Umbilical Cord Blood Collection Research Articles

Umbilical cord blood collection through elective cesarean section in an ovine model – a pilot study

Umbilical cord blood collection through elective cesarean section in an ovine model – a pilot study

Feasibility and Safety of Autologous Cord Blood Derived Cell Administration in Extremely Preterm Infants: A Single-centre, Open-label, Single-arm, Phase I trial (CORD-SaFe study)

Evidence from preclinical studies in small and large animal models has shown neuroprotective effects of intravenous administration of umbilical cord blood derived cells (UCBCs). This study aimed to evaluate the feasibility of umbilical cord blood (UCB) collection, extraction of UCBCs, and subsequent safety of intravenous autologous administration of UCBCs in extremely preterm infants (born <28 weeks gestation). A single-centre, open-label, single-arm, safety and feasibility clinical intervention trial was conducted at Monash Medical Centre and Monash Children's Hospital, Melbourne, Australia. Participants were extremely preterm infants born at less than 28 weeks completed gestation, and exclusions included major congenital malformation, maternal blood-borne virus infection, and severe brain injury on postnatal cranial ultrasound. UCB was collected at birth, and UCBCs were characterised (total nucleated cell count (TNC), mononuclear cell count (MNC), CD34+ cell count) and cryopreserved. Infants were reinfused with autologous UCBCs (25-50 million MNCs/kg) intravenously in the second postnatal week. Primary outcomes included feasibility: sufficient UCB volume (>7mL) and UCBC numbers following processing (>25×106TNCs/kg); and safety: absence of adverse events directly related to UCBC administration. Forty-four UCB collections were attempted and sufficient UCB volume/UCBC extraction was demonstrated in 37 (84.1%) infants. Good Manufacturing Practice (GMP) grade cells were obtained in 31/44 (70.4%) of infants. Median (IQR) TNCs and MNCs collected were 130 (67-207) x 106/kg and 60 (39-105) x 106/kg, respectively. 23 infants with median (IQR) gestation of 26 (24-27) weeks and birth weight of 761 (650-946) grams were administered cells at a median (IQR) dose of 42.3 (31.1-62.3) x 106 MNCs/kg). No serious adverse events were noted, and the infusions were well-tolerated. This phase-1 clinical trial has shown UCBC collection and reinfusion was feasible in approximately 70% of extremely preterm infants and was well tolerated without any serious adverse events. Funding to support this study was obtained from National Health and Medical Research Council of Australia, Cerebral Palsy Alliance, National Stem Cell Foundation of Australia, and Lions Cord Blood Foundation.

Using autologous umbilical cord blood and placental cells for hypoxic-ischemic encephalopathy: an exploratory safety and feasibility study.

Introduction. Hypoxic-ischemic encephalopathy (HIE) caused by lack of oxygen and perfusion to the brain can lead to acute neurological damage in newborns. Therapeutic hypothermia (TH) is the most effective and safest treatment. However, mortality remains high with numerous long-term sequelae. Cellular therapies, particularly umbilical cord blood (UCB), are being studied as alternative therapies. The aim of this study is to assess the feasibility and safety of combining autologous cord blood cell infusion with moderate hypothermia. Population and methods. Twelve infants of 36 weeks gestational age or older, diagnosed with moderate or severe HIE and with umbilical cord blood (UCB) collected were included. UCB was volume-reduced, and up to four doses were obtained. These doses were infused within the first 72 postnatal hours. Time to the first infusion and possible adverse reactions to the infusion were evaluated. Results. Between 2014 and 2019, 12 infants were included in the protocol (TH + UCB), 9 with a diagnosis of moderate HIE and 3 with severe HIE. In all cases, at least one dose of UCB was obtained for infusion. In all cases, the first dose was infused within 24 hours in every case, and no adverse reactions attributable to the infusion were observed. Conclusions. The collection, processing, and infusion of fresh autologous umbilical cord blood for use in newborns with HIE are feasible and safe under our conditions.

