title: Four phases of checks for exclusion of umbilical cord blood donors.
abstract: OBJECTIVE
  The aim of this study was to analyse umbilical cord blood (UCB) collection over 1 year between October 2008 and September 2009, seeking ways to improve the number of suitable banked UCB units. Four phases of the process were investigated, from the consent form to the banking procedure, paying attention to the discarded UCB units.
  
  
  METHODS
  We recruited couples at 35 weeks of gestation and took an accurate history, focusing on genetic, immunological and infectious diseases. We collected UCB from pregnant women who delivered vaginally or by Caesarean section between the 37-41(+6) weeks of gestation. Some units were discarded on the basis of the patients' history, obstetric events or biological criteria. In utero collection was the preferred method of collection.
  
  
  RESULTS
  During the study period, between October 2008 and September 2009, there were 1,477 deliveries in our unit. The number of couples interested in UCB donation was 595 (40.2%-595/1,477). We collected 393 UBC units. We excluded 122 patients at the phase of the history taking, counselling and informed consent (first phase check). Of the 393 units collected, 162 (41.3%) were banked whereas 231 (58.7%) were discarded because they did not fulfil biological criteria (third phase check). The volume of UCB units collected after Caesarean section was greater than the volume of units collected after vaginal delivery (95.4 mL versus 85.0 mL, respectively; p <0.01). The UCB units collected after vaginal delivery contained a higher number of total nucleated cells compared to the units collected after Caesarean section (970x10(6) cells versus 874x10(6) cells, respectively; p=0.037). None of the banked UCB units was discarded at the clinical check 6 months after delivery (fourth phase check).
  
  
  CONCLUSIONS
  Our study shows that strict observance of each of the checks and the collection strategy is important to guarantee the safety of the UCB units and to maximise the cost-benefit ratio. After the appropriate checks we banked UCB units from only 27.2% (162/595) of the couples who gave consent to the procedure and from only 11% (162/1,477) of all the deliveries in the 12 month study period, as 59.8% of couples were not properly informed about UCB donation.
authors.affiliation: Obstetrics and Gynaecology Unit, Di Venere Hospital, Bari, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Volpe
authors.forename: Michele
authors.initials: M
authors.lastname: Santodirocco
authors.forename: Lazzaro
authors.initials: L
authors.lastname: Di Mauro
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Miscio
authors.forename: Filippo Maria
authors.initials: FM
authors.lastname: Boscia
authors.forename: Brunella
authors.initials: B
authors.lastname: Muto
authors.forename: Nicola
authors.initials: N
authors.lastname: Volpe
mesh_terms: D000094902:Blood Banking / Q000379:methods*; D001793:Blood Preservation; D001803:Blood Transfusion; D002585:Cesarean Section; D046148:Donor Selection / Q000379:methods*; D005260:Female; D005312:Fetal Blood; D006801:Humans; D066298:In Vitro Techniques; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors