Umbilical Cord Blood (UCB) as an alternative source of hematopoietic stem cell transplantation in hematological and non-hematological disorders.
The achievement of transplantation is greatly connected to the level of TNC and CD34+ cells. The assessment of ideal situations can decline the amount of
sample rejection due to low cell count and increases the quality of cord blood units (CBUs) in the blood bank and the reaching to the better engraftment.
In this study, we reviewed some factors that are in our control and could impact on cord blood quality and quantity.
Umbilical cord blood (UCB) is an effective source of
Hematopoietic Stem Cells Transplantation (HSCTs) in some
hematological and non-hematological disorders . One of the
main issues that effect on transplantation outcome is Cord Blood
(CB) cell count, furthermore to Human Leukocyte Antigen (HLA)
similarity and CD34+ cell count [2,3]. Despite all the benefits it has
such as without risk for donors, as soon as possible availability, a
lower limitation at HLA similarity and lower GVHD than another
source, the uses of this source is limited because of the low
numbers of cells in one unit . The numbers of total Nucleated
Cells (TNC) and CD34+ cells are worthy markers of CB quality
since they have been informed to be associated with engraftment
. Consequently, by considering the maternal and infant factors
and also controlling the affective issues, such as mode of collection,
time and temperature of collection, transport and processing,
freeze and thaw techniques, can raise the CB yield.
There are no doubt some factors such as maternal age and
weight, gestational period, cord length, placenta weight, number
of previous live births, mode of delivery, maternal smoking, race,
maternal diseases, fetal distress, fetal distress and baby’s sex can
impact on cord blood yield but control of these issues are out
of hand and we cannot interfere with them . Due to the high
cost of cord blood storage and the direct relationship between
the numbers of cells in a cord blood unit with the result of
transplantation, umbilical cord blood banks seek to improve the
quality and quantity of their center in order to provide the best
service. Therefore, by controlling some of the factors mentioned
above, we can achieve this.
The most important factor in cord blood collection is the
training of staffs because having well-trained staffs can collect a
high volume of blood with the best quality .
Mode of collection
There are two major techniques for CB collecting: in-uterus
and ex-uterus collection. Each method has some advantages
and disadvantages. In overall, in-uterus CB collection yielded a
meaningfully superior volume, TNC, CD34+ cells and CFU than
Type and amount of anticoagulant
There are not many studies in this regard, but given that the
umbilical cord blood sample is processed within a maximum of 48
hours after sampling, there is no particular problem in the sample
if the anticoagulant ratio is met. Usually used citrate phosphate
dextrose-adenine 1(CPD-A1) amount of 35ml in a 250cc bag
Time and temperature
According to studies and or experience transportation and
stored in CB before processing must be at room temperature and
processing initiate as soon as possible until 48h after sampling. In
this time and temperature, CBUs have higher quality and quantity
If the process done by the device, we have higher cell count
and quality than manually .
Di-Methyl Sulf-Oxide (DMSO) is used by most CBBs for frizzing.
But the important point about this is the concentration of DMSO,
that up to a final concentration of 10% have a lower toxicity and
higher functionality .
Since CBB requires critical financial investment and
organizational attempt, banking proficiency should be optimized.
CBBs requisite develop plans to increase the TNC content of stored
units. Have a CBB with suitable samples can assistance to high
probably to transplantation of patients undergo blood diseases
and other disorders can management with this source. Sometimes
the only method to treat is CB transplant, thus should not lose the
chance for having high-quality samples.
Professor, Chief Doctor, Director of Department of Pediatric Surgery, Associate Director of Department of Surgery, Doctoral Supervisor Tongji hospital, Tongji medical college, Huazhong University of Science and Technology