Invited Commentary on Williams, et al: Storage of Placental Blood – A Feasibility Study for Development of a Fetal Blood Bank

jpedsurg.org

Although the use of cord blood for hematologic disorders is well established, the idea of utilizing such samples for allogenic blood transfusions in neonates is relatively new. Transfusion practices in the neonatal intensive care unit (NICU) rely on adult blood donation despite underlying biochemical differences in adult hemoglobin (HbA) and fetal hemoglobin (HbF). With oxygen more readily released by HbA, adult transfusions in neonates carry a theoretical risk of oxidative stress. This risk potentially leads to complications such as bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), necrotizing enterocolitis, and retinopathy of prematurity [1-4].

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Article · Jul 2025 · 1 min read

In brief

This commentary examines the feasibility of using stored placental blood for neonatal transfusions instead of adult donor blood. The approach addresses biochemical differences between fetal and adult hemoglobin that may contribute to oxidative stress and NICU complications including BPD, IVH, and retinopathy of prematurity.

Cord blood contains fetal hemoglobin (HbF), which may reduce oxidative stress compared to adult hemoglobin (HbA) in neonatal transfusions.
Adult blood transfusions in NICUs theoretically increase risk of BPD, IVH, necrotizing enterocolitis, and retinopathy of prematurity.
Establishing a fetal blood bank could provide HbF-rich transfusions better matched to neonatal physiology than current adult donor blood.
Biochemical differences between HbA and HbF affect oxygen release kinetics, with potential clinical implications for premature infants.

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