Unrelated Cord Blood Banking and Transplantation: Implications for Obstetricians
M Angeles Soler,
Steven G. Kaali.
Cord blood is recognised as a rich source of haematopoietic stem and progenitor cells and its use has increased greatly in recent years. Since first cord blood transplantation was performed in Paris in 1988, knowledge of the biologic characteristics of umbilical cord blood has improved, and the benefits of using cord blood stem cells have become apparent. In fact, cord blood has showed to have several advantages as compared to bone marrow: easy availability, lower risk of infectious diseases transmission such as CMV and EBV and lower risk of graft versus host disease. However, cord blood units progenitors content is usually only sufficient for smaller recipients, usually children weighing less than 40 Kg. Gluckman et al showed grafting occurring in 85 percent of patients receiving 37 million or more nucleated cells per kilogram of body weight. In spite of this, use of cord blood in greater recipients is increasing and an effort to improve cord blood haematopoietic content is mandatory. In fact, the main limitation factor for the wide use of CB as a source of hematopoietic progenitor for transplantation is cell dose. Some of the specific areas identified by some studies for improvement of CB cell content are donor selection and CB collection. Implications of obstetricians in these issues are very important and necessary. We have evaluated cord blood donors selection criteria and two different modes of collection in order to optimise the cord blood banking proceedings and increase the quality of the CB units stored. We will review the results of our previous studies in these areas and the results of literature.
Keywords: Umbilical cord blood (UCB), infectious disease, cryopreservation, hematopoietic cell, pregnancy, Multiple gestation, IVF, prematurity, morbidity, single embryo transfer, PGD, blastocyst, cleavage stage embryo, ovulation induction
Rights & PermissionsPrintExport