Use of Autologous Umbilical Cord Blood in Neonatal Cardiac Surgery: A European Survey of Current Practices and...

To evaluate current clinical practices, identify perceived barriers, and explore healthcare professionals' perspectives on the use of autologous umbilical cord blood (AUCB) in neonatal cardiac surgery across Europe.

A descriptive, cross-sectional online survey was distributed to healthcare professionals involved in neonatal cardiac surgery. The questionnaire, developed ad hoc by a multidisciplinary expert team, assessed institutional AUCB use, perceived benefits and barriers, and professionals' interest in further information. The survey was disseminated through European scientific societies and professional social media platforms. Data were collected anonymously and analyzed using descriptive statistics.

A total of 50 responses were analyzed. The majority of respondents were neonatologists (50%), followed by pediatric cardiologists and pediatric anesthesiologists; 69% were based in Spain. Only 10% of participants reported institutional use of AUCB, primarily for selected patients in the postoperative setting. Reported benefits included reduced transfusion requirements and decreased exposure to allogeneic blood products. Among non-users, key barriers included logistical challenges (32%), insufficient scientific evidence (27%), and preference for allogenic sources (10%). The most frequently cited overall obstacle for the general use of UCB was lack of education and training (75%), followed by regulatory restrictions. Only 18.8% considered the current evidence sufficient to support routine AUCB use. Despite limited implementation, overall interest was high (mean rating 4.6/5), with many respondents expressing interest in future collaboration.

AUCB use in neonatal cardiac surgery remains limited and institution-dependent across Europe. Significant barriers-including insufficient training, logistical challenges, and perceived evidence gaps-hinder broader adoption. These findings highlight the need for standardized protocols, targeted educational strategies, and further clinical evidence to facilitate safe and effective integration of AUCB into neonatal cardiac care.