Umbilical cord blood collection: Techniques and clinical indication

Umbilical cord blood (UCB) is a useful source of hematopoietic stem cells, offering impressive advantages over other stem cell sources, including ease of production and reduced incidence of graft-versus-host disease. This review discusses advanced wire blood production techniques, evaluates its current medical applications, and addresses the technical and moral in this field. It highlights the therapeutic potential of metallic blood in the treatment of hematological diseases, genetic disorders and immunodeficiency, and explores new therapeutic areas, including regenerative medicine and autoimmune diseases. Future prospects focus on technological improvements to increase cell yield and viability, expand medical testing and develop global regulatory standards. In particular, through collaborative efforts in technology and ethics, umbilical cord blood can advance disease treatment paradigms and improve the outcomes of regenerative cures.

Umbilical Cord Blood Collection Protocol and the Impact on the Nucleated and Progenitor Cell Quantity and Quality

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Umbilical Cord Blood Collection During Cesarean Section: Effect on Maternal Blood Loss and Morbidity [ID 2683610

INTRODUCTION: Umbilical cord blood collection (UCBC) for stem-cell banking is routinely performed during cesarean sections (CS). Few studies have examined the maternal effect. This study's objective is to evaluate whether UCBC during CS is associated with increased maternal blood loss and morbidity. METHODS: This was a single-center retrospective cohort study of primary CS (PCS) in 2021. Exclusion criteria were age less than 18, multifetal gestation, gestational age less than 34 weeks, emergency, and infection. Data were compared between participants with and without UCBC during PCS. Extensive demographic data was collected and compared. The primary outcome was quantitative blood loss (QBL). Secondary outcomes were operative time, hemorrhage medication usage, and blood transfusion (BT). RESULTS: Eight hundred two PCS were reviewed, and 191 were excluded. Of the remaining 611, UCBC was attempted in 151 (24.7%). The UCBC cohort had higher gestational age (39.1 versus 38.7; P=.007), were less often in labor (P=.004) or on magnesium (P=.022), and were more likely to be scheduled (P=.002). Quantitative blood loss was higher with UCBC (1,091.5 versus 1,007.5 mL; P=.075). In non-labored PCS, the QBL difference was statistically significant (941.8 versus 798 mL; P=.034). Umbilical cord blood collection was associated with increased operative time (62.4 versus 56.8 minutes; P&lt;.001) and postoperative BT (7.2% versus 3.3%; P=.036). There were no associations between UCBC and usage of hemorrhage medications. CONCLUSION: Umbilical cord blood collection increases QBL in nonlabored PCS. Umbilical cord blood collection increases operative time and postoperative BT in PCS. Patients should be appropriately counseled and selected for UCBC based on hemorrhage risk factors.

A cost-effectiveness analysis of using umbilical cord blood pH for the diagnosis and management of neonatal asphyxia in term high-risk pregnancy.

The objective was to evaluate the cost-effectiveness of using umbilical cord blood pH (UC-pH) in combination with APGAR score for neonatal asphyxia, in terms of high-risk pregnancies, compared to using the APGAR score only. Neonatal outcomes and the proportions of patients admitted to the neonatal intensive care unit (NICU) were evaluated. A cost-effectiveness ambispective analysis study was carried out, comparing (i) UC-pH combined with APGAR score and (ii) APGAR score only in 399 term pregnancies with a high risk for neonatal asphyxia. Costs included implementation, medical, and admission costs. Incremental cost-effectiveness ratios (ICER) were calculated. The proportions of patients admitted to the NICU were evaluated. UC-pH combined with APGAR score demonstrated a cost-effective outcome (3990.64 USD vs 5545.11 USD) and an ICER shown as saving 103.66 USD compared to the APGAR score alone. The need for NICU admission was less in the umbilical cord blood collection group (18 vs 33 cases). A combination of UC-pH with APGAR score assessment for neonatal asphyxia in a high-risk term pregnancy can effectively reduce costs and requirement for NICU admission.

Effect of cord blood double collection method on cord blood hematopoietic stem cell transplantation-related indices and blood gas analysis.

