Cord Blood Donation
What is a cord blood bank?
Cord blood bank is a facility that collects, tests, processes and stores donated cord blood. Blood from each cord is frozen (cryopreserved) as an individual cord blood unit that is available to transplant.
Cord blood bank recruits pregnant mothers to donate their newborn's umbilical cord blood after the delivery.
What is cord blood?
During pregnancy, the blood in placenta extracts oxygen and other nutrients from mother's circulation and delivers them to the baby through the umbilical cord serving as a lifeline of nourishment from the mother to baby. After the baby is born and the umbilical cord is cut, some blood remains in the blood vessels of the placenta and the umbilical cord. This blood is called placental blood or umbilical cord blood or just “cord blood".
This blood is very precious because it is rich in stem cells similar to those found in bone marrow. This is why cord blood can be used for transplantation instead of bone marrow.After a baby is born, the placenta and the umbilical cord are usually discarded along with that very precious blood in them. If it is removed and properly stored, the cord blood can save the life of a patient who is suffering from a life threatening disease such as malignant blood disorder, immunodeficiency, congenital disorders and many other diseases.This very rich source of life-saving cells must be collected at birth or it is lost forever.
What are stem cells?
Stem cells are the “master cells” of the body. Blood stem cells (or hematopoetic stem cells) are blood- forming cells. The blood stem cells are unspecialised cells, in other words, if stimulated they have the ability to divide and then develop into red blood cells, white blood cells or platelets .
What are stem cells used for?
Stem cells produced from cord blood can be used in transplantation.
What is the difference between cord blood transplantation and bone marrow transplantation ?
Originally, the stem cells for transplantation were obtained from the bone marrow of a donor; therefore the procedure was called bone marrow transplantation. More recently, three sources of stem cells have been used: bone marrow, peripheral blood (ordinary human blood) and umbilical cord blood. This is why transplants are now called bone marrow transplants, peripheral blood stem cell transplants or cord blood transplants depending on the source of the stem cells. The common term for all three types of transplantation is Hematopoietic Stem Cell Transplantation, which is abbreviated as "HSCT".
What types of disease can HSCT transplantation treat ?
In general, HSCT can be used to treat patients who are suffering from life threatening diseases, including:
Cancer of the blood such as leukemia and lymphoma.
Bone marrow failure when the bone marrow is no longer working
Hemoglobinopathies such as Sickle cell anaemia, thalassaemia
Immunodeficiencies - when the immune system is not working properly
Inherited metabolic disorders - which affect the breakdown or metabolism of nutrients for energy, growth and repair.
Why we need a bank with many units?
For the transplantation to be successful, stem cells taken from the cord blood must match the patient's tissue type. So, for patients to have the best chance of finding a match, cord blood bank must store as many cord blood donations as possible. In other words, it is crucial to store large number of cord blood units, in order to improve the chances of finding suitable matches for patients.
For how long can cord blood be stored?
Once the cord blood sample has been frozen, it will be stored until it is given to a patient who needs stem cell transplantation. Research has suggested that frozen stem cells can be preserved for 10 or more years.
How can a doctor search for a suitable match for a patient awaiting stem cell transplantation?
All stored units should be entered on a database (with their tissue types) which can be accessed by different transplant centers. These centers can access the database in order to search for a suitable match for a patient who needs stem cell transplantation.
Will donating cord blood affect the baby?
Cord blood is collected after the baby has been delivered. Cord blood is collected from the placenta and the umbilical cord, parts that would have otherwise been discarded after birth. It is collected after the umbilical cord has been clamped, cut off the baby's body, and cleaned with antiseptic solution. If the mother chooses to donate the cord blood, this will not affect labour and delivery nor the health of the newborn baby and his mother.
Can every mother donate cord blood?
Most mothers can donate cord blood. Cord blood can be collected both after vaginal delivery and Caesarean section However, cord blood can not be collected if the mother is carrying twins or other multiple births. This is because the placenta will be smaller than with single births and it will not be possible to collect enough cord blood from the placenta.Cord blood samples and donating mothers will be tested for different infectious disease as it is the case with all blood donations. Tests might include screening for various blood-borne infections such as:
Hepatitis B & C virus.
Human T-lymphotropic virus.
Human immunodeficiency virus.
Cytomegalovirus or Epstein Barr virus.
Syphilis.
What are the advantages of cord blood transplantation?
Exact match not necessary: When using stem cells from bone marrow or peripheral blood, there must be a very close match between the tissue type of the patient and the donor. However, for a transplant using cord blood stem cells, exact match is not required (four or five of the six HLA antigens are matched). In other words, an adequately matched cord blood unit can be found even though a matched adult unit is not available.
Easy to find: Because of computerized databases matching blood cord unit can be searched for and transported worldwide.
Less risky: A unique aspect of cord blood transplantation is the less than expected severity of Graft-versus-host disease, This adverse effect of stem cell transplantation is less common after cord blood transplantation.
What is a double cord blood transplant?
Cell dose has a critical role in the success of HSCT. For children, there are generally enough stem cells in a single cord blood unit for transplantation. However, there are usually not enough cells in a cord blood unit for transplantation of adult patients. To overcome this problem, most adults are transplanted with two cord blood units rather than one ; this procedure is called double cord transplant.
In conclusion, public cord blood banks collect units from mothers who are willing to donate their child’s cord blood. These units are stored, placed on national and international registries, and are available to any person in need of stem cell transplantation.
Although there have been a growing number of cord blood banks worldwide, it is unfortunately true that the Arabic world is very deficient in this facility. However, King Abdullah International Medical Research Center is embarking on establishment of a new Cord Blood Bank at the National Guard Health Affairs.
References:
-Expanding the role of umbilical cord blood transplantation. Brunstein C.G., et al. Br J Haematol. 2007; 137:20-35.
Chronic graft-versus-host disease (cGVHD) following unrelated donor hematopoietic stem cell transplantation (HSCT): Arora M. et al. Biol Blood Marrow Transplant. 2007;13:1145-52.
Hematopoietic stem cell donor selection: the Europdonor experience. Oudshoorn M. et al. Hum Immunol. 2006; 67:405-412.
NHS Cord Blood Bank: http://cord.blood.co.uk/index.asp
Cord Blood Forum: http://www.cordbloodforum.org/index.html