Commercial Cord Blood Banking

What is meant by Commercial Cord Blood Banking? How does it work? What is the significance of cord blood banking? Read further to know more about Commercial Cord Blood Banking.

The umbilical cord and its blood were once regarded as medical trash before the 1990s.

Umbilical cord blood is now banked or stored by parents because the stem cells it contains are being used or have the potential to be used in the treatment of serious and disabling disorders.

This paves the way for commercial cord blood banking.

What is Cord Blood Banking?

The blood that stays in the placenta and umbilical cord after birth is known as cord blood. Maternal-fetal cell transfer occurs at or close to term to strengthen both the mother’s and the foetus’ immune systems in advance of labour. As a result, cord blood at the time of birth is a great source of immune system cells and stem cells.

A System that preserves umbilical cord blood for use in the future is known as a Cord Blood Bank.

Private and public cord blood banks have emerged in response to the prospect of using cord blood to treat immunological and blood-related illnesses.

Public cord blood banks operate similarly to public blood banks in that they accept donations to be utilised for anybody in need. Historically, the medical establishment has been more open to the idea of public cord blood banking. Private cord blood banks only keep cord blood for the donor or the donor’s family to potentially use.

However, the Indian Council of Medical Research (ICMR) asserts that there is no scientific support for cord blood storage for future self-use, posing moral and social concerns.

The ICMR does not advocate using stem cells for commercial purposes and Commercial cord blood banking also.

When the mother is expecting the next child and there is an older child in the family with a problem that can be treated with these cells, private cord blood preservation is advised.

In other cases, parents should be made aware of the current restrictions on banking.

Also read: Sickle Cell Disease

Cord Blood

The blood from the newborn that is still present in the placenta and umbilical cord after birth is known as cord blood. Umbilical cord blood is a rich source of stem cells; cord blood banking is the process of conserving it for use in the future.

Hematopoietic stem cells, which are unique cells, are present in them and can be employed to cure certain disorders.

In the body, hematopoietic stem cells can develop into many types of blood cells.

Worldwide, cord blood banking is advised as a source of hematopoietic stem cells for transplantation for haematological malignancies and illnesses where its usage is advised (derived from bone marrow, peripheral blood, or umbilical cord blood).

The utility of cord blood as a source of stem cells for any other ailments has not yet been shown.

Collection and Cryopreservation of Cord Blood

After the umbilical cord has been severed, cord blood is collected from the foetal end of the cord, taking up to 75 +/- 23 mL from the newborn. Usually, it is completed ten minutes after delivering delivery.

The placenta may be used to obtain more stem cells. The placenta is transported to the stem cell lab, where it is processed for extra stem cells after the healthcare professional takes cord blood from the placental end of the umbilical cord. In order to guarantee that there will be enough cells for a transplant, sufficient cord blood collection requires at least 75mL.

Before the cord blood is kept for future use, it is tested for viruses, such as HIV and Hepatitis B and C, and tissue typing is done to ascertain the kind of human leukocyte antigen.

Additionally, it will be checked for bacterial and fungal growth as well as nucleated cell count, cell viability, blood group antigen ABO & Rh blood group system, molecular cluster, and blood group antigen.

The cord blood unit is collected, sent to the lab for processing, and then frozen. There are numerous methods for processing a cord blood unit, and opinions on the optimum method vary.

Red blood cells can be removed using some processing techniques while being retained using others. For the cord blood to survive the cryogenic process, a cryopreserved is added regardless of how the unit is processed. The cord blood unit can be placed in a liquid nitrogen tank to maintain freezing at 196 °C after being gradually cooled to 90 °C.

To keep the cells alive while they are being frozen, the slow freezing procedure is crucial. Even though many cryopreservation protocols include employing dimethyl sulfoxide (DMSO), gradual or controlled rate cooling, and quick thawing, there isn’t currently agreement on the best practices for these cord blood cells.

Uses of Cord Blood

Despite primarily coming from donors, cord blood stem cells are now being used to treat a number of deadly diseases, most notably malignancies, blood disorders, and genetic diseases of the blood and immune system.

In 1988, a six-year-old boy with Fanconi anaemia received the first successful treatment using cord blood stem cells that had been clinically studied. Since that time, cord blood has gained more and more acceptance as a source of stem cells for use in stem cell therapy.