Umbilical cord blood has been widely used in clinical transplantation. Blood gas analysis of umbilical cord blood is routinely used to evaluate neonatal asphyxia. This study aimed to evaluate an improved umbilical cord blood collection method that does not affect the results of umbilical cord blood gas analysis and hematopoietic stem cell transplantation-related indices. Three hundred pregnant women were recruited between December 2019 and August 2022. In total, 270 umbilical cord blood samples were included and randomly divided into 3 groups. Group A was defined as the group in which both umbilical cord blood samples for hematopoietic stem cell transplantation and blood gas analysis were collected. Group B was defined as the group from which umbilical cord blood was collected for hematopoietic stem cell transplantation. Group C was defined as that wherein umbilical cord blood was collected only for blood gas analysis. Hematopoietic stem cell transplantation-related indices were detected in groups A and B, and blood gas analysis was performed in groups A and C. Hematopoietic stem cell transplantation-related indices were not significantly different between groups A and B. The pH, base excess, and lactic acid values were not significantly different between groups A and C. The cord blood double collection method would not affect the results of umbilical cord blood gas analysis and hematopoietic stem cell transplantation-related indices. It is suitable for cord blood collection when preparing for hematopoietic stem cell transplantation and blood gas analysis.

Abstract 17 Umbilical Cord Blood Collection. How Do Different Factors Affect CD45 Cell Viability in Our Experience?

Abstract Introduction Umbilical cord blood (UCB) is an important source of hematopoietic stem cells for transplantation in some hematological diseases. One of the main factors influencing sample quality and transplantation success, in addition to histocompatibility, is the number of viable CD34+ cells. Over the years, different factors that could directly affect viability have been studied and evaluated. It is important to be able to define favorable ranges for obtaining high viabilities and optimal samples for their use. Objectives The aim of our study is to evaluate the incidence of three factors temperature during transport, volume and time between collection and process of UCB over cellular viability previous to cryopreservation. Methods We analyzed 10483 UCB samples collected between 2018 and 2022. Cell viability values were analyzed in total CD45 using flow cytometry with 7-AAD and Annexin V. We evaluated the relationship between cell viability with the three factors mentioned above. Results We observed a tendency for viability to decrease as the blood volume collected decreases, and as the temperature and elapsed hours increase. In concordance, we found that viability is dependent on the 3 factors analyzed (p &amp;lt;&amp;lt;0.001), observing that its variability can be explained in 4% by the variation of elapsed hours as well as the collection volume, while temperature explains this variation in 1%. Discussion With our samples we can assume that the variations in the ranges analyzed would not affect them to a great extent, since they are not determinant for obtaining an average viability lower than that established as acceptable in our bank (75%). On the other hand, we also conclude that viability cannot be explained from the variation of a single factor, so it would be important to analyze the interactions between them. For the time being, and in order to improve the quality of the samples, we consider it necessary to emphasize the collection of a good volume of blood and the rapid transport of the samples for processing.

Fresh Umbilical Cord Blood-A Source of Multipotent Stem Cells, Collection, Banking, Cryopreservation, and Ethical Concerns.

Umbilical cord blood (UCB) is a rich source of hematopoietic cells that can be used to replace bone marrow components. Many blood disorders and systemic illnesses are increasingly being treated with stem cells as regenerative medical therapy. Presently, collected blood has been stored in either public or private banks for allogenic or autologous transplantation. Using a specific keyword, we used the English language to search for relevant articles in SCOPUS and PubMed databases over time frame. According to our review, Asian countries are increasingly using UCB preservation for future use as regenerative medicine, and existing studies indicate that this trend will continue. This recent literature review explains the methodology of UCB collection, banking, and cryopreservation for future clinical use. Between 2010 and 2022, 10,054 UCB stem cell samples were effectively cryopreserved. Furthermore, we have discussed using Mesenchymal Stem Cells (MSCs) as transplant medicine, and its clinical applications. It is essential for healthcare personnel, particularly those working in labor rooms, to comprehend the protocols for collecting, transporting, and storing UCB. This review aims to provide a glimpse of the details about the UCB collection and banking processes, its benefits, and the use of UCB-derived stem cells in clinical practice, as well as the ethical concerns associated with UCB, all of which are important for healthcare professionals, particularly those working in maternity wards; namely, the obstetrician, neonatologist, and anyone involved in perinatal care. This article also highlights the practical and ethical concerns associated with private UCB banks, and the existence of public banks. UCB may continue to grow to assist healthcare teams worldwide in treating various metabolic, hematological, and immunodeficiency disorders.

