Umbilical cord blood (UCB) is a source of progenitors for hematopoietic stem cell transplantation. Donor selection and collection procedures are two of the most important areas for improving UCB quality. Our exclusion rate is 32.5% of potential donors, mainly due to obstetrical and clinical reasons and after cryopreservation an additional 5.03% because obstetrics or neonatal problems. The most important and constant obstetric factors influencing UCB quality appears to be the placental and newborn weight. In our experience, placental weight was the only variable that independently influenced on volume, TNC, CD34+ cells and CFU content of collections. Neonatal weight >= 3300 could be the optimal selection criteria for collecting UCB with >= 120 x 10(7) TNC content. In utero vaginal deliveries provides a larger volume and a higher number of nucleated cells, percentage of CD34+ cells and colony-forming units (CFUs) than ex utero.

Background and Objectives: Umbilical cord blood (UCB) contains haematopoietic stem cells and can be used as an alternative to bone marrow transplantation in certain cases. Engraftment was dependent upon the haematopoietic progenitor cell content of the cord blood units. This study was designed to investigate the influence of obstetric, neonatal and collection factors on the volume and haematopoietic content of UCB donations. Material and Methods: A retrospective analysis of obstetric and neonatal factors was performed from 300 cord blood donations in Valencia Cord Blood Bank. Maternal, neonatal and collection factors influencing cord blood quality measured as volume, total nucleated cell count, CD34+ cells and colony-forming units (CFU) were analysed. Results: Bigger babies produced cord blood units with larger volume, higher cells counts, CFU and CD34 cell counts. In the multivariate analysis, we found that both placental weight and mode of collection were predictor variables for total nucleated cell count, CD34 cells and CFU. Conclusion: Our study concludes that cord blood units must be collected before placental delivery and that birth weight, as an estimation of the placental weight, could be added to standard cord blood donors criteria in order to improve the bank efficiency.

Background and objectives. Collection strategy is the first step for collecting good quality cord blood (CB) units. There are two principal different techniques to collect CB from the umbilical vein: in the delivery room while the placenta is still in the uterus by midwives and obstetricians or in an adjacent room after placental delivery by CB-bank trained personnel. In this study, the benefits and disadvantages between two different CB collection strategies were evaluated in order to improve CB bank methodology.Design and methods. Valencia CB bank maintains the two different collection strategies aforementioned. Before processing CB units, volume was calculated and samples were drawn for cell counts. After processing and before cryopreservation, samples for cell counts, CD34 analysis, viability, clonogenic assays and microbiology were drawn directly from the bags. We compared the efficiency of the two collection techniques.Results. Obstetric date and umbilical CB was obtained from 848 vaginal (484 collected in uterus and 364 collected ex uterus). The proportion of excluded CB units before processing was 33% for ex uterus and 25% for in uterus. The difference was statistically significant. A larger volume and a higher number of total nucleated cells, CD34+ cells and CFUs were harvested in the in uterus collection group.Interpretation and conclusions. Based on our findings, we conclude that the mode of collection influences the hematopoietic content of CB donations. Collection before placental delivery is the best approach to CB collection and allows optimizing CB bank methodology.

The use of cord blood (CB) for transplantation has increased greatly in recent years. The collection strategy is the first step in collecting good-quality CB units. There are two main techniques for collecting CB from the umbilical vein: in the delivery room while the placenta is still in the uterus by midwives and obstetricians or in an adjacent room after placental delivery by CB bank trained personnel. In this study, the benefits and disadvantages between the two different CB collection strategies were evaluated, in order to improve CB bank methodology. Valencia CB bank maintains the two different collection strategies. CB was obtained from 569 vaginal and 70 caesarean deliveries and obstetrical and clinical charts were reviewed. Before processing CB units, volume was calculated and samples were drawn for cell counts. After processing and before cryopreservation samples were drawn for cell counts, CD34+cell analysis, viability, clonogenic assays and microbiology were drawn directly from the bags. We compared the efficiency of the two collection techniques. Obstetric data and umbilical CB were obtained from 569 vaginal (264 collected in utero and 305 collected ex utero) and 70 caesarean deliveries. The proportion of excluded CB units before processing was 33% for vaginal ex utero, 25% for vaginal in utero and 46% for caesarean deliveries. Differences were statistically significant. For vaginal deliveries a larger volume and a higher number of nucleated cells, percentage of CD34+ cells and colony-forming units (CFUs) were harvested in the in utero collection group. There was no statistical difference between CB collected after placental expulsion from vaginal and caesarean deliveries. Comparison between all vaginal and caesarean deliveries did not show any difference. We conclude that the mode of collection influences the haematopoietic content of CB donations. Collection before placental delivery is the best approach to CB collection and allows optimisation of CB bank methodology. Caesarean deliveries seem to contain similar progenitor content to vaginal deliveries.