Cord Blood Quality and Banking Predictors Across Three Regulatory Phases: A Retrospective Study of 73,925 Units Collected over a 20-yr Period

Background: Public cord blood (CB) banks provide essential hematopoietic stem cell sources for patients without matched donors. With haploidentical and haplo-cord transplantation expanding, reassessing CB banking quality and efficiency is increasingly important. We analyzed 20-yr operational data from Korea's largest public CB bank to identify quality trends and predictive factors for banking success. Methods: We retrospectively analyzed CB units processed at a single public CB bank across three regulatory phases: phase 1 (pre-Act, 05/2006-06/2011), phase 2 (07/2011-12/2020), and phase 3 (Act Amendment, 01/2021-12/2025). Multiple linear regression with mean-centered predictors and multivariable logistic regression with bootstrap validation were used to identify factors influencing pre-processing total nucleated cell (TNC) count and banking outcome, respectively. Results: <0.001). Conclusions: Quality metrics improved across regulatory phases despite declining banking rates. Collection volume, delivery mode, and hospital-level variation are key modifiable factors. Standardized collection protocols and collector education are warranted to optimize CB banking efficiency.