Collecting the Cord Blood - Instructions

Collecting cord blood is a simple process, but one must understand the processes and have the experience, knowledge and patience to achieve required results.

{Please Note: Cord blood 'collectors', as well as midwifes and doctors participating in cord blood collection, all undergo specific training in order to be certified as cord blood collectors. These instructions are for informative purposes only.}

It's important to remember that collecting cord blood for a public cord blood bank is intended to benefit mostly severely affectedi patients, either children or adults. This may be their only chance to overcome the disease. Thus, it is crucial to pay attention to to all the details involved in the collection process and finally achieve the maximum hughest yield of cord blood. Thus, sticking to the proper guidleines may possibly make the difference if the unit  is suitable and usable for a transplant or not. It is important that the collection be done under the most optimal conditions available.

Above all, one must remember: the mother and baby's welfare come first. In event, question of risk arises, no collection should be performed

1. Blood Sample from the Mother

A small blood sample from the mother is required for the detection of viral and microbial infections, in her blood, such as Hepatitis B and C, HIV and syphilis. The sample will be taken with the tubes included in the collection kit (2 SST volume 8.5 – 5 m"l) via a vacutainer tube. The blood is withdrawn from the vein in the arm. The sample should be preferably taken before the cord blood extraction in order to get a maximal sterile  sample.

The test tube should be filled to maximum, and gently mixed a few times after filling. The barcodes on the tube, the kit and the consent forms must be compared. After filling the tubes, they are placed in a vacuum bag included in the kit and stored standing up when possible. This blood sample must be taken from the mother within 7 days preceding or following the birth.

2. Preparation for Collecting Cord Blood

Cord blood collection should be done immediately after the cutting the umbilical cord. The collection bag and the rest of the equipment should be prepared in advance. Identification stickers from the kit should be stuck on the bag. It's important to confirm the parents', but primarily the mother, consent before collection.

3.Cord blood collection

There are three main factors which greatly affect the quality of the cord blood and the success of its collection. The following are the factors which can affect and improve the results.

A. Cord Blood Volume
Cell quantity is directly linked with the amount of cord blood collected in the bag. The quantity is a key factor in the decision to store the unit and proceed with the unit and the possible use for patient transplantation. Many different things can affect the collected cord blood volume but are not in our control, such as: pregnancy age, newborn's sex, birth weight, umbilical cord length and more. Other factors are possible to control:

• It's important to collect as close as possible to the cutting site of the umbilical cord.
• The  the bag should be placed about 10cm under the bed's height.
• The needle should be held in place during the entire collection, and constant blood flow should be ensured.
• With every contraction of the womb more blood will flow into the umbilical cord and from there into the bag.
• As the flow rate decreases eventually,gently squeeze the cord between two fingers towards the end.

B. Preventing Infection
The birth area is by nature not sterile, but it is possible to prevent nearly 100% of infections by carefully following instructions.

• Use a disposable sheet, included in the kit to cover the surrounding area and provide a clean spot.
•  It's important to wipe the entire umbilical cord with sterile gauze pads provided in the kit prior to sterilization.
• Leave a gauze pad, wrapped around the cord, close to the needle insertion site in order to avoid leakage to the direction of the needle and bag.
• Sterilization is done with the provided solution, containing the active ingredients: alcohol and chlorhexidine .
• After wiping with this solution,wait for 30 seconds for the evaporation of the solution which allows only then effective sterilization.
• The tube should be tied before removing the needle in order to prevent air from entering the bag.

C. Preventing Blood Clots
Clotting in the collection bag causes continued destruction of the cells and disturb the processing of the unit. While it may not be possible for total prevention, with careful attention it can mostly be prevented.

• Shaking the bag to mix the blood with the anti-coagulating agent included in the bag.
• Finishing the collection process and tying the tube immediately after the flow stops. Trying to add another milliliter or two can harm the entire unit.
• Squeezing the blood in the tube into the bag only if it's done immediately with no waiting.

Summary: Collecting cord blood requires meticulous attention and utmost professionalism in order to get maximum results. Even with all the best efforts at times, not all the collected units are finally  suitable for freezing and transplantation. Public cord blood banks around the world report that less than half of the collected units are suitable with sufficient cell content for storage and transplantation.