The crucial thing is not the volume of the cord blood collection, but the number of stem cells it contains. Transplant doctors develop recommendations based on the Total Nucleated Cell count, or TNC, because it is the easiest measure to reproduce between different labs. For treating cancer, the transplant dose should be at least 25 million TNC per kilogram of patient body weight (1 kilogram equals 2.2 pounds). The average cord blood collection holds 8.6 million TNC per mL. Thus, the optimal transplant dose requires harvesting: 1.3 mL of cord blood for every pound of patient weight, -or- 2.9 mL of cord blood for every kg of patient weight
However, as more transplant centers are adopting the practice of giving adult patients "double cord blood transplants" with two cord blood units, it is less critical for both units to have adequate cell dose.
References: Reed, W et al., Blood 2003;101(1):351 Barker, JN et al., Blood 2005;105:1343-1347 Eapen, M et al. Lancet 2007;369:1947-54 Rocha & Gluckman Brit. J. Haematology 2008;147:262-274 Delaney, C et al., Brit. J. Haematology 2009;147:207-216 Michallet et al. 2010 Blood 2010;116:Abstract#361
Do I need to store the cord blood in the country where I plan to use it?
No. First, you must store blood in a lab that is permitted by the regulations of the country where you will give birth. Second, you should store cord blood in a lab that can receive and process the collection within 48 hours of birth. After cord blood is collected at birth, the stem cells start to die while the blood is waiting to be processed and frozen. The quicker it gets to the lab the better. By comparison, if you ever need the cord blood for therapy, it will be shipped in a vessel that keeps it frozen. When cord blood is released for therapy can travel to the other side of the world with no loss of viability, because it travels frozen. It is only thawed at the clinic where it will be used.
What are the most important things to do when collecting cord blood?
1. Read the instructions on the kit! Too many healthcare providers think that they don't need to read and follow instructions. 2. Sterilize before every needle stick. When in doubt, sterilize again! 3. Volume, volume, volume. You want to "milk the cord" for as much blood as possible. If the blood vessel you are using stops working, try another or move upstream, but sterilize first.
