Abstract 29 Unprecedented Experience of Cord Blood Banking in Ukraine During Russian Invasion in 2022

INTRODUCTION: On February 24, 2022, Russia started the unprovoked and unjustified attack on the entire territory of Ukraine. Besides tremendous human losses, the war caused the biggest refugee crisis in Europe since World War II. Approximately 7 million people fled the country; women, some pregnant, and children made 90% of them. Cord blood (CB) banking appeared to be an industry especially sensitive to these unprecedented conditions. OBJECTIVE: The objective of this study was to analyze the experience of CB banking in Ukraine during the Russia-Ukraine war in 2022. METHODS: Thematic analysis was performed. RESULTS: Despite the scarce number of hematopoietic stem cell (SC) transplants for blood malignancies performed there, Ukraine has been a country with a developed regenerative medicine program, with dozens of clinical trials applying perinatal tissues SC. Access to SC therapy was one of the main purposes of medical tourists in Ukraine. The Ukraine’s first CB bank launched in 2003 at the Institute of Cell Therapy LLC and was the main supplier of cell and tissue products to state medical institutions in the country. Thus, the consequences of war, such as disrupted logistics (24,000 km of roads and 300 bridges were destroyed during the first 100 days), ruination of hospitals including maternity clinics (almost 700 health facilities were damaged as of June 9, 2022), lack of human staff (men were mobilized for army and women fled the country), and lack of petroleum, made the successful implementation of contracts on CB storage and SC therapy for both Ukrainian and foreign patients sometimes impossible. The lack of liquid nitrogen experienced during the beginning of the war endangered at least 40,000 CB samples stored at Ukrainian CB banks, as well as biological material at fertility clinics. DISCUSSION: The unprecedented experience of CB bank operation during the war showed that, for safety reasons, CB banking facilities should be located distantly from strategic objects (eg, railways, airports, and military bases), and should have significant reserve storages of liquid nitrogen, generation reserves, bomb shelter. However, having dedicated personnel was the most important factor allowing for the enterprise functioning in force-majeure events.