Donating and storing umbilical cord blood: key facts at a glance

Stem cells from umbilical cord blood

Stem cell therapies help to boost blood formation and immune defences in certain serious diseases such as leukaemia. Stem cells are found in bone marrow, a source that has long been used for donations in cases where the cells provide a good match. New insights now show that stem cells are also found in the blood of the umbilical cord. This field is currently developing rapidly, as transplants with umbilical cord blood display significant advantages over the conventional method.

Is there value in storing umbilical cord blood?

In contrast to collecting stem cells from the bone marrow, umbilical cord blood can be collected without surgery. After birth, a specialist collects the blood from the cord and placenta under highly sterile conditions. After being tested, the blood is then frozen and stored in a biobank for later use.

Fewer defence mechanisms in the body

The use of cells from umbilical cord blood leads to fewer defence mechanisms in the body because these cells are even more immature than those taken from bone marrow. Put simply, this makes them more flexible when it comes to finding a match. A cord blood transplant also vastly increases the potential field of donation – and this can save lives, as specialists today need months to find and prepare a bone marrow donation. It's then often too late for the transplant, as Professor Danie Surbek from Inselspital Bern explains in an interview with Swissmom. By contrast, transplants from an umbilical cord blood bank can be retrieved at any time. From a medical point of view, therefore, there is value in storing umbilical cord blood.

Disadvantages of storing umbilical cord blood

1. A major disadvantage is the limited amount of stem cells available in umbilical cord blood. In most cases to date, children were the recipients of stem cell transplants from umbilical cord blood, as smaller quantities are sufficient for children.
2. The limited amount also means that there’s only a good chance of a match if many donations are available in the stem cell banks. Large stem cell banks are therefore needed to cover the demand.
3. This, coupled with storage technicalities, results in high costs for umbilical cord banks.
   

Embryonic and adult stem cells

Stem cells arise from the division of the fertilised egg cell. By further dividing, they can develop different functions. A distinction is made between embryonic stem cells, which are at a very early stage of development and can therefore still form almost all body cells, and adult stem cells, which serve an important regenerative function in the body. Stem cells from umbilical cord blood lie somewhere in between.

Donating umbilical cord blood

In principle, it’s quite simple to donate umbilical cord blood. Expectant parents can find out more at their antenatal check-ups and are permitted to wait until shortly before the birth to make their decision. A guide issued by the Council of Europe provides a comprehensive overview. While private donations can be made practically everywhere, public donations are currently only possible in selected clinics.

Public umbilical cord blood donations are currently possible at the following locations: Department of Obstetrics and Gynaecology Inselspital Bern, University Hospitals Basel and Geneva, Cantonal Hospital Aarau.

How does an umbilical cord blood donation work?

The decision in favour of or against a donation can be made at the latest when entering the delivery room, but ideally it’s made earlier. After the birth, a blood sample is taken from the umbilical cord. In the lab, the blood stem cells are isolated and the sample numbered. This is followed by a safety test after which the sample is frozen in liquid nitrogen and stored (cryopreservation). If the sample is stored in a public stem cell bank, it will be used as soon as a patient with the same tissue characteristics requires a stem cell transplant.

Difference between public and private umbilical cord banks

So what’s the difference between public and private donation banks? Parents who donate their child's umbilical cord blood publicly:

• Release it for any future transplants.
• No longer have a claim to it.
• Hand over the costs to the state.

However, donations are only possible in about 20% of births, as – for economic reasons – the public banks require a high stem cell content.

Costs of private storage

Private stem cell banks store umbilical cord blood for a fee – which is paid by the parents themselves – and make it available if the child or family registers a need. In this case, almost all blood donations are accepted, as the stem cell content can be lower for intra-family transplants. The costs for these families amount to around CHF 3,000 to CHF 5,000, depending on the biobank. As stated in an info page on the FOPH website, experts estimate that the probability of privately stored blood stem cells ever being used for therapy is low.

Did you know? SSCB is the only private biobank with NetCord-FACT accreditation in Switzerland. This certification is a standard requirement for all public biobanks and guarantees the quality of the entire process.

Hybrid umbilical cord banks

Recently, so-called hybrid donation banks have also been trialled in Switzerland, like those already existing in the UK and Germany. Hybrid biobanks store the donation for personal use, but also register it anonymously in the public stem cell donation register. In the case of a public claim, the parents can decide whether they want to release the umbilical cord blood and have their costs refunded, or whether they want to continue to store it.

Risks of an umbilical cord blood donation

Umbilical cord blood is only collected after a normal pregnancy if the mother and child are both healthy. Depending on the course of the birth and the amount of blood available, collection cannot always be guaranteed. No donations are made in the case of premature births. Other risks include a family history of cancer or infectious diseases such as HIV. To rule out any risks, donor parents first fill out a questionnaire and the expectant mother takes a blood test.

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