Until umbilical cord blood (UCS) was found to be rich in stem cells , the cord used to be discarded along with the placenta.
Now, its incredible benefits for treating certain types of childhood cancer, and its potential applications for curing other diseases in adulthood, have made cryopreservation of UCS a very valuable possibility. We will tell you what the law says about this practice, what must be done to save the UCS and what applications stem cells can have.
What are Stem cells?
These are cells that have two properties: they are capable of self-renewal (producing more stem cells) and originating daughter cells (cell lines that will eventually become specialized cells).
This is explained in Engadget. They add that today there is talk of curing with these ‘magic’ cells “genetic diseases, regenerating tissues damaged by blows or the passage of time, creating organs ready for transplantation or healing without even having to treat the disease in question.”
The National Transplantation Organization adds that years ago it was discovered that umbilical cord blood contains these cells, called ‘blood stem cells’ , which specialize in the renewal of all blood cells (red blood cells, white blood cells and platelets).
And already “in the 90s, stem cell transplants from umbilical cord blood (UCS) began to be performed in patients whose bone marrow was diseased, verifying that clear therapeutic successes were obtained”. Its main use is transplants in patients with certain congenital or acquired diseases of the bone marrow , such as acute or chronic leukemias.
The Josep Carreras Foundation adds that “umbilical cord blood contains a sufficient quantity of stem cells to be able to perform hematopoietic transplants in children, adolescents and low-weight adults.
Among their advantages , over bone marrow stem cells: they can be used successfully even if donor and recipient are not totally compatible, they are easily located and are available almost immediately since they are stored frozen in umbilical cord blood banks.
What to do to conserve umbilical cord blood?
Normally the cord was discarded after the baby was born, but since the possibility of its use for transplantation was opened, the units began to be stored and thus the public banks of SCU were created throughout the world.
According to the ONT, in Spain there are seven public banks and after the approval of the old RD 1301/2006 (currently replaced by RD Law 9/2014), ‘which establishes the quality and safety standards for donations, obtaining , the evaluation, processing, preservation, storage and distribution of human cells and tissues’, there are also private UCS Banks, where umbilical cord blood is preserved for possible autologous (own) use.
The SCU is collected after delivery and once the umbilical cord has been cut , and does not pose any risk to the newborn or its mother. Once the baby is born, and after separating it from the mother’s body, the umbilical cord is clamped and before the delivery of the placenta the umbilical vein is punctured and the blood is stored in a sterile bag that will be labeled with the data of Mother.
Two tubes of venous blood will also be drawn from the mother for analysis to exclude the possibility that she is affected by infectious diseases transmitted by transfusion (hepatitis B and C, HIV, Syphilis, etc.).
Cord blood units are immediately transported to the Cord Blood Bank, where they undergo rigorous controls to discard samples that do not meet the strict quality standards needed for successful transplants.
Blood that passes these controls is analyzed and frozen for use in transplants. The one that does not comply with the regulations is destroyed or used for scientific purposes.
When it comes to conserving cord blood, speed is essential , since there is only a 48-hour margin to extract it and complete the cryopreservation process in liquid nitrogen, maintaining maximum levels of quantity and quality.
Once extracted, the transfer of the blood must be carried out without sudden changes in temperature, or excessive heat or cold. They are then cryopreserved at 196 below zero.
Who can donate?
A cord blood donor can be any healthy pregnant woman over 18 years of age , with a normal (non-pathological) pregnancy and an uncomplicated delivery.
To preserve the UCS, the newborn’s weight must be greater than 2,500 g, show no symptoms of infection, an Apgar test greater than 8 and with good evolution at 10 minutes.
How to become a donor to a public bank?
When a pregnant woman wishes to be an umbilical cord blood donor, she should go to one of the existing Cord Blood Banks in Spain or to one of the maternity wards attached to the collection program of a public bank, where the gynecologist will report on how the process works .
And, as the Josep Carreras Foundation explains, not all maternity wards are prepared for the collection of umbilical cord blood units, since it is a process that requires specialized personnel and the necessary technical means.
The mother will sign an informed consent, which will be accompanied by:
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A detailed medical history with possible infectious, hematological or any other diseases that contraindicate the use of cord blood.
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Carrying out a blood test on the mother at the time of delivery to rule out any infectious process that could be transmissible to cord blood, especially tests for hepatitis B and C, HIV and syphilis, among others.
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A clinical exam of your baby at birth and optionally after three months by a pediatrician.
This is explained by the National Organization of Donors, and adds that any pathological result that results in the studies carried out on the occasion of the donation of cord blood, will be communicated to the mother by the responsible doctor.
“The umbilical cord blood will be cryopreserved and eventually used to carry out a transplant to any anonymous patient in the world who needs it, without financial compensation for the family.”
And it is that the altruistic and public donation of SCU implies that all the cords stored in these banks are available to be used in the transplant of any compatible patient who needs it.
Furthermore, research is currently being carried out (always with the consent of the donor mother) with those UCS cells that are not useful for transplantation and in the future these investigations could have repercussions in the treatment of non-hematological diseases.
In Spain, the Spanish Registry of Bone Marrow Donors of the Carreras Foundation (REDMO) carries out searches, both for marrow donors and cord blood units, in coordination with the National Transplant Organization and SCU banks.
Altruistic donation or private bank
Data from the Josep Carreras Foundation against leukemia, indicate that Spain is the fifth country in the world in the number of cryopreserved cord blood units : more than 45,000, thanks to more than 140 authorized maternity hospitals.
The collection process, and the subsequent analyzes that must be carried out, as well as the freezing process and its maintenance, are fully paid for by the National Health System. The only condition that public health establishes is that the cord unit must be available to any patient who may need it.
But you can also choose to keep the SCU in private banks for family use (also called banks for autologous use). It differs from the public ones, in that the cord blood is saved for the event that the donor himself may need it later.
According to Dr. Josep Carreras, the greatest utility of these banks are families with children who suffer from diseases that may require a transplant of their own cells.
Currently, any private cord bank based in Spain must transfer the information on the umbilical cords that it has stored and, in the event that a Spanish or foreign patient needs a unit, they must transfer it completely free of charge.
Hence, when families decide to save their umbilical cord blood for private use, they usually turn to foreign companies that are not legislated by this regulation.
Its price is usually around 1,800 euros. If this is the option, you just have to contact one of them and they will take care of your transfer and conservation, in coordination with the maternity. Some private health insurances also offer this option.
Delayed cutting of the umbilical cord
Parents can also choose not to preserve umbilical cord blood. In this case, to take full advantage of its benefits, it is advisable to follow the WHO instructions and let the blood rich in stem cells pass to the baby, between one and three minutes before cutting it.
Delayed cord clamping is not only essential for premature babies, but it is also very beneficial for all newborns. As the cord continues to beat, it allows more blood to reach the baby, which means more iron, more hemoglobin, a greater antioxidant effect and a decrease in inflammation in cases of induced labor.
Other studies also point to notable long-term benefits: Children whose cords were cut three minutes after birth have better neurological development.
But the newborn can even benefit from late cord cutting if stem cells are to be donated or preserved.
Doing so ensures that the baby receives the appropriate amount of blood and allows the cord blood stem cells to be kept in a public or public bank.
If you have questions or need more information about SCU, you can consult the Umbilical Cord Blood Donation Guide.
Photos | iStock and Philms on Flickr
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