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Section 1 General Info
Question | CBB answer |
The information has been reviewed in year : | |
Name of the cord blood bank: | |
Number of cord blood units the cord blood bank plans to store for public use (unrelated patients): | |
Section 2 Cord Blood Units in Inventory
Question | CBB answer |
Current processing method(s): |
Plasma and RBC reduced (automatic) | checkfalse |
Plasma reduction only | checkfalse |
Plasma and RBC reduced (manual) | checkfalse |
RBC reduction only | checkfalse |
Total Nucleated Cell Count (x10E7) of your cord blood units stored for Unrelated Patients (Public Use). |
< 125 : | |
125 - 149 : | |
150 - 199 : | |
200 - 250 : | |
> 250 : | |
Section 3 Cord Blood Collection
Question | CBB answer |
Current practice for collecting cord blood: | |
Current antiseptic: | |
Collection bag: | |
Agitation during collection: | |
Section 4 Conditioning and transport from Collection Centre to cord blood bank
Question | CBB answer |
Secondary bag used by the cord blood bank (sealed, plastic bag or similar to avoid any leakage): | |
Transport conditions: |
Insulating transport container | checkfalse |
Active refrigeration system | checkfalse |
Passive refrigeration system (gel, blocks) | checkfalse |
Electronic temperature probe | checkfalse |
Non-electronic temperature probe | checkfalse |
Qualified transporter | checkfalse |
Unqualified transporter | checkfalse |
Air transport | checkfalse |
Ground transport | checkfalse |
Other, | checkfalse |
Temperature range for storage and transportation of fresh product: | |
Section 5 Evaluation
Question | CBB answer |
Pre-processing Evaluation: Current threshold for accepting a cord blood unit for public use in the cord blood bank: |
Net weight in grams (excluding bag and anticoagulant) before processing | |
TNC (10E7) before processing | |
Viability CD45 positive cells (%) | |
Viability CD45 positive cells (method) | |
Viability CD34 positive cells (%) | |
Viability CD34 positive cells (method) | |
Criteria that are completed before accepting a cord blood unit for public use in the cord blood bank: |
Medical History | checkfalse |
Collection Report | checkfalse |
Informed Consent | checkfalse |
Maternal IDM results | checkfalse |
Temperature and integrity of the bag | checkfalse |
Other, | checkfalse |
Used method for CD34 enumeration: | |
The cord blood banks uses external proficiency testing for QC of the cord blood banks FACS lab: | |
The cord blood bank performs post processing/pre-freeze CD34 cell count: | |
Acceptable time from collection to processing: | |
Section 6 Processing-Packaging
Question | CBB answer |
The pre-freeze processing method(s) cord blood bank uses at any stage in time: |
AXP | checkfalse |
SEPAX | checkfalse |
Optipress | checkfalse |
Prepacyte | checkfalse |
Manual- plasma and red cell reduction | checkfalse |
RBC/plasma reduction with HES | checkfalse |
Ficoll sedimentation | checkfalse |
Centrifugation and volume reduction | checkfalse |
No processing | checkfalse |
Manual- plasma reduction only | checkfalse |
Other, | checkfalse |
The current pre-freeze processing method(s): |
AXP | checkfalse |
SEPAX | checkfalse |
Optipress | checkfalse |
Prepacyte | checkfalse |
Manual- plasma and red cell reduction | checkfalse |
RBC/plasma reduction with HES | checkfalse |
Ficoll sedimentation | checkfalse |
Centrifugation and volume reduction | checkfalse |
No processing | checkfalse |
Manual- plasma reduction only | checkfalse |
Other, | checkfalse |
Additives currently in use in addition to anticoagulants and DMSO during processing: |
HES | checkfalse |
Prepacyte | checkfalse |
Plasmalyte | checkfalse |
Albumin | checkfalse |
Isotonic salt solution NaCl (saline) | checkfalse |
No additive | checkfalse |
Other, | checkfalse |
Cryoprotectant additives currently in use: | |
Cryopreservation method currently in use: |
BioArchive | checkfalse |
MVE 1850 Vapor freezer | checkfalse |
Programmed cryopreservation with Air Liquid program (FREEZAL) | checkfalse |
Programmed freezer | checkfalse |
Two-step (equilibrium) freezing | checkfalse |
Cryobag currently in use: | |
Currently used packaging when a unit is stored: | |
Segments currently stored with the unit by the cord blood bank: |
One attached segment | checkfalse |
Two or more attached segments | checkfalse |
Separate segments detached from the bag, but stored with the CBU | checkfalse |
Other samples | checkfalse |
None | checkfalse |
Section 7 Testing
Question | CBB answer |
Does your cord blood bank currently store extra material? |
Cord blood DNA | checkfalse |
Cord blood material for DNA extraction | checkfalse |
Plasma/cord blood | checkfalse |
Maternal DNA | checkfalse |
Maternal material for DNA extraction | checkfalse |
Maternal plasma/serum | checkfalse |
HLA typing at time of listing: |
HLA-A | |
HLA-B | |
HLA-C | |
HLA-DRB1 | |
HLA-DRB2 | |
HLA-DPB1 | |
Section 8 Storage
Question | CBB answer |
The following type(s) of storage container is currently used by the cord blood bank: |
BioArchive tank | checkfalse |
Conventional storage tank-Vapor phase | checkfalse |
Conventional tank-Liquid phase | checkfalse |
Double walled liquid Nitrogen | checkfalse |
Type following type(s) of storage monitoring is currently by the cord blood bank: |
Alarm on individual tanks only | checkfalse |
Centralized system-local | checkfalse |
Centralized system-remote monitoring | checkfalse |
LN2 level | checkfalse |
Lid opening | checkfalse |
System default | checkfalse |
Temperature monitoring | checkfalse |
No temperature monitoring | checkfalse |
Section 9 Adverse Events Reporting
Question | CBB answer |
Adverse Event Reporting used by the cord blood bank: |
Competent authority | checkfalse |
Internal report | checkfalse |
National registry | checkfalse |
Transplant centre | checkfalse |
WMDA | checkfalse |