Optimizing donor selection for public cord blood banking: influence of maternal, infant, and collection characteristics on cord blood unit quality.
Author(s): Page KM, Mendizabal A, Betz-Stablein B, Wease S, Shoulars K, Gentry T, Prasad VK, Sun J, Carter S, Balber AE, Kurtzberg J
Publication: Transfusion, 2014, Vol. 54(2), Page 340-352
PubMed ID: 23711284 PubMed Review Paper? No
Purpose of Paper
The purpose of this paper was to determine the effects of gestational age, birth weight, maternal age, parental race, delivery method, collection volume and delayed processing on the number of colony forming units (CFUs), percentage of CD34 positive cells (CD34+) and post-processing total nucleated cell count (post-TNCC) in cord blood (CB).
Conclusion of Paper
The number of CFUs, CD34+ cells, and post-TNCC decreased with increasing gestational age and time between collection and processing (combined room temperature transport and storage) and increased with increasing birth weight. Further, CFU, CD34+ and post-TNCC were higher when parents self-identified as white rather than African American, from male infants than females, when maternal age was >20 years rather than <20 years, and when >80 mL blood was acquired from vaginal delivery rather than cesarean delivery.
Studies
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Study Purpose
The purpose of this study was to determine the effects of gestational age, birth weight, maternal age, parental race, delivery method, collection volume and delayed processing on the number of CFUs, CD34+ cells and post-TNCC in CB. CB was shipped by courier from 0.25 miles to more than 600 miles before processing. Once processed, dimethyl sulfoxide (DMSO) was added before being frozen in a control rate freezer.
Summary of Findings:
CB from babies with a gestational age of 34-37 weeks had more CFUs and higher CD34+ counts than those from babies with gestational ages of 38-40 weeks (p=0.0182 and p<0.0001, respectively) or 41-42 weeks (p=0.006 and p<0.0001, respectively). Further, the post-TNCC from CB increased with increasing gestational age. Overall, CB from parents self-identifying as white had more CFUs (p=0.0001), CD34+ cells (p=0.0057), and post-TNCC (p<0.0001) than CB from parents self-identifying as African American, and these differences persisted after normalization for volume. The CB from heavier babies (>3500 g) had higher yields of CFU (p=0.0003), CD34+ cells (p<0.0001), and post-TNCC content (p<0.0001) than CB from babes weighing less than 3500 g, and the post-TNCC, CD34+ counts and CFU in CB increased with each 500 g incremental increase in birth weight. CB from male infants had a higher amount of CD34+ cells than CB from female infants (p=0.0002), but this was complicated by differences in birth weight, parental age, and cesarean section rates. Univariate analysis showed significantly more CFUs (p=0.0381), CD34+ cells (p=0.0217) and post-TNCC (p=0.0480) in CB when the maternal age was >20 years than when the mother was <20 years old. There was an interaction between collection volume and delivery method, such that when only specimens with >80 mL of CB were considered, CB from vaginal deliveries had higher CFU (p=0.0002), and CD34+ cell counts (p=0.0130) than CB from cesarean sections. Compared to CB with transport and storage durations before processing of <10 h or 10-23 h, specimens with transport and storage durations of >24 h had lower viability (p<0.0001, both), CFUs (p=0.0001, p=0.0035), CD34+ cell counts (p=0.0001, p=0.0045), and post-TNCC (p=0.0001, p=0.0003). The authors show that post-TNCC is associated with CFU and CD34+ cells, but that using post-TNCC alone as a marker of quality excludes some units that would likely perform.
Biospecimens
Preservative Types
- Frozen
Diagnoses:
- Not specified
Platform:
Analyte Technology Platform Cell count/volume Light microscopy Cell count/volume Flow cytometry Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Storage Between site transportation method Courier
Storage Specimen transport duration/condition <10 h
10-23 h
>24 h
Preaquisition Patient age 34-37 weeks gestation
38-40 weeks gestation
41-42 weeks gestation
<20 years
>20 years
Preaquisition Surgical procedure type Vaginal delivery
Cesarean section
Preaquisition Patient race White
Black or African American
Preaquisition Patient gender Female
Male
Biospecimen Aliquots and Components Aliquot size/volume <80 mL
>80 mL