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Effect of Delayed Clamping on Cord Blood Donation

Effect of Delayed Clamping on Cord Blood Donation. Dr M Guttridge NHS Cord Blood Bank. NHS Cord Blood Bank. Operational since Feb 1996 First unit issued for transplant in February 1998 6 collection centres in London Fact-NetCord accredited in 2004 HTA licensed from 2006

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Effect of Delayed Clamping on Cord Blood Donation

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  1. Effect of Delayed Clamping on Cord Blood Donation Dr M Guttridge NHS Cord Blood Bank

  2. NHS Cord Blood Bank Operational since Feb 1996 First unit issued for transplant in February 1998 6 collection centres in London Fact-NetCord accredited in 2004 HTA licensed from 2006 Over 19,500 units banked 40% from BME communities Over 400 Cord Blood units issued

  3. Delayed clamping associated with: • Lower levels of anaemia at day 2 (1.2% versus 6.3%), • higher ferritin and lower prevalence of iron deficiency at 4 months • Volume of blood remaining in cord/placenta was 37% lower in delayed clamping group • 25mL versus 39mL

  4. Study Overview • All 6 collection centres participated in study • L&D introduced policy of delayed clamping • No intervention in birth process • Midwives recorded time to clamping • ‘Immediate’ = less than 10 seconds • Data where midwife wasn’t sure was excluded. • Only collections over 50mL were evaluated for TNC. • Effect on collection volume and TNC calculated.

  5. Time (seconds) Number Mean (seconds) SD (seconds) Immediate 400 10 to 30 267 26 7 31 to 60 51 56 10 61 to 179 28 113 16 180 + 14 210 112 Data Overview Mean collection volume was: 65.08 ± 29.57mL (n=760) Mean TNC (x10^7) was: 121.37 ± 61.6 (n=509) Table: breakdown of clamping times in the study

  6. 120.00 100.00 80.00 <10 10 to 30 Mean Collection Volume (mL) 60.00 31 to 60 61 to 179 180+ 40.00 20.00 0.00 Time to Clamping (Seconds) ResultsEffect on Collection Volume 67.8 65.9 64.1 62.6 55.2 n=400 n=267 n=51 n=28 n=14 p>0.2295

  7. 250 200 <10 150 10 to 30 TNC (x10^7) 31 to 60 61 to 179 100 180+ 50 0 Time to Clamping (seconds) Effect on CollectionTotal Nucleated Cell Count 124.2 121.5 116.9 103.9 101.2 n=264 n=177 n=37 n=21 n=10 p>0.1312

  8. 120 100 80 Banked Proportion Banked (TNC >140x10^7) 60 Not Banked 40 20 0 <10 10 to 30 31 to 60 61 to 179 180+ Time to Clamping (seconds) Impact on Banking Rate 78 58 8 4 2 186 118 29 17 8

  9. Conclusions • Delayed clamping was rare during the study • 52.6% clamped immediately • 87.8% clamped within 30 seconds • 1.8% clamped after 180 seconds • Mean collection volume was 65.08mL • Mean nucleated cell (TNC) count was 121.37x10^7 • Delayed clamping did not significantly impact on collection volume or TNC

  10. Acknowledgements • Edward Dobranszky – coordinated the study and collated the data. • Midwives at the collection centres • Luton and Dunstable, St George’s, Northwick Park, Watford, Barnet, UCL • Jesmina James – Clinical Scientist • Dr Rachel Pawson – Medical Director

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