Dear Sir, Umbilical cord blood (UCB) is a very rich source of transplantable stem cells, which are thought to be a useful treatment for a number of genetic diseases, blood malignancies and immune deficiencies in paediatric and adult patients lacking a suitable related or unrelated donor1. Banking UCB is a way of preserving potentially life-saving cells that are usually discarded after the interruption of the blood supply from the umbilical cord to the newborn infant2,3. UCB harvesting after vaginal delivery or Caesarean section is a simple, risk-free and quick procedure that does not change the normal course of the birth4. Since UCB is a graft source and UCB transplantation provides good results5, the UCB collection rate for banking should be optimised. The aims of this retrospective, preliminary, singlecentre study were to assess the collection rate of UCB from selected suitable donors and to investigate the factors influencing this rate. Between January 2014 and June 2016, during the phase of antenatal selection of UCB donors, 365 pregnant women were consecutively recruited for donation and entered the study. Enrolment took place, a few days before each woman's delivery, in the obstetric department of "Policlinico Umberto I" hospital in Rome. In accordance with local regulations, eligibility for donation was assessed by the staff of the Cord Blood Bank from detailed clinical and family information and written informed consent was obtained from the donor parents. All documentation was kept in a safe place in the delivery room. As a reminder, a certified statement of suitability for UCB donation was issued to the pregnant women to be given to health care personnel at the time of admission to hospital. Among the 365 families investigated, the majority (87.4%) resulted suitable for UCB donation while the remaining 12.6% were ineligible. Table I gives an overview of the causes of ineligibility: the most common reason was a documented maternal infection (32.6%) followed by autoimmune diseases and systemic immunological diseases present in the parents of the unborn child (30.5%). Despite the 319 potential planned donations, after delivery only 121 UCB samples (about 38%) were collected. Table II shows the reasons why UCB was not collected. In most cases this was because of dystocial childbirth and urgent Caesarean section (16.6%). Unfortunately, although the suggested operating procedure requires the reason for non-collection to be recorded, in our experience this was not done in the majority of cases (almost 60%) and the causes, therefore, remain unknown. This finding may be related to the standard of the department involved in the study and probably also to the shortage of staff; indeed, because of the advanced level of care for obstetrics and neonatology, the staff were probably taking care of complicated pregnancies. Furthermore, in about 5% of the deliveries UCB was not harvested because the delivery room staff were not informed about the potential, suitable donation; this could be attributed to the study population of pregnant women who, obviously, lose interest in donation during their hospitalisation and labour

Collection of umbilical cord blood for banking: collection rate and factors influencing collection / Valle, V; Screnci, M; Murgi, E; Capozzi, M; Girelli, G.. - In: BLOOD TRANSFUSION. - ISSN 1723-2007. - (2016).

Collection of umbilical cord blood for banking: collection rate and factors influencing collection.

Girelli, G.
Primo
2016

Abstract

Dear Sir, Umbilical cord blood (UCB) is a very rich source of transplantable stem cells, which are thought to be a useful treatment for a number of genetic diseases, blood malignancies and immune deficiencies in paediatric and adult patients lacking a suitable related or unrelated donor1. Banking UCB is a way of preserving potentially life-saving cells that are usually discarded after the interruption of the blood supply from the umbilical cord to the newborn infant2,3. UCB harvesting after vaginal delivery or Caesarean section is a simple, risk-free and quick procedure that does not change the normal course of the birth4. Since UCB is a graft source and UCB transplantation provides good results5, the UCB collection rate for banking should be optimised. The aims of this retrospective, preliminary, singlecentre study were to assess the collection rate of UCB from selected suitable donors and to investigate the factors influencing this rate. Between January 2014 and June 2016, during the phase of antenatal selection of UCB donors, 365 pregnant women were consecutively recruited for donation and entered the study. Enrolment took place, a few days before each woman's delivery, in the obstetric department of "Policlinico Umberto I" hospital in Rome. In accordance with local regulations, eligibility for donation was assessed by the staff of the Cord Blood Bank from detailed clinical and family information and written informed consent was obtained from the donor parents. All documentation was kept in a safe place in the delivery room. As a reminder, a certified statement of suitability for UCB donation was issued to the pregnant women to be given to health care personnel at the time of admission to hospital. Among the 365 families investigated, the majority (87.4%) resulted suitable for UCB donation while the remaining 12.6% were ineligible. Table I gives an overview of the causes of ineligibility: the most common reason was a documented maternal infection (32.6%) followed by autoimmune diseases and systemic immunological diseases present in the parents of the unborn child (30.5%). Despite the 319 potential planned donations, after delivery only 121 UCB samples (about 38%) were collected. Table II shows the reasons why UCB was not collected. In most cases this was because of dystocial childbirth and urgent Caesarean section (16.6%). Unfortunately, although the suggested operating procedure requires the reason for non-collection to be recorded, in our experience this was not done in the majority of cases (almost 60%) and the causes, therefore, remain unknown. This finding may be related to the standard of the department involved in the study and probably also to the shortage of staff; indeed, because of the advanced level of care for obstetrics and neonatology, the staff were probably taking care of complicated pregnancies. Furthermore, in about 5% of the deliveries UCB was not harvested because the delivery room staff were not informed about the potential, suitable donation; this could be attributed to the study population of pregnant women who, obviously, lose interest in donation during their hospitalisation and labour
2016
umbilical cord blood
01 Pubblicazione su rivista::01f Lettera, Nota
Collection of umbilical cord blood for banking: collection rate and factors influencing collection / Valle, V; Screnci, M; Murgi, E; Capozzi, M; Girelli, G.. - In: BLOOD TRANSFUSION. - ISSN 1723-2007. - (2016).
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/934100
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