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Cord Blood Banks

Stem Cell History

The term “stem cell” has been in use since 1868, when Ernst Haeckel used those words to describe a fertilized human egg. He used the term because he said the fertilized egg would eventually become a human being which had stemmed from the egg. Over the many years of scientific research, the term became commonly used to mean any cell that is pluripotent, meaning it has the ability to develop into many different types of cells. Eventually, the research done using stem cells lead to the first successful bone marrow transplant.
In 1998 two scientists managed to extract the first stem cells from a human embryo, which led to the huge controversy in the beginning of the 21st century regarding the ethics surrounding the use of human embryos for research purposes.

This controversy led to a ban on using human embryos to obtain stem cells, imposed by George W. Bush, who cited religious reasons for his decision. Barack Obama has quietly reversed most of the ban, and the research continues. The controversy did serve to motivate researchers to look for possible sources of stem cells that did not involve the use of human embryos, in order to allow research to continue and lives to be saved, without contravening the rules. This led to the discovery of adult stem cells, amniotic stem cells, and cord blood stem cells, among others. This, in turn, has led to the collection, screening, preserving, and freezing of cord blood in order to use it to treat a range of blood disorders and cancers. It boggles the mind to think that at one time, cord blood was throw away with the cord and placenta, with no realization of the value it holds.

First Was Cord Blood

Cord blood – the blood contained within a baby’s umbilical cord and the placenta at birth – is a very rich source of the precursors to blood cells, called hematipoietic stem cells. These cells, when mature, become new blood cells, and can be transplanted into those who suffer from certain types of diseases (mostly blood diseases at this point) in order to help them manufacture new, healthy blood. About 35,000 of these stem cell transplants have been done worldwide, and the number increases as new discoveries are made of all the different ways stem cells can help an ailing body regenerate itself.

How to Store the Cord Blood

Fifty years ago, the idea of a cord blood bank would have seemed to belong to the realm of science fiction, but today cord blood banks are not only a reality, they are a worldwide reality. As our medical and scientific knowledge grows by leaps and bounds, the original discovery that stem cells exist has resulted in increased understanding of the many ways in which stem cells can be used to treat diseases which were previously untreatable, or which responded poorly to conventional drug therapies. With that expanding knowledge came the realization that parents could choose to store their child’s cord blood in a cord blood bank, in case that child – or any other member of the family – developed a disease which required the use of stem cell treatment. Thus was born the cord blood bank, which is a company that contracts to collect the cord blood and store it, cryogenically frozen, until it is needed. Since the storage of cord blood is a delicate process, and storage facilities must be able to meet exact specifications to ensure that the stored cord blood remains at the perfect storage temperature and is never affected by a power failure or a heat wave or even a natural disaster, if that can possibly be avoided, the process is not inexpensive.

Why keep Stem Cells

The potential uses for stem cell use may be virtually unlimited, but up to now, science has successfully used cord blood stem cells in the treatment of nearly 80 different diseases. These range from childhood leukemia and anemia, to Non-Hodgkin’s lymphoma, and Tay-Sachs disease. Cord blood stem cells can regenerate blood, organ tissue, and the immune system, so this treatment has the ability to treat metabolic disorders, cancers, bone marrow syndromes, blood disorders, immunodeficiencies, and hemoglobinopathies. All of the diseases currently being treated with cord blood stem cells are just the beginning – there are many scientists researching the possible future uses of stem cells, which could include regenerating structural and connective tissues, which could lead to successfully treating things like lung cancer, type I diabetes, rheumatoid arthritis, liver fibrosis, and Parkinson’s disease. While there are many uses and potential uses for cord stem cells, research takes time. There is a lot of research and testing and evaluating and trials between ideas and actual treatment, so these potential treatments may take a long time to come to fruition.

When can it be collected ?

Cord blood is collected shortly after the birth of a baby. Once the umbilical cord has stopped pumping and is clamped off, then a blood collection technician will insert a needle into the largest vein in the cord, and suck all of the blood that remains in the cord out into a blood bag. There is usually between 50 and 100 mls of blood in the cord, with about 75 mls being the minimum amount needed for a transplant. More stem cells are available in the placenta, so after the cord blood is removed, the placenta is often sent to a laboratory where the stem cells are extracted from it. All of the blood will be tested for diseases like HIV and hepatitis, as well as other disorders. If the blood is clear of all diseases, and no other disorders are detected, then it can be processed, preserved, and frozen. The blood must be slowly cooled to -90 degrees Celsius, before being placed in a liquid nitrogen tank to bring the temperature down to -196 degrees Celsius. The blood is stored at that temperature until needed, when it is thawed quickly, ready for use.

Cord Blood Legalitise

The whole procedure of collection and storage must be done in accordance with local jurisdictional regulations. In the USA, the Food and Drug Administration is in charge of regulating cord blood, although exact regulations vary by state. All cord blood banks must be accredited according to local rules and regulations, even if the blood bank company’s main office is in another state. In other countries of the world, the regulations for cord blood banks may be slightly different, but they all have the same aim, and that is to ensure that cord blood is collected, preserved, and stored in accordance with policies intended to make the process as safe as possible.

Parents Choice

Expectant parents are now faced with the choice of whether or not to preserve their infant’s cord blood, and if they opt to do so, then they are faced with yet more decisions. They can choose a private cord blood bank, where they must pay a significant amount of money for the initial collection and testing of the blood, and then pay a monthly or yearly fee for storage. On the other hand, they could choose to donate the cord blood to a public cord blood bank, where it might be used to save a life that otherwise would be lost. They must make the effort to educate themselves on the topic, in order to enable themselves to make a decision that is best for their child and their family. One surprising risk to the procedure is that of overzealousness on the part of the person doing the collecting of the cord blood. In a natural birth, the umbilical cord continues to pulse, pumping blood into the infant for several minutes after birth. This allows the blood from the placenta, which the baby needs, to be pumped into the child. If the cord blood is harvested too soon, or the cord is clamped early to save a bit more cord blood, it can deprive the baby of this much-needed blood, causing the baby to develop anemia in the first few days of life. It is feared that this practice could become widespread if the process is not heavily regulated and monitored.

How to Proceed

Once the parents have opted to save their child’s cord blood, and are looking at where it should go, they need to continue their education in the subject by learning about what would happen should their child or a sibling ever need a stem cell transplant. They will discover that one unit of cord blood does not contain enough stem cells to do a successful transplant with, so after their child is 10 years old or so, the sample alone is useless. If the child develops an immunological disorder, then the cord blood sample will be useless because it will contain the same disorder. If a sibling becomes ill, the cord blood may not be compatible with their blood, and so may be unusable. There are a whole host of reasons why that sample may not be the lifesaver that it first sounded like, but that does not mean that it could never help anyone. If donated to a public blood bank, it can be combined with other samples to provide enough stem cells to save a life.