Cord blood collection
NHSBT provides a directed cord blood collection service to haematologists / oncologists for patients who may require a transplant in the future. It is the responsibility of the clinician treating the patient to be transplanted to complete a referral form (Request for a Directed Cord Blood Collection).
Cord blood for transplantation
In general, cord blood is a suitable source of haemopoietic stem cells for transplantation where:
- The intended recipient is less than 16 years of age or whose size is commensurate with that age
- The stem cells are intended as a vehicle for gene therapy for the index donor infant affected with a genetic disease amenable or potentially amenable to gene therapy in the future
- The cord blood collection is intended for other future children of the same parents at risk of a specific genetic disease treatable by transplantation where the index donor is not affected by that genetic disorder
Collections will not be made from mothers with positive mandatory marker screening tests. In the unlikely event of a very small collection, the clinician will be asked whether it should be discarded or banked.
Collection of cord blood for directed transplantation
It is the responsibility of the referring Consultant to make initial communications with the Consultant Obstetrician at the chosen maternity unit. The requirement for mandatory microbiology screening applies to the mother who must be consented for virology tests and cord blood collection before referral. In the first instance, the referring Consultant should contact the NBS Lead Consultant with responsibility for directed cord blood collections.
The referring Consultant must:
- Obtain relevant donor information, donor selection and written consent from the mother for testing- Obtain written consent for discard of the cord blood
- Arrange for blood samples from the mother (and father if possible) to be sent to the Stem Cell Laboratory up to 30 days prior to the planned cord blood collection
- Ensure that a sample from the patient is provided
- Identify funding for the collection, processing, testing, cryopreservation and long-term storage
NHSBT staff co-ordinate the collection of cord blood by:
- Approaching the relevant obstetrician to gain written consent for a directed cord blood collection
- Liaising closely with midwifery staff at the delivery hospital -Arranging for all the necessary tests to enable the directed cord blood collection to be banked
- Advising midwifery/obstetric staff of the requirements of a directed cord blood donation and delivering specialist equipment and materials required and a detailed protocol of the collection procedure
Advising on arrangements for sending the collection to the stem cell laboratory for processing and cryopreservation
The safety and well-being of mother and baby remains the primary responsibility of the obstetric team.
Midwifery Staff are responsible for:
- Performing the collection according to the protocol provided by the NHSBT staff
- Sending the donation to the stem cell laboratory according to instructions provided by the NBS staff
- Informing the stem cell laboratory that cord blood has been collected and is on its way
Following collection, the stem cell laboratory will:
- Arrange for HLA typing of the cord blood unit
- Undertake CD34 counting and CFU enumeration on the cord blood unit
- Arrange for virology testing of cord blood samples
- Arrange for a full blood count and prepare a blood film
- Arrange for red cell phenotyping
- Process and cryopreserve the unit for use by named patient only
- Send a report to referring consultant
Following cryopreservation, there will be a yearly fee for continued storage.