Delayed clamping of the umbilical cord after delivery and implications for public cord blood banking

作者：Allan David S^*; Scrivens Nicholas; Lawless Tiffany; Mostert Karen; Oppenheimer Lawrence; Walker Mark; Petraszko Tanya; Elmoazzen Heidi

来源：Transfusion, 2016, 56(3): 662-665.

DOI：10.1111/trf.13424

BACKGROUNDPublic banking of umbilical cord blood units (CBUs) containing higher numbers of cells ensures timely engraftment after transplantation for increasing numbers of patients. Delayed clamping of the umbilical cord after birth may benefit some infants by preventing iron deficiency. Implications of delayed cord clamping for public cord blood banking remains unclear.
STUDY DESIGN AND METHODSCBUs collected by Canadian Blood Services at one collection site between November 1, 2014, and March 17, 2015, were analyzed. The delay in cord clamping after birth was timed and classified as no delay, 20 to 60 seconds, more than 60 seconds, or more than 120 seconds.
RESULTSOf 367 collections, 100 reported no delay in clamping while clamping was delayed by 20 to 60 seconds (n=69), more than 60 seconds (n=98), or more than 120 seconds (n=100) in the remaining cases. The mean volume and total nucleated cells (TNCs) in units with no delay in clamping were significantly greater than mean volumes for all categories of delayed clamping (Tukey's test, p<0.05 for each comparison). The proportion of units with more than 1.5 x 10(9) TNCs was significantly reduced when clamping was delayed (p=5.5 x 10(-8)). The difference was most marked for cords that were clamped more than 120 seconds after delivery (6.2% compared with 39%).
CONCLUSIONSDelayed cord clamping greatly diminishes the volume and TNC count of units collected for a public cord blood bank. Creating an inventory of CBUs with high TNC content may take more time than expected.

• 出版日期2016-3