Background:
Therapeutic options for perinatal brain damage are limited. A new therapeutic approach
is treatment with UCB cells. Evidence for stem cells as a potential intervention for
neurological diseases is emerging. Collection of UCB in this critical-risk-group is
organisationally and technically challenging. In emergencies the collection cannot
be planned. In pre-term infants late cord clamping and anatomic conditions reduce
the availability of UCB.
Study design:
UCB should be collected from all high-risk-group neonates born 12/2017 – 12/2018.
Four high-risk-groups are included: neonates with symptomatic hypoxemia, gestational
age ≤30+0 weeks, intrauterine growth restriction (IUGR) and multiples with twin-twin
transfusion syndrome (TTTS). Feasibility of the collection (successful patient enrolment,
technical realization, puncture number and localisation) and quality of obtained blood
(volume, sterility, cell-vitality) are assessed.
Aim of the study:
The aim of the study is to assess feasibility of UCB-collection in this critical-risk-group
and to determine whether treatment options with autologous UCB for these infants exist.
Preliminary Results:
36 neonates were enrolled (hypoxemia n = 4, IUGR n = 16, pre-term infants n = 16).
11 cases were missed due to team-intern coordination difficulties, immediate maternal/foetal
life-threatening conditions or anatomical limitations. Additional UCB was collected
from 7 neonates in initially critical clinical condition (shoulder dystocia, placental
abruption, terminal bradycardia) and later discarded for not meeting the inclusion
criteria of hypoxemia.
Conclusions:
Collection and preparation of UCB in neonates at high risk of brain damage is challenging
but possible. Extensive preparation and detailed team-briefings are necessary. The
collection of UCB in critical cases requires a multidisciplinary approach.
