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Optimizing donor selection for public cord blood banking: influence of maternal, infant, and collection characteristics on cord blood unit quality
Author(s) -
Page Kristin M.,
Mendizabal Adam,
BetzStablein Brigid,
Wease Stephen,
Shoulars Kevin,
Gentry Tracy,
Prasad Vinod K.,
Sun Jessica,
Carter Shelly,
Balber Andrew E.,
Kurtzberg Joanne
Publication year - 2014
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12257
Subject(s) - cord blood , medicine , umbilical cord , gestational age , transplantation , obstetrics , gynecology , pregnancy , immunology , biology , genetics
Background Banked unrelated donor umbilical cord blood ( CB ) has improved access to hematopoietic stem cell transplantation for patients without a suitably matched donor. In a resource‐limited environment, ensuring that the public inventory is enriched with high‐quality cord blood units ( CBUs ) addressing the needs of a diverse group of patients is a priority. Identification of donor characteristics correlating with higher CBU quality could guide operational strategies to increase the yield of banked high‐quality CBUs . Study Design and Methods Characteristics of 5267 CBUs donated to the C arolinas C ord B lood B ank, a public bank participating in the N ational C ord B lood I nventory, were retrospectively analyzed. Eligible CBUs , collected by trained personnel, were processed using standard procedures. Routine quality and potency metrics (postprocessing total nucleated cell count [post‐ TNCC ], CD 34+, colony‐forming units [ CFUs ]) were correlated with maternal, infant, and collection characteristics. Results High‐quality CBUs were defined as those with higher post‐ TNCC (>1.25 × 10 9 ) with CD 34+ and CFUs in the upper quartile. Factors associated with higher CD 34+ or CFU content included a shorter interval from collection to processing (<10 hr), younger gestational age (34‐37 weeks; CD 34+ and CFUs ), Caucasian race, higher birthweight (>3500 g), and larger collection volumes (>80 mL ). Conclusions We describe characteristics identifying high‐quality CBUs , which can be used to inform strategies for CBU collection for public banks. Efforts should be made to prioritize collections from larger babies born before 38 weeks of gestation. CBUs should be rapidly transported to the processing laboratory. The lower quality of CBUs from non‐ C aucasian donors highlights the challenges of building a racially diverse public CB inventory.