Medical criteria for exclusion of umbilical cord blood donation

A Canadian physician affiliated with a public umbilical cord blood stem cell bank in Alberta is interested in input from other cord blood stem cell bankers as to their criteria for exclusion of potential donors based on medical history. His institution's criteria for exclusion of cord blood donations include:

• any history of maternal illness during the period of the pregnancy
• prescribed maternal medications including anti-emetics
• older age mother (>36 year)
• young maternal age (<18 years)
• receipt of blood and blood products, including Rh immune globulin within one year of conception
• ineligible to donate whole blood for any reason

His institution excludes donations if the mother has taken prescribed medications because they do not know which of the drugs might be harmful to stem cells. This has been a problem for them as many potential donors are excluded because of use of anti-emetics.

He comments that it would be important for workers in the field to address this issue so that there can be uniformity in the selection criteria, especially where prescribed drugs are concerned. Readers are referred to their institution's full list of exclusionary criteria.

The following comments have been received.

ADDENDA Jan 10, 2005

1. A California cord blood banker agrees that uniformity is a great goal in cord blood collections, but reminds us that it took the United States some time to achieve uniformity for whole blood donors. Her cord blood bank (as well as others) is working with the National Marrow Donor Program's various cord blood committees to standardize the criteria. She suggests that interested individuals contact the NMDP for a more detailed list of criteria. Many of the California colleague's cord blood bank donor criteria are based on whole blood donors. To answer the specific questions raised by the Canadian cord blood banker:
   • The California cord blood bank does not exclude donors just because of a history of maternal illness during pregnancy. Instead their Medical Director evaluates the illness. They would not exclude someone who had a cold/flu.
   • They evaluate what medications a donor has taken before excluding them and would not exclude for anti-emetics, anti-hypertensive medications, or most other medications that would not cause a whole blood donor to be excluded.
   • They do not have an upper age limit for donors, although they do exclude donors less than 18 years.
   • They do exclude donors who have received blood and blood products within the previous 12 months, but do not defer a donor just because they received Rh immune globulin.
   • They do not exclude donors just because they have been ineligible to donate whole blood; rather they evaluate the reason and make a decision based on that evaluation. Usually if a donor has been permanently deferred, they would defer them too. But a donor who has been deferred, for example, for low hematocrit would not be excluded at the California cord blood donor center.
   Finally, while the Canadian cord blood bank does not accept donors who have had a Caesarian-section, the California cord blood bank would accept such a donation, because there are several ways to collect the cord blood without contaminating the field.

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