Umbilical Cord Blood Banking is a lifesaver for your family, “Create one life, save another”: A review
Umbilical Cord Blood Banking (UCB)is also known as “stem cell banking”.
An umbilical cord blood bank is a facility which stores umbilical cord blood for future use.
Cord blood is collected from the placenta during the third stage of labour.
Cord Blood is what remains in the umbilical cord and placenta post-delivery; there is a maternal-fetal transfer of cells that boost the immune systems of both the mother and baby.
It is composed of hematopoietic stem cells, red blood cells, white blood cells, plasma and platelets. It contains higher numbers of Natural Killer cells, T-cells and Endothelial progenitor cells. Multipotent cells, which are unrestricted adult stem cells, can be found in cord blood, which is different from embryonic stem cells which are pluripotent. Cord blood is a source of mesenchymal stem cells, which can be used to treat hematopoietic and genetic disorders such as cancer.
This process does not pose any risk to the baby or mother.
Cord blood collection is not advisable in complicated deliveries like twin gestation and prematurity [1].
History
Umbilical cord blood banking started around the 1990s. The first successful cord blood transplant (CBT) was done in 1988 on a child diagnosed with Fanconi Anemia. Early efforts to use CBT in adults led to mortality rates of about 21%. 30,000 CBT procedures have been performed and banks hold about 600,000 units of cord blood.
Collection and storage
The method most commonly used in clinical practice is the “closed technique”. In this method, the technician cannulates the vein of the severed umbilical cord using a needle that is connected to a cord blood bag. On average, the closed technique enables the collection of about 75 mL of cord blood. There are only 5 min to collect the cord blood after the birth of the baby, clamping of the cord and before the delivery of the placenta. The umbilical cord blood collection is typically depleted of red blood cells before cryopreservation to ensure high rates of stem cell recovery. It is then slowly cooled to -90oC, in a liquid nitrogen tank followed by cryopreservation at -196oC.
The collected umbilical cord blood is then stored in a cord blood bank for future uses or transplantation [2].
Umbilical cord blood uses
Fig. 1. Picture showing the potential uses of umbilical cord blood.
Umbilical cord blood is approved by the FDA for the treatment of nearly 80 diseases. Researchers are also exploring how cord blood can cross the blood-brain barrier and reduce inflammation. The treatments have been performed more than 35,000 times around the globe to treat cancers. The most exciting applications have been with Autism, Cerebral palsy, Alzheimer’s, Diabetes, HIV, and inflammatory response in COVID-19 as these and other perinatal (cord & placental tissue-derived) stem cells can secrete anti-inflammatory molecules.
Private and public cord banking
Cord blood is stored by both public and private cord banks. The latter are usually for-profit organizations that store cord blood for the exclusive use of the donor or donor’s relatives. Public cord banking is supported by the medical community. Private cord banking is generally not recommended unless there is a family history of a specific genetic disease [3].
Cord blood banking cost
As most parents would like to bank their babies’ cord blood to help safeguard their families, most cord blood banks have an upfront fee for collecting, processing and cryo-preserving. Some cord blood banks may charge approximately Rs 100,000 which includes the price of the kit provided to collect and safely transport the cord blood, and approximately Rs 60,000 for storage per year.
Regulation
The Food and Drug Association (FDA) governs the collection, processing, storage, labelling, packing & distribution of cord blood stem cells. There are two different standards CGTP (Current Good Tissue Practices) & CGMP (Current Manufacturing Practices) CGTP standards apply to the collection, processing and storage of human cells, tissues and cellular tissue-based products and are regulated by the Centre of Biological Evaluation and Research. Current Good Manufacturing Practice (cGMP) is a set of regulations that was initially put forth by the FDA to ensure that business organizations, manufacturers, and packagers of pharmaceutical products, medical devices, blood, and certain foods proactively guarantee that their products are effective, safe, and pure.
Conclusion
Stem cell research has given “The Miracle of Birth” a whole new meaning; a just delivered infant has the potential to save the life of another human being just by donating cord blood that would otherwise be discarded.
ReferencesReferences
[1] Anupam S, Vinod G, Payal M, et al. Umbilical cord blood banking: consensus statement of the indian academy of pediatrics. 2018;55.
[2] Wikipedia, the encyclopedia, “Cord Blood” https://en.wikipedia.org/wiki/Cord_blood
[3] Adami V, Malangone W, Falasca E, et al. A closed system for the clinical banking of umbilical cord blood. Blood cells, molecules & diseases. 2005;35:389-97.
[4] Sullivan MJ. Banking on cord blood stem cells. Nat Rev Cancer. 2008;8(7):555-63.
[5] https://www.ama-assn.org/delivering-care/ethics/umbilical-cord-blood-banking
L. Indumathi
Nurse Educator