Recent research has revealed that cord blood transplants have special benefits over conventional bone marrow transplants, especially for children.

In rare circumstances where a suitable bone marrow donor cannot be found, cord blood transplants can even save a patient’s life. Siblings and other family members with the same tissue type as you can also receive cord blood stem cells. There is a 25% probability that siblings will match, and there is a 50% chance that grandparents and parents will match using cord blood.

Advantages of Cord Blood Banking

• Compared to bone marrow, more people can obtain stem cells from cord blood. This is due to the fact that, unlike a bone marrow transplant, cord blood does not need to closely match the recipient’s own blood.
• The probability that a person’s body will reject stem cells from cord blood is lower than that of bone marrow.
• During cancer therapies, cord blood stem cells may help the immune system. This is not a method of using bone marrow stem cells.
• Compared to collecting bone marrow, collecting cord blood is less difficult, uncomfortable, and dangerous for the donor.
• The newborn or the person giving birth is not in danger from the cord blood harvest.
• Donating cord blood to public banks could help save other people’s lives.

Public Bank of Cord Blood

Similar to public blood banks, public cord blood banks accept contributions from anyone, discard donations that don’t pass certain quality control standards and use national registries to identify recipients for their samples.

Public banks frequently blended many samples together when preparing the therapy for a single patient since patients who need cord blood frequently require more cells than a single harvest would have provided.

Since cord blood transplants don’t require an exact genetic match as bone marrow transplants do, it’s simpler to give patients samples from unrelated donors.

It’s common to hear that between 60 and 80% of gifts to public banks are eliminated because they contain medical waste. The majority of this is due to the fact that most cord blood collections fail to capture enough viable cells. Some of this is due to contamination that occasionally happens during collection or difficulties arising from shipment.

Public cord blood banking has been more widely accepted by the medical community because matches are almost always likely to be better there than in a private bank, and because it doesn’t have the same problems that cord blood from private banks does (such as potential lower quality control and lower medical usefulness of using a patient’s own potentially diseased cord blood).

Private Bank of Cord Blood

Parents generally pay a high price for private banking, which is not covered by insurance. The utilisation of cord blood may also be influenced by the enterprise’s long-term profitability. Therefore, whether the expecting parent should spend on cord blood banking depends in part on whether the expense is justified by the likelihood of using cord blood in the future and the benefits of doing so.

Verifying a possible private bank’s credentials is crucial.

The “Human Cells, Tissues, and Cellular and Tissue Based-Products” category of the Food and Drug Administration in the US governs the use of cord blood.

Private banks are subject to less strict regulatory requirements since the FDA classifies cord blood stored at public banks as “drugs” but does not classify cord blood stored at private banks for use by the donor as a drug.

Ownership of Cord Blood

Human umbilical cord blood carries the baby’s DNA and cells. However, the approval of the mother alone is typically required for the collection, and the father’s assent is very infrequently taken into account.

As of 2007, the contracts of the biggest cord blood banks do not expressly indicate that the cord blood belongs to the donors and the child with all the rights and privileges one would reasonably expect from ownership. The ambiguity opens for future uses that are not permitted by the donors or the child. Most privately run cord blood banks give mothers complete ownership of the cord blood they bank up until the minor from whom the cord blood was drawn turns 18 years old. At that point, the minor has full ownership rights to any stored cord blood.

Concerns Related to Cord Blood Banking

It may not be wise or effective to use one’s own cord blood cells, particularly in situations of leukaemia and cancer in children. Because the blood also carries the same genetic abnormality, children who develop immunological disorders frequently cannot receive a transplant using their own cord blood.

Additional problems include the potential for the cord blood unit to be contaminated with same cancer that was discovered later in life. For instance, abnormal cells have been found in filters containing newborn blood of children whose acute leukaemia was not discovered until they were between the ages of 2 and 6 years old.

Conclusion

Commercial cord blood banking involves storing a newborn’s umbilical cord blood stem cells for potential future medical use. The decision to bank cord blood is personal and should be based on individual circumstances and considerations such as the family history of genetic disorders and the likelihood of using the stored cells. It is important to carefully research and compare different cord blood banking options and consider the cost, storage options, and reputation of the facility before making a decision.

Article written by:  Aryadevi E S