Effectiveness of Video Assisted Teaching On Knowledge Regarding Umbilical Cord Blood Collection for Stem Cell Therapy Among Women Attending an Antenatal Outpatient Clinic in A Selected Hospital in Puducherry, India - A Prospective Homogeneous Quasi-Experi

Umbilical cord blood was previously considered a waste product. It is now used to treat a variety of diseases. Umbilical cord blood is the blood that remains after childbirth in the placenta and the attached umbilical cord. Cord blood is collected because stem cells found in it can be used to treat hematopoietic and genetic disorders. The study aimed to see how effective video-assisted teaching on cord blood collection for stem cell therapy was among antenatal women. A quasi-experimental (onegroup pretest and post-test) research design was adopted for this study. Sixty antenatal women who were attending antenatal OPD were selected by Purposive sampling. The structured questionnaire collected data to assess the level of knowledge regarding umbilical cord sample collection and stem cell therapy. In addition, structured, validated video-assisted teaching was done by experts in the field. The present study depicts that the pre-test means the level of knowledge of 5.48 with an SD of 2.04 was increased to 19.45 with an SD of 1.45 in the post-test after video-assisted teaching. Video-assisted teaching was found to be highly significant at p &lt;0.001. The study concluded that the investigator-designed Video-assisted education effectively improved umbilical cord blood collection knowledge for stem cell therapy among antenatal women. The significant limitation of the study is that it is not double-blinded, as it involves a specific teaching course.

Contamination Rate of Cryopreserved Umbilical Cord Blood Is Inversely Correlated with Volume of Sample Collected and Is also Dependent on Delivery Mode.

Cord blood (CB) collected at birth has become a valuable stem cell source for hematopoietic stem cell transplantation (HSCT). However, the collection of umbilical cord blood always bears a risk of microbiological contamination, both in vaginal birth and in cesarean section. A total of 10 054 umbilical cord stem cell samples were successfully cryopreserved between 2010 and 2020, of which 783 (8%) samples were tested positive for bacterial contamination. Umbilical CB with a volume of less than 60 mL showed a bacterial contamination rate of 12%, and above 60 mL volume a rate of 6% was found demonstrating an inverse relationship between sample volume and contamination rate (correlation coefficient r = −0.9). The contamination rate was associated with the mode of delivery and showed a significantly higher contamination rate of 9.7% when compared with cesarean deliveries (1.4%). The 10-year period consistently shows an average contamination rate between 4% and 6% per year. It is conceivable that the inverse relationship between volume and contamination rate might be related to thinner veins although no scientific evidence has been provided so far. The lower contamination rate in cesarean sections appears to be related to the sterile operating setting. Overall, the rate of bacterial contamination varies and depends on the type of birth, the way of delivery, and probably the experience of the staff.

Knowledge, Perception and Willingness to Pay for Cord Blood Banking: A Pilot Study

Umbilical cord blood was once a waste product. Now, years after the first successful cord blood transplant, it is an alternative source of hematopoietic stem and progenitor cells, compared to bone marrow and peripheral blood, which can cure children and adults from malignant and non-malignant diseases. The aim of this research was to assess the knowledge and perception for cord blood banking among Malaysian pregnant women and also ascertain the willingness to pay. Population selected for this study is Malaysian pregnant women who visited the Mom & Baby Expo in Midvalley, Kuala Lumpur. 43% of the respondents aged between 18-25 years old with good education background, good job and total household income of more than RM 5,000. 89% of respondents were at the 1st trimester and 2nd trimester of pregnancy. Approximately about 47% of respondent had some knowledge of cord blood banking. Almost 90% of respondents agreed that storing the cord blood will be useful for future treatment. Approximately 54% of respondents agree that most of the information about cord blood banking were obtained from medical health care professional. The level of knowledge correlate with the education background, higher education level showed more knowledge. Majority of 93% have not stored their children’s umbilical cord blood before. Based on the perception, 41% of the respondents thought its unnecessary to store cord blood despite knowing it is not harmful for mother or baby. About 51% thinks that the price of the cord blood is very expensive. About 81% of respondent agree that the maximum benefit can be gained from storing the cord blood is to baby itself. 49% respondents agreed that about 25% and below possible chances that a child's cord blood could benefit for his siblings. After explanation, about 41% were sure to store cord blood compared to 68% prior to it. Approximately 78% prefer to store cord blood in public bank because no fee charged. Almost 50% respondents are not willing to pay the cost approximately RM3, 000. The survey also found that the most affordable price that they can pay is between RM 500- RM 1,000. Awareness is present but detailed knowledge regarding its exact benefits and advantages still unclear. Public education should be done by everyone instead of only medical personnel. A reduction in the cost of umbilical cord blood collection and preservation and more knowledge would motivate the public to store cord blood. More campaigns and awareness programs are necessary especially among the younger generation, the future parents.

