units after processing and storage: meets current quality recommendations[J]. Transfus Apher Sci, 2022, 61(3): 103356. PMID: 35058136. DOI: 10.1016/j.transci.2022.103356.
4 Fernandez A, Chasovskyi K. The use of umbilical cord blood for autologous transfusion in neonatal open heart surgery[J]. J Cardiothorac Vasc Anesth, 2020, 34(2): 483-488. PMID: 31151859. DOI: 10.1053/j.jvca.2019.05.007.
5 Chakrabarty P, Rudra S. Autologus or allogenic uses of umbilical cord blood whole or RBC transfusion: a review[J]. Mymensingh Med J, 2013, 22(1): 210-217. PMID: 23416835.
6 Rabe H, Mercer J, Erickson-Owens D. What does the evidence tell us? Revisiting optimal cord management at the time of birth[J]. Eur J Pediatr, 2022, 181(5): 1797-1807. PMID: 35112135. PMCID: PMC9056455. DOI: 10.1007/s00431-022-04395-x.
7 Jiao Y, Li XY, Liu J. A new approach to cerebral palsy treatment: discussion of the effective components of umbilical cord blood and its mechanisms of action[J]. Cell Transplant, 2019, 28(5): 497-509. PMID: 30384766. PMCID: PMC7103597. DOI: 10.1177/0963689718809658.
8 Liu J, Sun W, Liu C, et al. Umbilical cord blood-derived exosomes in maternal-fetal disease: a review[J]. Reprod Sci, 2023, 30(1): 54-61. PMID: 35157260. DOI: 10.1007/s43032-022-00879-1.
9 Arbell D, Bin-Nun A, Zugayar D, et al. Deformability of cord blood vs. newborns' red blood cells: implication for blood transfusion[J]. J Matern Fetal Neonatal Med, 2022, 35(17): 3270-3275. PMID: 33541145. DOI: 10.1080/14767058.2020.1818203.
10 Barshtein G, Pries AR, Goldschmidt N, et al. Deformability of transfused red blood cells is a potent determinant of transfusion-induced change in recipient's blood flow[J]. Microcirculation, 2016, 23(7): 479-486. PMID: 27406436. DOI: 10.1111/micc.12296.
11 Falck AJ, Medina AE, Cummins-Oman J, et al. Mercury, lead, and cadmium exposure via red blood cell transfusions in preterm infants[J]. Pediatr Res, 2020, 87(4): 677-682. PMID: 31649339. DOI: 10.1038/s41390-019-0635-x.
12 Fedevych O, Chasovskyi K, Vorobiova G, et al. Open cardiac surgery in the first hours of life using autologous umbilical cord blood[J]. Eur J Cardiothorac Surg, 2011, 40(4): 985-989. PMID: 21353580. DOI: 10.1016/j.ejcts.2011.01.011.
13 Sarin K, Chauhan S, Bisoi AK, et al. Use of autologous umbilical cord blood transfusion in neonates undergoing surgical correction of congenital cardiac defects: a pilot study[J]. Ann Card Anaesth, 2018, 21(3): 270-274. PMID: 30052213. PMCID: PMC6078044. DOI: 10.4103/aca.ACA_194_17.
14 Chasovskyi K, Mykychak Y, Rudenko N, et al. Five-year experience with arterial switch operation in the first hours of life[J]. Semin Thorac Cardiovasc Surg, 2017, 29(1): 70-76. PMID: 28684001. DOI: 10.1053/j.semtcvs.2017.01.011.
15 Chasovskyi K, Fedevych O, Vorobiova G, et al. Arterial switch operation in the first hours of life using autologous umbilical cord blood[J]. Ann Thorac Surg, 2012, 93(5): 1571-1576. PMID: 22459547. DOI: 10.1016/j.athoracsur.2012.01.104.
16 Neema PK. In response to "Use of autologous umbilical cord blood transfusion in neonates undergoing surgical correction of congenital cardiac defects: a pilot study"[J]. Ann Card Anaesth, 2018, 21(3): 275-276. PMID: 30052214. PMCID: PMC6078038. DOI: 10.4103/aca.ACA_103_18.
17 Taguchi T, Suita S, Nakamura M, et al. The efficacy of autologous cord-blood transfusions in neonatal surgical patients[J]. J Pediatr Surg, 2003, 38(4): 604-607. PMID: 12677575. DOI: 10.1053/jpsu.2003.50131.
18 Titkov KV. Autotransfusion of cord blood erythrocytes in newborns with malformations requiring early surgical intervention[J]. Anesteziol Reanimatol, 2014, 59(6): 38-43. PMID: 25831701.
19 Holzapfel LF, Rysavy MA, Bell EF. Red blood cell transfusion thresholds for anemia of prematurity[J]. Neoreviews, 2023, 24(6): e370-e376. PMID: 37258497. PMCID: PMC10865726. DOI: 10.1542/neo.24-6-e370.
20 Khodabux CM, von Lindern JS, van Hilten JA, et al. A clinical study on the feasibility of autologous cord blood transfusion for anemia of prematurity[J]. Transfusion, 2008, 48(8): 1634-1643. PMID: 18507748. DOI: 10.1111/j.1537-2995.2008.01747.x.
