Bhandari Rusha, Lindley Amy, Bhatla Deepika, Babic Aleksandar, Mueckl Kathy, Rao Rakesh, Brooks Paula, Geiler Vicki, Gross Gilad, Al-Hosni Mohamad, Shenoy Shalini
Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Missouri.
Saint Louis University School of Medicine and SSM Health Cardinal Glennon Children's Hospital, St. Louis, Missouri.
Pediatr Blood Cancer. 2017 Jul;64(7). doi: 10.1002/pbc.26412. Epub 2017 Jan 23.
Umbilical cord blood (UCB) is an important source of hematopoietic stem cells for transplantation especially in minority populations with limited chances of finding a histocompatible volunteer donor in the registry. UCB has the advantages of early availability, successful outcomes despite some histocompatibility mismatch, and low incidence of chronic graft-versus-host disease. Public cord blood banks that disseminate UCB products for transplant depend on voluntary donation at participating hospitals and obstetrical providers for collection.
Using survey questionnaires, we evaluated attitudes toward UCB donation, the frequency of donation, and provider opinions on UCB collection in the greater St. Louis metropolitan area that caters to minority ethnicities in significant numbers.
Our data suggest that nervousness and lack of information regarding the donation and utility of the product were ubiquitous reasons for not donating. Additionally, irrespective of age or level of education, women relied on healthcare providers for information regarding UCB donation. Providers reported primarily time constraints to discussing UCB donation at prenatal visits (54%). Of the interviewees, 62% donated UCB. Fallout due to refusal or preferring private banking was miniscule.
These results suggest that dedicated personnel focused on disseminating information, obtaining consent, and collecting the UCB product at major hospitals can enrich cord blood banks especially with minority cords. Sustained and focused efforts could improve upon a relatively high wastage rate and ensure a robust supply of UCB products at local public banks.
脐带血是移植用造血干细胞的重要来源,对于在登记处找到组织相容性匹配的志愿捐赠者机会有限的少数族裔群体而言尤其如此。脐带血具有可早期获取、尽管存在一些组织相容性不匹配仍能取得成功结果以及慢性移植物抗宿主病发病率低等优点。分发脐带血产品用于移植的公共脐带血库依赖参与的医院和产科机构的自愿捐赠来进行采集。
我们使用调查问卷,评估了大圣路易斯都会区(该地区有大量少数族裔)对脐带血捐赠的态度、捐赠频率以及医疗服务提供者对脐带血采集的看法。
我们的数据表明,对捐赠以及该产品的用途感到紧张和缺乏相关信息是不捐赠的普遍原因。此外,无论年龄或教育程度如何,女性都依赖医疗服务提供者获取有关脐带血捐赠的信息。医疗服务提供者报告称,产前检查时讨论脐带血捐赠主要存在时间限制(54%)。在受访者中,62%捐赠了脐带血。因拒绝捐赠或倾向于私人储存脐带血而导致的流失极少。
这些结果表明,在大型医院配备专注于传播信息、获取同意并采集脐带血产品的专门人员,可以充实脐带血库,特别是增加少数族裔脐带血的储备。持续且有针对性的努力可以改善相对较高的浪费率,并确保当地公共脐带血库有充足的脐带血产品供应。