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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 onlycheckfalse
Plasma and RBC reduced (manual)checkfalse
RBC reduction onlycheckfalse
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 containercheckfalse
Active refrigeration systemcheckfalse
Passive refrigeration system (gel, blocks)checkfalse
Electronic temperature probecheckfalse
Non-electronic temperature probecheckfalse
Qualified transportercheckfalse
Unqualified transportercheckfalse
Air transportcheckfalse
Ground transportcheckfalse
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 Historycheckfalse
Collection Reportcheckfalse
Informed Consentcheckfalse
Maternal IDM resultscheckfalse
Temperature and integrity of the bagcheckfalse
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:
AXPcheckfalse
SEPAXcheckfalse
Optipresscheckfalse
Prepacytecheckfalse
Manual- plasma and red cell reductioncheckfalse
RBC/plasma reduction with HEScheckfalse
Ficoll sedimentationcheckfalse
Centrifugation and volume reductioncheckfalse
No processingcheckfalse
Manual- plasma reduction onlycheckfalse
Other, checkfalse
The current pre-freeze processing method(s):
AXPcheckfalse
SEPAXcheckfalse
Optipresscheckfalse
Prepacytecheckfalse
Manual- plasma and red cell reductioncheckfalse
RBC/plasma reduction with HEScheckfalse
Ficoll sedimentationcheckfalse
Centrifugation and volume reductioncheckfalse
No processingcheckfalse
Manual- plasma reduction onlycheckfalse
Other, checkfalse
Additives currently in use in addition to anticoagulants and DMSO during processing:
HEScheckfalse
Prepacytecheckfalse
Plasmalytecheckfalse
Albumincheckfalse
Isotonic salt solution NaCl (saline)checkfalse
No additivecheckfalse
Other, checkfalse
Cryoprotectant additives currently in use:
Cryopreservation method currently in use:
BioArchivecheckfalse
MVE 1850 Vapor freezercheckfalse
Programmed cryopreservation with Air Liquid program (FREEZAL)checkfalse
Programmed freezercheckfalse
Two-step (equilibrium) freezingcheckfalse
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 segmentcheckfalse
Two or more attached segmentscheckfalse
Separate segments detached from the bag, but stored with the CBUcheckfalse
Other samplescheckfalse
Nonecheckfalse


Section 7 Testing

Question

CBB answer

Does your cord blood bank currently store extra material?
Cord blood DNAcheckfalse
Cord blood material for DNA extractioncheckfalse
Plasma/cord bloodcheckfalse
Maternal DNAcheckfalse
Maternal material for DNA extractioncheckfalse
Maternal plasma/serumcheckfalse
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 tankcheckfalse
Conventional storage tank-Vapor phasecheckfalse
Conventional tank-Liquid phasecheckfalse
Double walled liquid Nitrogencheckfalse
Type following type(s) of storage monitoring is currently by the cord blood bank:
Alarm on individual tanks onlycheckfalse
Centralized system-localcheckfalse
Centralized system-remote monitoringcheckfalse
LN2 levelcheckfalse
Lid openingcheckfalse
System defaultcheckfalse
Temperature monitoringcheckfalse
No temperature monitoringcheckfalse


Section 9 Adverse Events Reporting

Question

CBB answer

Adverse Event Reporting used by the cord blood bank:
Competent authoritycheckfalse
Internal reportcheckfalse
National registrycheckfalse
Transplant centrecheckfalse
WMDAcheckfalse

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