The umbilical cord, traditionally viewed as medical waste after childbirth, is recognized today as a rich source of powerful regenerative cells. These cells, found within the cord blood and tissue, can be harvested and cryogenically preserved for future therapeutic use. Banking this material provides a biological resource that is genetically unique to the newborn and their immediate family. This resource is now used in established treatments for various life-threatening conditions, offering a form of cellular therapy.
The Biological Value of Cord Components
The umbilical cord contains two primary types of stem cells, each with different functions. The blood remaining in the cord and placenta is rich in Hematopoietic Stem Cells (HSCs). These cells are multipotent, meaning they can develop into all types of blood and immune cells, including red cells, white cells, and platelets. They are used for rebuilding a patient’s blood and immune system following disease or intensive therapy.
The tissue of the umbilical cord, particularly a gelatinous substance called Wharton’s Jelly, is the source of Mesenchymal Stem Cells (MSCs). MSCs are distinct from HSCs because they can differentiate into non-blood cells, such as bone, cartilage, muscle, and fat cells. MSCs also possess strong immunomodulatory properties, meaning they can help regulate the body’s immune response and reduce inflammation.
Both HSCs and MSCs derived from the cord are considered more primitive or youthful compared to stem cells collected from an adult donor, such as those from bone marrow. This youthfulness gives them advantages, including a higher proliferative capacity and a lower risk of causing graft-versus-host disease in allogeneic transplants.
Established Medical Treatments Using Cord Blood
Cord blood transplantation, utilizing Hematopoietic Stem Cells, is an established treatment for nearly 80 different life-threatening diseases, predominantly those affecting the blood and immune system.
Hematological Malignancies
A major category of treated conditions includes hematological malignancies, such as various forms of leukemia and lymphoma. Following high-dose chemotherapy or radiation, which eliminates cancerous cells, the transplanted cord blood HSCs repopulate the bone marrow. This restores the patient’s ability to produce healthy blood and immune components.
Inherited Blood Disorders
Cord blood transplantation is also a standard treatment for severe inherited blood disorders, notably sickle cell anemia and thalassemia. These genetic conditions result in faulty blood cell production. The stem cell transplant replaces the defective hematopoietic system with one capable of producing healthy blood cells.
Inherited Metabolic Disorders
These stem cells are used to treat inherited metabolic disorders, such as Hurler syndrome, Krabbe disease, and adrenoleukodystrophy. In these conditions, a missing or faulty enzyme causes toxic substances to accumulate, leading to progressive damage to the brain and other organs. Replacing the patient’s blood and immune system with healthy cord blood cells allows the donor cells to produce the necessary enzymes, which can cross into the central nervous system. This approach prevents further neurological deterioration.
Differences Between Private Banking and Public Donation
Parents who choose to save their baby’s cord blood and tissue face a choice between private banking or public donation. Private banking involves paying initial processing and annual storage fees to reserve the cells exclusively for the family’s use, typically by the child or a genetically compatible family member.
The main advantage of private banking is the guaranteed availability of a perfect genetic match for the child and a partial match for siblings. The probability of the child ever needing their own banked cells is low, estimated between 1 in 400 and 1 in 200,000. However, the material is immediately available for use in treatments or clinical trials.
Conversely, public donation involves donating the cord blood to a public registry, making it available to any patient worldwide who is a suitable match. There is no cost to the family for donation, as collection and storage are typically funded by grants or non-profit organizations.
The cord blood unit must meet strict quality and volume standards to ensure its viability for a transplant recipient. While the donated unit is unlikely to be available to the donor family later, public banking expands the pool of available cells for unrelated individuals. For families without a known genetic disease, public donation is often the recommended path.
The Collection Process and Safety Considerations
Collecting the umbilical cord blood and tissue is a straightforward and non-invasive procedure performed immediately after birth. The collection occurs only after the baby has been delivered and the umbilical cord has been clamped and cut, ensuring there is no risk or pain to the newborn or the mother. The process does not interfere with the birth plan or the initial bonding time.
To collect the cord blood, a trained healthcare provider inserts a sterile needle into the umbilical vein of the cord, which is still attached to the placenta. The blood flows by gravity into a specialized collection bag, and the entire process typically takes less than five minutes. After the placenta is delivered, the provider can then collect a segment of the umbilical cord tissue for later processing, if the parents have elected to store it. The collected blood and tissue are then packaged and shipped to the designated cord blood bank for testing, processing, and long-term cryogenic storage in liquid nitrogen vapor.