Evaluation of Microbial Contamination Rates in Umbilical Cord Blood Collection and Processing for Biobanking in Vietnam

The umbilical cord blood (CB) has recently been considered an abundant source of hematopoietic stem cells (HSCs) for transplantation compared to bone marrow. However, the collection and processing of CB have a high risk of microbial contamination. Hence, the procedures to collect and process the UCB are carefully considered. This study evaluates the microbial contamination rate to find the frequency and distribution of bacterial organisms among CB sampling and processing in Vietnam. In addition, this study correlates with contamination rates between the delivery method, cesarean section, and vaginal delivery. The results create best practices to avoid a high level of contamination of UCB during collection and processing for biobanking.

Plasma Concentrations and Maternal-Umbilical Cord Plasma Ratios of the Six Most Prevalent Carotenoids across Five Groups of Birth Gestational Age.

Carotenoids are antioxidant nutrients with the potential to provide protection against oxidative stress. Plasma carotenoid concentrations are lower in newborn infants compared to their mothers; however, limited information is available regarding how concentrations differ by gestational age. The objective of this research is to assess maternal and umbilical cord plasma carotenoid concentrations and maternal-umbilical cord plasma ratios across five groups of birth gestational age. Mother-infant dyads were enrolled at delivery for collection of maternal and umbilical cord blood. Plasma carotenoids were analyzed by HPLC and LC-MS/MS. Birth gestational age was categorized into five groups, and the Kruskal–Wallis test compared carotenoid concentrations and maternal-umbilical cord plasma ratios between these groups. A p-value of < 0.05 was considered statistically significant. 370 mother-infant dyads were included, with most infants delivered at early term (20.3%) or term (64.6%). Though maternal plasma concentrations increased with birth gestational age, we observed less variability in umbilical cord plasma concentrations, thus the maternal-umbilical cord plasma ratio also increased with birth CGA groups for lutein + zeaxanthin (p = 0.008), β-cryptoxanthin (p = 0.027), α-carotene (p = 0.030); β-carotene approached significance (p = 0.056). Additional research is needed to determine if carotenoid concentrations were physiologic to varying gestational ages or if they were impacted by factors associated with preterm birth.

Optimal umbilical cord blood collection, processing and cryopreservation methods for sustained public cord blood banking

Background aimsUmbilical cord blood is an established source of stem cells in patients with hematologic malignancies who do not have HLA-compatible matched related or unrelated donors. The success of an umbilical cord blood transplant depends on the dose of total nucleated and CD34+ cells infused. Therefore, collecting, banking and listing high-quality cord blood units with high total nucleated and CD34+ cell dose are essential. MethodsHere the authors describe their cord blood bank's novel collection technique, which involves both in utero and ex utero collection of a single cord blood unit. The authors also evaluated maternal, neonatal and collection parameters that may impact the cell dose. ResultsMaternal gestational age and race, and neonatal weight and sex correlated with the total nucleated cell dose. ConclusionsThe optimized collection of umbilical cord blood is critical for its use as a source of stem cells for transplantation.

