Stem cells can be thought of as basic building blocks of our body. They can replicate and renew themselves and have the potential to become almost any other type of cell in the body. Stem cells are found, for example, in bone marrow, peripheral blood and in umbilical cord blood and umbilical cord tissue as well as in many other tissues in the body. They are ‘master’ cells from which all of the various types of blood cells, as well as tissue in bone, muscle, heart, liver, kidney, skin etc., develop.

Umbilical cord blood and cord tissue is a rich source of stem cells and parents now have the opportunity to store (cryo-preserve) these stem cells at the time of birth.

Haematopoietic (blood-forming) stem cells, the predominant type of stem cell found in umbilical cord blood, give rise to the cellular elements of blood i.e. red blood cells, white blood cells and platelets. Haematopoietic stem cell transplantation currently plays a vital role in the treatment of diseases such as bone marrow failure, leukaemia, lymphoma, other types of blood cancers, inherited blood and metabolic- disorders, and immune-deficiency syndromes. To-date, over 80 types of diseases have been treated with cord blood stem cells.

Stem cells from umbilical cord tissue have the potential to promote healing and enable the repair of diseased or injured tissue.

After your baby has been born and the umbilical cord cut, some blood remains in the blood vessels of the placenta and in the portion of the umbilical cord that remains attached. This is called umbilical cord blood, or ‘cord blood’ for short. Cord blood is a rich source of blood-forming (haematopoietic) stem cells.

In the umbilical cord tissue is a gelatinous substance which functions as the primary connective tissue of the umbilical cord, referred to as Wharton’s Jelly. This cord tissue contains a type of stem, the mesenchymal stem cell, often referred to as the regenerative stem cell. These cells are excellent candidates for Regenerative Medicine and Tissue Engineering applications.

Cord blood is the blood that remains in the vein of the umbilical cord and placenta at the time of birth. This blood is rich in haematopoietic (blood-forming) stem cells and is approved for treatment of certain blood diseases.

Cord tissue is the tissue surrounding the umbilical vein and vessels in the cord and is rich in mesenchymal stem cells. These stem cells have the capacity to differentiate into cells such as cartilage, bone, muscle and nerve cells and have the the potential to be used for applications that differ from cord blood stem cells.

Generally speaking, either your baby or a sibling. Your baby’s stem cells will always be a 100% match for him/her. To determine whether a sibling is a match, ‘tissue typing’ HLA (Human Leukocyte Antigen) typing is performed. This determines whether siblings are able to use each other’s stem cells for approved therapies. Each brother or sister of the same biological parents has a 25% chance of being a match. Biological parents will be a partial match (‘haploidentical). In cases where a person is unable to use his or her own stem cells due to an inherited condition, cord blood from a matched sibling, who did not inherit the condition, is the preferred source of stem cells in a transplant situation. This is one of the key reasons to bank cord blood for each child in the family.

In the past, umbilical cord blood and cord tissue have been viewed as medical waste and discarded, resulting in the loss of this potential life-saving resource. More than 97% of cord blood is still disposed of after birth and lost as a potential source of stem cells should a transplant be needed. These stem cells can now be saved with CryoSave so that your child can potentially benefit from established cord blood transplant therapies, as well as new developments in cellular therapy and regenerative medicine, in his or her lifetime.

Saving both cord blood and cord tissue will provide you with two different types of stem cells (hematopoietic stem cells from cord blood and mesenchymal stem cells from cord tissue) – which means more potential treatment options for your family.

The probability that a child, or his or her sibling, will develop a disease that requires a stem cell transplant is low, however, if a transplant is needed, cord blood stem cells stored in a family stem cell bank have certain advantages.

Advantages:

• Cord blood can be made available for transplant in a relatively short period of time compared to other sources of stem cells; it is collected in advance, tested, cryo-preserved and stored.
• Cord blood stem cells are more naïve than most other sources of stem cells. Cord blood is collected at birth and exposure to harmful environmental factors is minimal at this point in time.
• In many studies, cord blood transplants have been shown to have significantly lower rates of the transplant complication graft vs host disease (GvHD), which improves outcomes.
• There is scope for new developments and treatment possibilities due to the ‘naïve’ nature and higher proliferation capacity of cord blood stem cells. Cord blood has, for example, been shown to induce regeneration of cells in the central nervous system and published results from internationally conducted clinical trials indicate that cord blood derived stem cells may be effective in treating neurological conditions such as autism and cerebral palsy.

