Cord Blood Banking in London: The First 1000 Collections

Abstract

Because not enough suitable bone marrow donors are available to provide transplants for all children in England who need them, the London Cord Blood Bank was established. Its goal is to collect, process, and store 10,000 unrelated stem-cell donations. Cord blood (CB) is collected at two hospitals by dedicated staff after delivery of the placenta, after a nurse counselor has interviewed the mothers for their medical, ethnic, and behavioral history. Targeting efforts have achieved a much broader ethnic mix than is found in bone marrow donor registries. A detailed consent form is completed before donation. CB units are processed under aseptic conditions within 24 hours of collection. Only collection volumes more than 40 ml are banked. At first the units were cryopreserved as whole blood, but presently volume reduction is achieved using a simple closed, semiautomated blood processing system. Quality control is monitored by bacteriological screening of all CB units. Recovery of progenitor cells has been excellent. Processed units are double packed and stored in the vapor phase of liquid nitrogen. Like blood samples from mothers, CB donations are screened for HIV 1 and 2, anti–hepatitis C virus antibody, hepatitis B surface antigen, and the Treponema pallidum hemagglutination(TPHA) for syphilis. Anti-cytomegalovirus testing also is performed. Donations are typed for HLA-A, -B, and -DR at medium resolution by the sequence-specific oligonucleotide probe and sequence-specific priming techniques. Units are cleared only after being reviewed by a staff physician. More than 40 percent of donations are derived from non-European caucasoid donors. Bacterial contamination has been markedly reduced by following stringent decontamination protocols. The bank also collects CB from siblings for children with leukemia or other hematological or immunological disorders. In this case, units are processed without volume reduction and stored for a year initially. Clonogenic assays are performed on all related units. Bone Marrow Transplant 1999;24:139–145