21 Yavuz BA, Okulu E, Arsan S, et al. Is autologous cord blood transfusion effective and safe in preterm infants?[J]. Turk J Pediatr, 2017, 59(3): 352-354. PMID: 29376587. DOI: 10.24953/turkjped.2017.03.022.
22 Reuther S, Floegel K, Ceusters G, et al. Contamination rate of cryopreserved umbilical cord blood is inversely correlated with volume of sample collected and is also dependent on delivery mode[J]. Stem Cells Transl Med, 2022, 11(6): 604-612. PMID: 35486383. PMCID: PMC9216499. DOI: 10.1093/stcltm/szac020.
23 Hare J, DeLeon PG, Pool K, et al. Optimal umbilical cord blood collection, processing and cryopreservation methods for sustained public cord blood banking[J]. Cytotherapy, 2021, 23(11): 1029-1035. PMID: 34247985. DOI: 10.1016/j.jcyt.2021.05.004.
24 Risso MA, Deffune E, Luzo ?CM. Using umbilical cord blood as a source of paediatric packed red blood cells: processing and quality control[J]. Vox Sang, 2023, 118(8): 637-646. PMID: 37278100. DOI: 10.1111/vox.13475.
25 Liang WB, Guo MH, Fan EY, et al. Erythrocyte concentrates recovered from under-collected whole blood: experimental and clinical results[J]. PLoS One, 2015, 10(2): e0117928. PMID: 25706725. PMCID: PMC4338272. DOI: 10.1371/journal.pone.0117928.
26 Kaufman DP, Khattar J, Lappin SL. Physiology, Fetal Hemoglobin[M]//StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2024.
27 Odom TL, Eubanks J, Redpath N, et al. Development of necrotizing enterocolitis after blood transfusion in very premature neonates[J]. World J Pediatr, 2023, 19(1): 68-75. PMID: 36227506. DOI: 10.1007/s12519-022-00627-0.
28 Bellach L, Eigenschink M, Hassanein A, et al. Packed red blood cell transfusion in preterm infants[J]. Lancet Haematol, 2022, 9(8): e615-e626. PMID: 35901846. DOI: 10.1016/S2352-3026(22)00207-1.
29 Hellstr?m W, Martinsson T, Morsing E, et al. Low fraction of fetal haemoglobin is associated with retinopathy of prematurity in the very preterm infant[J]. Br J Ophthalmol, 2022, 106(7): 970-974. PMID: 33547036. PMCID: PMC9234406. DOI: 10.1136/bjophthalmol-2020-318293.
30 Orlando N, Pellegrino C, Valentini CG, et al. Umbilical cord blood: current uses for transfusion and regenerative medicine[J]. Transfus Apher Sci, 2020, 59(5): 102952. PMID: 32972860. DOI: 10.1016/j.transci.2020.102952.
31 Hellstr?m W, Martinsson T, Hellstrom A, et al. Fetal haemoglobin and bronchopulmonary dysplasia in neonates: an observational study[J]. Arch Dis Child Fetal Neonatal Ed, 2021, 106(1): 88-92. PMID: 32847833. PMCID: PMC7788221. DOI: 10.1136/archdischild-2020-319181.
32 Glaser K, H?rtel C, Dammann O, et al. Erythrocyte transfusions are associated with retinopathy of prematurity in extremely low gestational age newborns[J]. Acta Paediatr, 2023, 112(12): 2507-2515. PMID: 37667535. DOI: 10.1111/apa.16965.
33 Prasad N, Kumar K, Dubey A. Fetal hemoglobin, blood transfusion, and retinopathy of prematurity in preterm infants: an observational, prospective study[J]. Indian J Ophthalmol, 2023, 71(7): 2803-2807. PMID: 37417124. PMCID: PMC10491026. DOI: 10.4103/IJO.IJO_692_23.
34 Jiramongkolchai K, Repka MX, Tian J, et al. Effects of fetal haemoglobin on systemic oxygenation in preterm infants and the development of retinopathy of prematurity PacIFiHER Report No. 2[J]. Br J Ophthalmol, 2023, 107(3): 380-383. PMID: 34620603. DOI: 10.1136/bjophthalmol-2021-319546.
35 Lust C, Vesoulis Z, Jackups R, et al. Early red cell transfusion is associated with development of severe retinopathy of prematurity[J]. J Perinatol, 2019, 39(3): 393-400. PMID: 30459388. PMCID: PMC6391181. DOI: 10.1038/s41372-018-0274-9.
36 Lee EY, Kim SS, Park GY, et al. Effect of red blood cell transfusion on short-term outcomes in very low birth weight infants[J]. Clin Exp Pediatr, 2020, 63(2): 56-62. PMID: 32024329. PMCID: PMC7029666. DOI: 10.3345/kjp.2019.00990.
