Cord blood

Umbilical cord blood refers to the blood obtained from the placenta and the umbilical cord immediately after childbirth. This blood is rich in hematopoietic stem cells, which possess the potential to differentiate into various types of cells in the body, making them pivotal in treating a range of diseases and conditions.

Cutting of Umbilical cord

Umbilical Nonseverance One Hour Postpartum

Origin and Composition

Cord blood is the blood that remains in the umbilical cord and placenta post-delivery. This blood is rich in stem cells, particularly hematopoietic stem cells, which are responsible for producing blood cells. These stem cells possess the ability to regenerate and differentiate into various blood cell types, such as red cells, white cells, and platelets.

Collection and Storage

Once a baby is born and the umbilical cord is clamped and cut, the remaining blood within the cord and placenta can be collected. There are primarily two methods for this collection:

In Utero Collection: The blood is collected after the baby's delivery but prior to the placenta's delivery. Ex Utero Collection: Following the delivery of the placenta, it is placed in a sterile supporting structure, allowing the umbilical cord to dangle through. The blood is then collected via gravity drainage, typically yielding between 40-150 mL. After the extraction, the cord blood units are promptly sent to a cord blood bank for further processing and storage. In public banks, the collected blood undergoes testing for infectious diseases, and the tissue type is identified. Following the necessary processing, which includes the removal of red blood cells, the cord blood is preserved in liquid nitrogen, making it viable for future use.

Public vs. Private Banking

Cord blood can be stored in either public or private cord blood banks.

Public Cord Blood Banks: These institutions store donated cord blood, making it available for any matching patient through networks like the National Marrow Donor Program (NMDP). There's generally no fee for donating to public banks, but certain collection fees might apply, which are sometimes covered by the bank or the collecting OB/GYN.

Private Cord Blood Banks: Operating on a for-profit basis, these banks store cord blood exclusively for the donor or the donor's family. The cost usually revolves around $2000 for the collection and an annual storage fee of about $100 (as of 2005). It's worth noting that the utility of privately banked cord blood for the donor's family is still a topic of debate in the medical community. Some countries, like France and Italy, have even made private banking illegal, while institutions like the European Group on Ethics in Science and New Technologies advise against it.

Advantages and Applications

Stem cells derived from cord blood have some unique properties:

They are more proliferative than those from bone marrow. They have a higher chance of matching family members, with fathers and siblings each having a 25% chance of being an exact match.

• Utilization in Treatment:

Once the preserved cord blood is needed, it is thawed and purified from the cryoprotectant. It can then be administered to patients. There are different types of treatments based on the source of stem cells:

• Allogeneic treatment: Stem cells are collected from a donor and given to another person.
• Autologous: Stem cells are collected from and used on the same person.
• Syngeneic: Stem cells are exchanged between identical individuals.

Since the late 1980s, cord blood stem cells have been pivotal in treating several genetic diseases, cancers, and disorders related to the blood and immune system. Most treatments use cells from unrelated donors.

Innovations and Advancements

In 2005, Peter Zandstra from the University of Toronto unveiled a technique to amplify the yield of cord blood stem cells, potentially benefiting both children and adults.

Controversies and Ethical Considerations

A 1997 study in the Journal of Pediatric Hematology/Oncology noted that the likelihood of a child needing their own stem cells by age 21 is roughly 1:2,700. The chances of a family member requiring those cells stand at about 1:1,400.

See also

• cord blood bank
• stem cell
• umbilical cord

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