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Cord Blood: What is it?

July marks National Cord Blood Awareness Month, a time to raise awareness on the significance of stem cells obtained from cord blood, and how their remarkable properties can be utilized in disease treatment. The first cord blood transplant was performed in 1988 and since then, more than 44,000 transplants worldwide have utilized this treatment. Cord blood refers to the blood from the umbilical cord and placenta after birth. The purpose of the umbilical cord is to send nutrients to the baby from the mother’s placenta. Blood is collected and stored from here, and contains hematopoietic stem cells, meaning it can be used to treat various diseases.


Hematopoietic stem cells can differentiate into 3 different types of cells - red blood cells, white blood cells, and platelets - distinguishing them from non-stem cells, which can only make copies of the existing template. Because of their remarkable adaptability, stem cells can be used to treat over 70 diseases, including immune system disorders, neurological ailments, genetic disorders, and certain forms of cancer; depending on the illness, they can be used as a primary form of treatment or as a last resort.


Stem cells can also be extracted from bone marrow, but extracting them from the umbilical cord poses fewer risks to the donor and allows the cells to be stored. Cord blood can also be frozen for storage, while bone marrow must be used immediately after harvestation. Additionally, cord blood stem cells’ extreme versatility makes it less likely than bone marrow stem cells to trigger immune system rejection. Bone marrow is also substantially more difficult to collect, as it poses several health risks and is generally painful for the donor, whereas cord blood poses minimal risks. Furthermore, bone marrow provides fewer benefits compared to cord blood, as hematopoietic stem cells can strengthen and reinforce the immune systems of cancer patients. However, despite the numerous benefits that cord blood provides, it contains fewer stem cells and multiple donations need to be combined to meet the required amount of stem cells for a treatment.


These stem cells have several applications in regenerative medicine, which refers to the “process of “replacing” or regenerating human cells, tissues, and organs to restore or establish normal function.” Researchers are exploring countless applications for cord blood, including the treatment of Type 1 diabetes to slow the loss of insulin production, and the potential to repair injured heart tissue and nervous system regeneration. Cord tissue could also potentially be used for medicinal purposes, as they are home to mesenchymal stem cells, which are currently being researched due to their ability to reduce inflammation, improve immune system function, and improve organ/tissue damage.


Typically, there are two types of cord blood transplants that can be used for treatment - autologous and allogeneic. An autologous transplant is performed when cord blood from a child is used by the same child later in life. This form of transplant is relatively rare, because these cells are unable to treat genetic diseases in the patient, as they contain identical genes to the patient themself. In an allogenic transplant, cord blood from another person is utilized to treat a child's disease. This transplant needs to be an adequate match for the child, meaning that the cells must be similar enough to those of the child in order for it not to result in an immune system rejection.



How to Donate


It is clear that cord blood is extremely important, but how can you help out and donate? Legislation regarding cord blood banking varies from state to state. For example, in California, physicians are encouraged to inform pregnant patients of all medically appropriate cord blood options. The California Department of Public Health provides information on cord blood banking in the California Prenatal Screening Program brochure. Depending on your state, your physician may or may not be required to inform you of all the medically appropriate cord blood options. In order to find out about your state’s regulations, click here.


There are several procedures that must be executed in advance; the cord blood bank must be notified of your due date six or more weeks prior, a family medical history needs to be taken, the mother’s blood should be tested, and consent must be given before going into labor. Subsequently, an obstetrician or hospital staff at your hospital will collect the cord blood. The process is simple and painless; the umbilical cord is cut and clamped, and blood is drawn from the umbilical vein with a needle attached to a bag. In total, this process only takes around 10 minutes. However, it is important to keep in mind that not all hospitals offer this service, and that it might not be covered by your health insurance.


Cord blood can either be donated to a public or private cord blood bank. Cord blood can be preserved cryogenically - frozen in liquid nitrogen - allowing it to last indefinitely. Public cord blood banks do not charge a storage fee, and the blood is stored for allogeneic transplants. Depending on the public cord bank, you could also opt for a direct donation if you have a relative with a disease that can be treated with the usage of stem cells. On the other hand, private banks are generally used for autologous treatments and charge a yearly fee for storage, with costs typically ranging from $1,000 to $2,000. Certain private banks will store cord blood free of charge if a relative has a disease that could be treated with stem cells. However, most medical organizations do not recommend using private cord blood banks, unless you have a child or relative that may need a stem cell transplant in the future.


Additionally, there are several factors to take into consideration before deciding to commit to a cord blood bank. For public banks, it is important to determine whether your hospital collaborates with a public cord blood bank. If not, consider the pathways for getting information on public cord blood banks with mail-in donation programs. For private cord banks, find out whether the cord blood bank is financially stable. If it isn’t, there is a high chance your sample could be moved to another bank in the event that it closes. Furthermore, make sure to consider the number of samples taken into the facility, the flexibility and policies for switching facilities, and the maintenance fees for storage.

In closing, as it is now the month of July, National Cord Blood Awareness Month, let us continue to raise awareness for this fascinating and potentially life saving treatment.


Happy National Cord Blood Awareness Month!


Written by Lily Sun

Researched by Natasha Koneru




Resources


http://www.aabb.org/aabbcct/therapyfacts/Pages/regenerative.aspx

https://www.acog.org/patient-resources/faqs/pregnancy/cord-blood-banking

https://www.cordblood.com/benefits-cord-blood

https://www.cordblood.com/how-its-used/current-future-uses

https://www.cordblood.com/benefits-cord-blood/umbilical-cord-blood-banking/cord-blood-banking-legislation

https://www.hopkinsallchildrens.org/Patients-Families/Health-Library/HealthDocNew/Cord-Blood-Banking


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