Characterisation of Naive Immunological Profile of Umbilical Cord Blood: The Role of Mucosal-Associated Invariant T Cells and Functional Defects of T Cells and Natural Killer Cells

Patients undergoing allogeneic haematopoietic stem cell (HSC) transplantation are susceptible to infection and reactivation of viruses, such as cytomegalovirus, due to impairment of the T cell compartment following intensive immunosuppressive therapy. There is a growing interest in evaluating cell-mediated immunity to improve the management of these infections. Over the last two decades, umbilical cord blood (UCB) has emerged as an alternative source of cellular products for the treatment of a range of haematological disorders. UCB HSCs have a number of distinguishing characteristics which differentiate them from adult HSCs, including increased proliferation and increased in vitro colony forming capacity. The use of UCB as HSC grafts for allogeneic stem cell transplant has a number of advantages, including immediate availability and reduced risk of graft-versus-host disease despite donor-recipient HLA disparity. However, the limited number of HSCs present in a single UCB collection and incomplete immune reconstitution because of delayed HSC engraftment has restricted the use of cord blood in stem cell transplantation. In addition, UCB transplantation is associated with lack of transferred adoptive immunity, resulting in transplant related morbidity and mortality due to infectious complications. While the human neonatal immune system is considered to be immature compared with its adult counterpart, the role of the innate immune cells in the immunological naïvety is not fully understood.Here, we describe the collection and characterisation of UCB units collected from a series of Irish mothers who delivered term infants by elective caesarean at a major Irish maternity hospital. Pre analytical variables included maternal factors such as gestation at delivery, blood group, age, medical history and BMI, and neonatal factors such as birth weight and gender. Mononuclear cells (MNC) were isolated and the immunological profile was analyzed by flow cytometry for the surface markers CD3, CD4, CD5, CD8, CD19, CD34, CD45, CD56, CD161 and the Vα24Jα17, Vα7.2, Vδ1, Vδ2 and Vδ3 T cell receptors. Progenitor cell colony forming ability was assessed by CFU-GM and BFU-E assays. Stimulation of T cells, by cross-linking of CD3 and CD28 using tetrameric antibodies, and Natural Killer (NK) cells, with IL12/IL18 and target cells, was assessed by measurement of surface expression of CD107a and intracellular production of IFNγ, IL4 and IL17a.We showed no difference in the overall numbers of B cells, T cells (CD4+ and CD8+) and γδ T cells between UCB (n=23) and adult blood (n=4); however, NK cells (p<0.001) and mucosal-associated invariant T (MAIT) cells (p<0.0001) were significantly depleted in UCB. Stimulated UCB T cells and NK cells (n=17) showed significantly reduced IFNγ production compared to adult blood counterparts (n=4) (p<0.01) Following thaw of cryopreserved UCB MNC, we observed no significant change in CFU-GM, CD34+ cell concentration or immunological profile/function compared to fresh MNC (n=7).Our study suggests that reduced numbers of circulating innate immune cell populations, as well as reduced cytokine responses following stimulation, may contribute to the naïve immunological phenotype and hyporesponsiveness of UCB. Further investigation and manipulation of these innate immune cell populations could improve UCB transferred adoptive immunity potential and assist in the management of post allogeneic stem cell transplant viral infections. DisclosuresNo relevant conflicts of interest to declare.

Evaluation of a clinical-grade, cryopreserved, ex vivo-expanded stem cell product from cryopreserved primary umbilical cord blood demonstrates multilineage hematopoietic engraftment in mouse xenografts

Background aimsAllogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative therapy for a wide range of malignant and genetic disorders of the hematopoietic and immune systems. Umbilical cord blood (UCB) is a readily available source of stem cells for allo-HSCT, but the small fixed number of hematopoietic stem and progenitor cells (HSPCs) found in a single unit limits its widespread use in adult recipients. The authors have previously reported that culturing UCB-CD34+ cells in serum-free media supplemented with a combination of cytokines and the histone deacetylase inhibitor valproic acid (VPA) led to expansion of the numbers of functional HSPCs. Such fresh expanded product has been advanced to the clinic and is currently evaluated in an ongoing clinical trial in patients with hematological malignancies undergoing allo-HSCT. Here the authors report on the cryopreservation of this cellular product under current Good Manufacturing Practice (cGMP). MethodscGMP VPA-mediated expansion was initiated with CD34+ cells isolated from cryopreserved primary UCB collections, and the functionality after a second cryopreservation step of the expanded product evaluted in vitro and in mouse xenografts. ResultsThe authors found that the cryopreserved VPA-expanded grafts were characterized by a high degree of viability, retention of HSPC phenotypic subtypes and maintenance of long-term multilineage repopulation capacity in immunocompromised mice. All cellular and functional parameters tested were comparable between the fresh and cryopreserved VPA-expanded cellular products. ConclusionsThe authors’ results demonstrate and support the practicality of cryopreservation of VPA-expanded stem cell grafts derived from UCB-CD34+ cells for clinical utilization.