Over the past 30 years, more than 35,000 cord blood transplants have been performed worldwide. These cord blood transplants have been carried out mainly to treat blood disorders such as bone marrow failure, haematological malignancies, inherited blood- and metabolic disorders and immuno-deficiency syndromes.

Storing stem cells from umbilical cord blood and cord tissue does not guarantee that they will be suitable to be used in any specific instance, for these diseases. As with any other transplant therapy, the efficacy of the therapy depends not only on the number of stem cells in the collection but on many other factors such as the compatibility between the recipient and the donor.

Umbilical cord blood is harvested quickly and painlessly just a few minutes after birth. Once your baby has been born, the umbilical cord will be clamped and cut as normal. Your doctor (or midwife) will then collect the blood that is left over in the cord. A needle is inserted into the vein in the umbilical cord and blood is quickly drained into a specialised blood bag. Generally speaking, the number of stem cells collected is directly proportional to the volume of blood collected.

Usually at least 80ml of blood can be collected from a full-term infant. Bear in mind that delayed clamping of the cord may significantly reduce the amount of blood that can be collected which will, in turn, result in a lower number of stem cells in the collection. However, the two procedures can be combined successfully.

No. The collection procedure is perfectly safe and pain-free for both mother and baby. Umbilical cord blood is only collected once the cord has been clamped and your baby separated from the cord. The collection procedure does not affect the birthing procedure that you have decided upon and that is carried out by your healthcare professional. As far as the mother and child are concerned, it is completely non-invasive.

After the birth, your doctor (or midwife) will place the cord blood bag and the cord tissue container back into the collection kit. A designated courier will collect the sample and deliver it to the CryoSave laboratory.

CryoSave’s is an Internationally Accredited (AABB Accredited) facility. All cord blood samples are processed using an internationally validated processing and cryopreservation protocol. Sample processing and storage is carried out under a strict quality management program. A cryo-preservative is added to the concentrated stem cells and they are frozen by a method of controlled-rate freezing and placed, for long-term storage, in the vapour phase of liquid nitrogen, in a cryo-preservation tank at below (colder than) -180 °C. The required blood tests on a sample of your baby’s cord blood will be performed by a private pathology laboratory.

Cord blood stem cells have been shown to remain viable for at least 20 years of storage.

CryoSave South Africa will cryo-preserve your baby’s cord blood and tissue stem cells for at least 20 years if you choose to bank your baby’s stem cells with us.

There are three main reasons why a cord blood collection may not be successful:

1. An insufficient amount of blood may be collected.
2. A lower-than-usual amount of blood may be collected and the stem cell count in the collection is very low.
3. The sample may be contaminated with bacteria at the time of the collection.

For a cord blood stem cell transplant to be successful, there needs to be a sufficient number of stem cells in the collection. The number of stem cells is, in general, directly proportional to the amount of blood collected. Usually, at least 80ml of blood can be collected from the cord of a full-term infant from an in-utero collection.

There are many medical and physiological reasons why a sufficient volume of umbilical cord blood is not able to be collected. This may occur, for example, in low birth-weight infants and in situations of delayed clamping of the umbilical cord. Usually, your obstetrician or midwife will tell you if he/she considers that a less-than-optimal amount of blood has been collected.

If a cord blood or cord tissue collection has not been successful, the CryoSave Medical or Laboratory Director will contact you telephonically and will discuss the reason/s for the unsuccessful collection with you. Please bear in mind that the various blood tests, stem cell counts and blood cultures are performed, on Cryo-Save’s behalf, by a Private Pathology Laboratory. It takes some time to obtain and collate the results, particularly the blood culture results, and you will only be contacted approximately 10 days after the birth of your baby.

Please be advised that cord blood and cord tissue collections are not successful in approximately 4% of cases, particularly in situations where the baby’s birth weight is less than approximately 2.8kg and the obstetrician/midwife delays the clamping of the umbilical cord. Because of the costs involved in the collection, processing and testing of the cord blood sample, if the collection is unsuccessful, the Collection Fee is unfortunately not refundable. This should be taken into consideration when deciding on cord blood stem cell collection and cryopreservation.