Allocation conflicts in cord blood transplantation: an evaluation of matching criteria of cord blood specimen and its impact on the work flow within an international cb network

Several CB specific prerequisites have to be taken into consideration to deal with the increasing number of stem cell transplants using multiple HLA mismatched umbilical cord blood (CB) specimen: As CB represents a limited and expensive resource there is a need for optimal allocation. On the other hand CB allocation cannot be optimal on a first come - first serve" basis because 20% of the CB could be allocated to more than one patient at the same time. Because of the immediate availability of CB the proportion of urgent patients is above average. Furthermore, reserving and releasing of a CB specimen has considerable influence for other patients. Using CB data from the NETCORD CB registry which maintains data from the CB banks in Barcelona, Milano and Düsseldorf and patient data from search requests, several analyses were performed to quantify the influence of these factors. To avoid and/or solve conflicts which occur much more often than in the BMD setting, there is a need for a global co-ordinated allocation of CB specimen. Within NETCORD common rules for data representation and logistics were developed to make CB data comparable and interchangeable. Modem communication technology based on Internet standards provides the technical basis for this extended need for fast and reliable communication.