the accreditation status of the banks varies substantially, which also reflects the diverse practices and goals that exist among the banks.

One practical example of this diversity is the different standards for banking cord blood units. Most banks require at least 40 to 50 ml for banking, although the volumes range from 10 to 50 ml.1 The total nucleated cell (TNC) count dose requirement was most often 8 × 108 or 9 × 108 cells, but that, too, varied among the banks.2 Some private banks indicated that they may store units that are smaller than what is currently considered clinically useful after they inform the parents of the donor and receive confirmation of their wishes.

Without a single system of accreditation, the banks’ standards can be expected to remain quite variably enforceable.

Recommendation 4.1: The Health Resources and Services Administration should identify a Cord Blood Accrediting Organization by means of an open, competitive request for proposal process. This organization should be charged with the delineation of standards for any cord blood bank, collection center, or transplant center desiring to participate in the National Cord Blood Stem Cell Bank Program.

Size of Identified Banks

The committee’s survey found that the number of units collected by banks also varied considerably and were as follows: Viacord, >60,000 units; St. Louis Cord Blood Bank, >40,000 units; the National Cord Blood Program of the New York Blood Center, 29,525 units; the American Red Cross Cord Blood Program, 18,680 units; Lifebank USA, 17,228 units; the Carolinas Cord Blood Bank, 17,000 units; Cryobanks International, Inc., 15,429 units; and StemCyte International Cord Blood Bank and Cord Blood Family Trust, 13,566 units.

Collection Processes

All but three of the cord blood banks indicated that obstetricians are among those who perform the cord blood collection. Staff nurses and designated collectors from the cord blood bank were also among the collectors at most delivery centers. No banks selected the “researcher” or the “other” category for this question, which was phrased as “Who collects the blood?”

1  

National Marrow Donor Program’s protocol requires 40 ml. Lifebank USA requires 35 ml. Sibling Cord Blood Program (CHORI) requires 20 ml. Viacord requires 10 ml, and StemCyte requires 10 ml.

2  

Engraftment speed and survival are related to the TNC count of the graft.



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