This document provides guidance for the selection of cord blood donations. It must be read in conjunction with Chapter 22 (haemopoietic progenitor cells) of the Guidelines for the Blood Transfusion Services of the United Kingdom - 8th Edition, 2013, which lists the general, and some specific aspects of donor selection.
Cord Blood is taken from the placenta of newborn infants. As placentae are normally treated as a waste product there is no risk to the infant or the mother. To ensure the donated material is safe to use it is important to exclude risk factors in the mother. On occasions tests may need to be performed on the cord blood but no additional testing of the infant should be required. Unless stated specifically, all guidelines apply to the mother of the infant whose cord blood is collected.
Mothers are selected firstly to ensure that their baby's cord blood stem cells are unlikely to harm any recipient. The ultimate responsibility for the selection of mothers rests with the respective National Medical Director.
The immediate responsibility is with the Qualified Healthcare Professional who must ensure that the mother fulfils the respective selection guidelines. When it is not clear from these guidelines if an individual is acceptable, cord blood should not be released for issue without discussion with a Designated Medical Officer.
The mother must be evaluated by a Qualified Healthcare Professional who has undergone appropriate training to use this document, to assess the suitability of their infant's cord blood for donation. They must verify their assessment by signing and dating the donation record.
Special note must be taken of the content of the Tissue Safety Entry in the A-Z.
It is the responsibility of the Qualified Healthcare Professional to ensure that the mother clearly understands the nature of the donation process. They must also understand the health questions and other information presented to them. The mother is asked about confidential aspects of their medical history, hence great care must be taken over privacy and confidentiality. This means that third party interpreters can only be used, as described in the A-Z entry on Communication Difficulties.
When there is a recognized risk to a recipient, the guidelines must be followed.
The following terms may be used:
Lists any other terms which may be covered by the Guideline.
Where additional clarity is required, a definition is provided.
This will indicate how the mother must be dealt with by the use of several terms:
Must not donate
The mother must not be accepted if any of the statements apply to them, unless a 'discretion' clearly applies. Often the exclusion will depend on time related factors. If a donation cannot be taken, the mother must be clearly advised why.
Refer to Designated Medical Officer
Is used when there is a need to seek further advice. The Designated Medical Officer is a suitably trained person authorized to undertake this task by the National Medical Director.
Gives reasons why a mother may be permitted to donate. The statements are conditional. All statements that must be fulfilled come before the final statement that they may be accepted. If the mother fulfils these requirements, as well as all others that apply, then they can be accepted.
See if relevant
Is used when an A-Z entry may or may not need to be consulted. This will depend upon the information provided by the mother.
This provides background information as to why a particular action or actions is required.
Means that the specified A-Z entry must be consulted.
Reason for Change
This indicates the background to any changes made to the entry since the last Edition or Release.
Some or all of these terms may be used under each subject heading or sub-heading.
This section was last updated in TDSG-CB Edition 203, Release 02