An analysis of the NHS Cord Blood Bank; Barriers to cord blood donation and quality parameters limiting storage

Ross, Alexandra

Abstract

The NHS Cord Bank was established in 1996 to build an inventory of altruistically donated cord blood units to provide equity of access to all patients eligible for a stem cell transplant. Fixed cord blood collection sites were selected in areas of high black and minority ethnic (BAME) populations and a performance indicator was set routinely to bank 40-50% of cord blood units from BAME donors. As well as providing an ethnically diverse inventory, the cord donations should be of high quality in terms of nucleated cell count to achieve the best possible outcomes for patients regardless of ethnicity.

Objectives were:
To validate the objective to bank at least 40% of donations from BAME donors at each of the six collection sites.
To analyse the nucleated cell content of banked BAME donations.
To monitor the provision of cord blood transplants to BAME patients
To understand barriers to donation through a qualitative research study with healthcare professional involved with the NHS cord blood banking programme.

Methods
Data were extracted from NHSBT software using a database query and analysed for both banked cord blood units and for cord units provided for transplant. Data relating to the self-reported donor ethnicity and collection site were extracted and analysed as a proportion of the whole bank, as a contribution of BAME donors from each collection site and to ascertain the proportion of BAME donations with a high TNC. Interviews and a focus group with fifteen healthcare professional, comprising five midwives, five community midwives and five cord blood collectors were undertaken to understand barriers to cord blood donation and collection. Thematic analysis was used to interpret the interviews with participants..

Results
Banking of at least 40% BAME donations was routinely met. Representation from all groups listed on the NHS Cord Bank ethnicity form was demonstrated in the collected and banked cord donations. Non-BAME donations comprise the greater proportion of high TNC cord units. The proportion of NHS Cord Bank cord blood transplants provided to BAME patients remained constant across the period studied. Changes in, and sharing of best practice across sites were identified which could remove or reduce the barriers to cord donation and collection.

Discussion
The initial strategy to select collection sites in areas of high BAME birth rate has been successful in building an inventory with a high proportion of BAME donations. Further work to understand and determine any link between the volume and TNC of collected cord blood with ethnicity and subsequently to improve the efficiency of collections from BAME donations is needed to improve availability of HLA matched cord. The importance of communication and information for both healthcare professionals working together and potential donors was highlighted as a means of improving donation and collection of cord blood.

• Thesis Type: Thesis
• Deposit Date: Nov 23, 2020
• Publicly Available Date: Jan 10, 2022
• Keywords: cord blood donation banking barriers
• Public URL: https://uwe-repository.worktribe.com/output/6873528
• Award Date: Jan 10, 2022