Umbilical cord blood transplants facilitated by the French cord blood banks network. On behalf of the Agency of Biomedicine, Eurocord and the French society of bone marrow transplant and cell therapy (SFGM-TC).

The public French Cord Blood Banks Network was established in 1999 with the objective of standardizing the practices governing umbilical cord blood (UCB) banking in France. The Network adopted a strategy to optimize its inventory and improve the quality of its banked units based on a quality improvement process using outcome data regularly provided by Eurocord. This study aimed to describe the results, over 10 years, of UCBT facilitated by a national network that used the same criteria of UCB collection and banking and to assess how modifications of banking criteria and unit selection might influence transplant outcomes. Nine hundred and ninety-nine units (593 single-unit and 203 double-unit grafts) were released by the Network to transplant 796 patients with malignant (83%) and non-malignant (17%) diseases. Median cell dose exceeded 3.5 × 107 TNC/kg in 86%. There was a trend to select units more recently collected and with higher cell dose. Neutrophil engraftment was 88.2% (85.7–90.7) and 79.3% (72.6–86.5) respectively for malignant and non-malignant diseases with a trend to faster recovery with higher cell doses. The respective 3-year transplant-related mortality were 31.1% (27.5–35.1) and 34.3% (27.0–43.5). OS was 49% ± 4 in malignant and 62% ± 4 in non-malignant disorders. In multivariate analysis, cell dose was the only unit-related factor associated with outcomes. Our results reflect the benefit on clinical outcomes of the strategy adopted by the Network to bank units with higher cell counts.

Collection of umbilical cord blood and the risk of complications in postpartum women after natural labour in the context of the possibility of umbilical cord stem cells usage in clinical practice.

Comparison of changes in peripheral blood venous morphology and the frequency of select complications in patients who underwent umbilical cord blood collection during the third stage of labour by in the utero method compared to patients who did not undergo this procedure. Presentation of current therapeutic possibilities of cord blood stem cells. The study involved 248 patients who had a vaginal delivery and had umbilical cord blood taken by in utero method during the third stage of labour. The control group consisted of the first 400 patients who gave vaginal delivery starting in 2019. Each patient had a venous peripheral blood count taken before delivery and 18 hours after delivery. Changes in the results of laboratory tests and the occurrence of adverse outcomes, such as postpartum curettage, postpartum haemorrhage and manual removal of placenta, in the 3rd and 4th stage delivery periods, were analysed. In the blood donor group there were significantly lower haemoglobin (11.32 g/L vs 11.61 g/L, p = 0.004) and haematocrit (32.83% vs 33.82% p = 0.001) concentrations after delivery. Umbilical cord donors had a greater difference in haemoglobin (postpartum minus prepartum) (-1.4 g/L vs -0.9 g/L, p = 000), and haematocrit (-4.05% vs -2.5% , p = 0.000). The study group had a higher percentage of patients with postpartum anaemia (haemoglobin concentration < 10 g/L) (15.9% vs 10.64%, p = 0.05), but the result were borderline significant. The groups did not differ in terms of the percentage of postpartum curettage, PPH, manual removal of placenta, percentage of severe anaemia (Hb < 7g/L) or transfusion requirement. Collection of umbilical cord blood during the 3rd stage of labour using the in utero method is associated with a statistically significant increase of blood loss and a higher probability of postpartum anaemia. The observed changes are minor and may have little clinical significance in otherwise healthy patients.