In the past, umbilical cord blood was mostly discarded as medical waste. In the 1970s, scientists realized that the small amount of blood remaining in the umbilical cord contains hematopoietic stem cells.
Umbilical cord blood, which flows through the umbilical cord and placenta of a newborn, contains mature blood cells and also a smaller quantity of stem cells. Over time, stem cells mature into adult cells, replacing old/damaged cells and thus participate in the body’s regeneration. Some research indicates that umbilical cord blood contains more stem cells than adult bone marrow, in some cases up to 10 times more (Gunning, 2007).
Use of Umbilical Cord Blood
After birth, umbilical cord blood can be stored and later used as a source of hematopoietic and other stem cells for treatment of diseases through a cell transplantation procedure. It is used to treat certain diseases and conditions (Drew, 2005, Moise, 2005):
-certain blood cancers (e.g., lymphoma)
-blood disorders (non-malignant, e.g., sickle cell anemia, Fanconi anemia)
-hereditary metabolic disorders (e.g., adrenoleukodystrophy)
-immune system disorders (e.g., adenosine deaminase deficiency; Duncan syndrome)
Ballen (2006) reports on studies examining the use of stem cells for treating autoimmune diseases such as lupus, systemic sclerosis, and multiple sclerosis. Gunning (2007) reported on stem cell research for regenerative use after heart attacks, strokes, spinal cord injuries, diabetes, liver damage, and even brain injuries, but much more research will be needed for the clinical application of stem cells in these cases.
Advantages of Umbilical Cord Stem Cells Compared to Bone Marrow Stem Cells (Waller-Wise R, 2011)
- Ease of collection
- No risk to mother or child (painless and safe collection for mothers and children, performed after birth once the umbilical cord has been cut)
- Less processing time required (available for use more quickly)
- Cheaper than bone marrow collection
- Lower risk of infection transmission (e.g., Epstein-Barr virus or cytomegalovirus)
- Less need for strict antigen typing
- Fewer rejections
Disadvantages of Umbilical Cord Stem Cells (Waller-Wise R, 2011):
- Longer engraftment time (it takes longer for leukocyte and platelet counts to rise than after bone marrow stem cell transplantation)
- Limited cell dose
– small unit volume
– no additional cells available
- Limitations of autologous transplantation due to hereditary diseases (e.g., a genetic mutation for cancer may already exist in the DNA of umbilical cord blood)
- Storage issues
– unknown duration of long-term storage
– costs associated with long-term storage
– quality control
Donation and Storage of Umbilical Cord Blood
In Slovenia, the public umbilical cord blood bank is currently not accepting new applications. The Professional College for Hematopoietic Stem Cell Transplantation of the University Medical Centre Ljubljana assessed in 2014 that a sufficient number of umbilical cord blood samples had been collected and stored to ensure adequate accessibility for potential recipients of hematopoietic stem cells, therefore further applications are not being accepted.
Private storage of umbilical cord stem cells is possible in private banks for the purpose of treating one’s own child (or their relatives) with stem cells from their own umbilical cord blood (this is an autologous or related allogeneic transplant). In addition to umbilical cord blood, you can also store the umbilical cord itself.
For consideration…
The probability that a child could use their own umbilical cord blood during their lifetime is extremely small: from 1:400 to 1:200,000 (Sullivan, 2008). At the same time, a newborn, by not donating umbilical cord blood, receives 40-50% more blood, hematocrit increases by 45%, the number of red blood cells increases by approximately 50%, ferritin levels increase, and they receive more blood clotting factors than if the umbilical cord is clamped before it stops pulsating or before 90 seconds. Blood viscosity also increases, which prevents the development of hemorrhagic disease of the newborn – hypoprothrombinemia (Evans, 2012, cited by Fogelson, 2011). And of course, they also receive stem cells. If cells are stored/donated, the umbilical cord must be clamped immediately to collect as many stem cells as possible, which are then stored.
Before donating/storing umbilical cord blood, tests must be performed that are negative for the presence of certain infectious diseases (e.g., HIV, hepatitis B and C, human T-cell lymphotropic virus, HTLV, cytomegalovirus-CMV, syphilis), and the mother and biological father of the child must not have genetic diseases in their family (e.g., hemophilia, leukemia, autoimmune diseases, etc.).
SOURCES: Source1, Source2, Source3, Source4