37 Pellegrino C, Papacci P, Beccia F, et al. Differences in cerebral tissue oxygenation in preterm neonates receiving adult or cord blood red blood cell transfusions[J]. JAMA Netw Open, 2023, 6(11): e2341643. PMID: 37934499. PMCID: PMC10630897. DOI: 10.1001/jamanetworkopen.2023.41643.
38 Torrejon-Rodriguez L, Pinilla-Gonzalez A, Lara Cantón I, et al. Effect of autologous umbilical cord blood transfusion in the development of retinopathy of prematurity: randomized clinical trial: study protocol[J]. Front Pediatr, 2023, 11: 1269797. PMID: 37900679. PMCID: PMC10602804. DOI: 10.3389/fped.2023.1269797.
39 Teofili L, Papacci P, Dani C, et al. Cord blood transfusions in extremely low gestational age neonates to reduce severe retinopathy of prematurity: results of a prespecified interim analysis of the randomized BORN trial[J]. Ital J Pediatr, 2024, 50(1): 142. PMID: 39113069. PMCID: PMC11305044. DOI: 10.1186/s13052-024-01714-w.
40 Kotowski M, Litwinska Z, Klos P, et al. Autologous cord blood transfusion in preterm infants: could its humoral effect be the kez to control prematurity-related complications? A preliminary study[J]. J Physiol Pharmacol, 2017, 68(6): 921-927. PMID: 29550804.
41 González EG, Casanova MA, Samarkanova D, et al. Feasibility of umbilical cord blood as a source of red blood cell transfusion in preterm infants[J]. Blood Transfus, 2021, 19(6): 510-517. PMID: 33370228. PMCID: PMC8580783. DOI: 10.2450/2020.0169-20.
42 Davenport P, Sola-Visner M. Hemostatic challenges in neonates[J]. Front Pediatr, 2021, 9: 627715. PMID: 33738269. PMCID: PMC7960661. DOI: 10.3389/fped.2021.627715.
43 Ferrer-Marín F, Sola-Visner M. Neonatal platelet physiology and implications for transfusion[J]. Platelets, 2022, 33(1): 14-22. PMID: 34392772. PMCID: PMC8795471. DOI: 10.1080/09537104.2021.1962837.
44 Thom CS, Davenport P, Fazelinia H, et al. Quantitative label-free mass spectrometry reveals content and signaling differences between neonatal and adult platelets[J]. J Thromb Haemost, 2024, 22(5): 1447-1462. PMID: 38160730. PMCID: PMC11055671. DOI: 10.1016/j.jtha.2023.12.022.
45 Cortesi V, Cavallaro G, Raffaeli G, et al. Why might cord blood be a better source of platelets for transfusion to neonates?[J]. Blood Transfus, 2024, 22(4): 292-302. PMID: 38557319. PMCID: PMC11251836. DOI: 10.2450/BloodTransfus.566.
46 Jansen M, Brand A, von Lindern JS, et al. Potential use of autologous umbilical cord blood red blood cells for early transfusion needs of premature infants[J]. Transfusion, 2006, 46(6): 1049-1056. PMID: 16734824. DOI: 10.1111/j.1537-2995.2006.00841.x.
47 Podraza W. A new approach to neonatal medical management that could transform the prevention of retinopathy of prematurity: theoretical considerations[J]. Med Hypotheses, 2020, 137: 109541. PMID: 31901610. DOI: 10.1016/j.mehy.2019.109541.
48 Bianchi M, Giannantonio C, Spartano S, et al. Allogeneic umbilical cord blood red cell concentrates: an innovative blood product for transfusion therapy of preterm infants[J]. Neonatology, 2015, 107(2): 81-86. PMID: 25401961. DOI: 10.1159/000368296.
49 Teofili L, Papacci P, Orlando N, et al. Allogeneic cord blood transfusions prevent fetal haemoglobin depletion in preterm neonates. Results of the CB-TrIP study[J]. Br J Haematol, 2020, 191(2): 263-268. PMID: 32510635. DOI: 10.1111/bjh.16851.
50 Teofili L, Papacci P, Giannantonio C, et al. Allogenic cord blood transfusion in preterm infants[J]. Clin Perinatol, 2023, 50(4): 881-893. PMID: 37866854. DOI: 10.1016/j.clp.2023.07.005.
51 Lopriore E, Huisman E, Zwaginga JJ, et al. Allogeneic cord blood transfusions for extremely preterm neonates: an extremely promising proof of concept[J]. Br J Haematol, 2020, 191(2): 150-151. PMID: 32608504. PMCID: PMC7689904. DOI: 10.1111/bjh.16918.
52 Samarkanova D, Codinach M, Aran G, et al. Quality and stability studies of red blood cell concentrates from umbilical cord blood compared to their adult counterparts[J]. Blood Transfus, 2024. PMID: 39133620. DOI: 10.2450/BloodTransfus.761. Epub ahead of print.

基金

武汉市科技局2022年度知识创新专项基础研究项目(2022020801010517)。

PDF(507 KB)

Accesses

Citation

Detail

段落导航
相关文章

/