Original article

Vol. 21 No. 6 (2023): Blood Transfusion 6-2023 (November-December)

Multi-component cord blood banking: a proof-of-concept international exercise

Authors

Key words: umbilical cord blood, regenerative medicine, neonatal transfusion, cord blood banking

Abstract

Background. Most public cord blood (CB) banks currently discard more than 80% of umbilical CB units not suitable for hemopoietic stem cell transplant due to low stem cell count. Although CB platelets, plasma, and red blood cells have been used for experimental allogeneic applications in wound healing, corneal ulcer treatment, and neonatal transfusion, no standard procedures for their preparation have been defined internationally.
Materials and methods. A network of 12 public CB banks in Spain, Italy, Greece, the UK, and Singapore developed a protocol to validate a procedure for the routine production of CB platelet concentrate (CB-PC), CB
platelet-poor plasma (CB-PPP), and CB leukoreduced red blood cells
(CB-LR-RBC) using locally available equipment and the commercial BioNest ABC and EF medical devices. CB units with >50 mL volume (excluding anticoagulant) and ≥150×109/L platelets were double centrifuged to obtain CB-PC, CB-PPP, and CB-RBC. The CB-RBC were diluted with saline-adenine-glucose-mannitol (SAGM), leukoreduced by filtration, stored at 2-6°C, and tested for hemolysis and potassium (K+) release over 15 days, with gamma irradiation performed on day 14. A set of acceptance criteria was pre-defined. This was for CB-PC: volume ≥5 mL and platelet count 800-1,200×109/L; for
CB-PPP: platelet count <50×109/L; and for CB-LR-RBC: volume ≥20 mL, hematocrit 55-65%, residual leukocytes <0.2×106/unit, and hemolysis ≤0.8%.
Results. Eight CB banks completed the validation exercise. Compliance with acceptance criteria was 99% for minimum volume and 86.1% for platelet count in CB-PC, and 90% for platelet count in CB-PPP. Compliance in
CB-LR-RBC was 85.7% for minimum volume, 98.9% for residual leukocytes, and 90% for hematocrit. Compliance for hemolysis ≤0.8% decreased from 89.0 to 63.2% from day 0 to 15. K+ release increased from 3.0±1.8 to
25.0±7.0 mmol/L from day 0 to 15, respectively.
Discussion.The MultiCord12 protocol was a useful tool to develop preliminary standardization of CB-PC, CB-PPP, and CB-LR-RBC.

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Authors

Dinara Samarkanova - Banc de Sang i Teixits, Barcelona, Spain; Transfusion medicine study group, Vall de Hebron, Barcelona, Spain

Margarita Codinach - Banc de Sang i Teixits, Barcelona, Spain; Transfusion medicine study group, Vall de Hebron, Barcelona, Spain

Tiziana Montemurro - Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

Larysa Mykhailova - Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

Giuseppa Tancredi - Sciacca Cord Blood Bank, Sciacca, Italy

Pasquale Gallerano - Sciacca Cord Blood Bank, Sciacca, Italy

Panagiotis Mallis - Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, Athens, Greece

Efstathios Michalopoulos - Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, Athens, Greece

Liam Wynn - Anthony Nolan Cell Therapy Centre, Nottingham, UK

Javier Calvo - Banc de Sang i Teixits de les Illes Balears, Cell Therapy and Tissue Engineering Group (TERCIT), Balearic Islands Health Research Institut (IdISBa), Palma, Spain

Oscar M. Pello - HSC Processing and Cell Therapy Unit, Marques de Valdecilla Foundation, Santander, Spain; Haematologic Neoplasms and Haematopoietic Stem Cells Transplantation Group, Marques de Valdecilla Research Institute, Santander, Spain

Ioanna Gontica - Public Cord Blood Bank of Crete, Department of Hematology, University Hospital of Heraklion, Crete, Greece; Hemopoiesis Research Laboratory, School of Medicine, University of Crete, Crete, Greece

Paolo Rebulla - Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

Sergio Querol - Banc de Sang i Teixits, Barcelona, Spain; Transfusion medicine study group, Vall de Hebron, Barcelona, Spain

Arantxa Cemborain - Hematology and Cell Therapy and Foundation for Applied Medical Research, Division of Cancer, Clínica Universitaria, University of Navarra, Navarra, Spain

Irene Fragiadaki - Haemopoiesis Research Laboratory, School of Medicine, University of Crete, Heraklion, Greece

Antonio Gaya - Banc de Sang i Teixits de les Illes Balears, Cell Therapy and Tissue Engineering Group (TERCIT), Balearic Islands Health Research Institut (IdISBa), Palma, Spain

Roger Horton - Anthony Nolan Cell Therapy Centre, Nottingham, UK

Maria Jose Martinez - Blood and Tissue Bank of Aragon, Aragon, Spain

Helen A. Papadaki - Public Cord Blood Bank of Crete, Department of Hematology, University Hospital of Heraklion, Crete, Greece

Cesare Perotti - Immunohaematology and Transfusion Service, Fondazione IRCCS Policlinico S. Matteo, Pavia Italy

Arun Prasath - Women's & Children's Hospital, Singapore, Singapore

Daniele Prati - Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

Stefania Villa - Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Po-liclinico, Milan, Italy

Sara Vallejo - HSC Processing and Cell Therapy Unit, Marques de Valdecilla Foundation, Santander, Spain

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