Here are the steps found in cord blood banking:. This is a simplified version of the steps to cord blood banking.
For a more detailed overview, you can read more about the steps to cord blood banking here. When the medical courier delivers the cord blood collection kit to the cord blood bank, it is quickly processed to ensure the continued viability of the stem cells and immune system cells found in the cord blood. As these tests are being conducted, the cord blood is processed to reduce the number of red blood cells and its total volume and isolate the stem cells and immune cells.
There are a number of different processing methods out there for a cord blood bank to use, and the processing method can ultimately affect the purity of the final product, which we'll explain in a minute. Once the stem and immune system cells have been isolated and extracted from the plasma and red blood cell, they are mixed with a cryo-protectant and stored in a cryo-bag.
We over-wrap our bags for added protection and use a technique called "controlled-rate freezing" to prepare the cells for long-term storage. The over-wrapped cryo-bag is housed in a protective metal cassette and placed in vapor-phase liquid nitrogen freezer for long-term preservation. As noted, there are different ways to process cord blood, and although the type of processing method doesn't always enter the conversation on cord blood banking, it is a big part of the purity of any cord blood collection.
Red blood cells can have a negative impact on a cord blood transfusion. In addition, there is a certain number of stem cells that need to be present in order for the cord blood to be effective in disease treatment. Each processing method has the ability to better reduce the number of RBCs and capture more stem cells.
Some processing methods like AutoXpress and Sepax are automated to ensure a level of consistency across all collections. HES is preferred by some banks because it was the original processing method used by most banks and it has a proven track record. You can read more about the different cord blood processing methods here.
In terms of performance, our PrepaCyte-CB processing method has taken the lead. PrepaCyte-CB greatly improves on parents' returns on investment because it yields the highest number of stem cells while showing the greatest reduction in red blood cells.
The ability to get better more quickly and a reduced chance of infection can prove vital in certain cases. Today, many conscientious parents are also considering delayed cord clamping DCC , a practice in which the umbilical cord is not clamped immediately but rather after it continues to pulse for an average of 30 seconds to seconds.
As noted early, our premium processing method, PrepaCyte-CB, is able to capture more immune system cells and reduce the greatest number of red blood cell contaminants. This makes it go hand in hand with delayed cord clamping because it is not as affected by volume, effectively making up for the smaller quantity with a superior quality.
You can read more about delayed cord clamping vs. Banked cord blood is most abundant in white blood cells and stem cells. While a lot of attention is paid to the stem cells, there are approximately 10 times more total nucleated cells TNCs than stem cells in any cord blood collection.
TNCs are basically white blood cells, or leukocytes; they are the cells of the immune system that protect the body. Despite stem cells comprising one-tenth of most collections, cord blood is still considered a rich source of hematopoietic he-mah-toe-po-ee-tic stem cells HSCs. Hematopoietic stem cells can become two categories of cells: myeloid and lymphoid cells.
Myeloid cells go on to form your red blood cells, platelets, and other cells of the blood. Lymphoid cells go on to become the B cells and T cells and are the basis for the immune system. Cord blood also contains mesenchymal meh-sen-ki-mal stem cells MSCs , but they are much more abundant in cord tissue, which we will discuss in a minute. In addition to the stem cells, researchers are discovering specific uses for the other types of cells in the treatment of certain conditions.
Cord blood Treg cells hold potential for preventing graft-versus-host disease in stem cell transplantations and ameliorating the effects of autoimmune diseases such as diabetes, rheumatoid arthritis and multiple sclerosis.
Cord blood natural killer cells also hold future potential. These cells have been programmed to target specific cancers and tumors in clinical trials.
This could make them exceptionally strong candidates for chronic or treatment-resistant cases of cancer. Another way scientists are working with stem cells is through expansion technologies that spur replication of the cord blood stem cells. If proven effective and approved by the U. Food and Drug Administration, these expansion technologies will allow scientists to culture many stem cells from a small sample. This could provide doctors and researchers with enough stem cells to treat multiple family members with one cord blood collection or provide the baby with multiple treatments over time.
To better prepare for the day when these expansion technologies are more easily accessible, some cord blood banks have begun to separate their cord blood collections into separate compartments, which can easily be detached from the rest of the collection and used independently. You can learn more about Cryo-Cell's five-chambered storage bag here. Stem cells develop to become mature blood cells including:.
Stem cells are an important treatment for many diseases, including cancer, blood disorders, and genetic and metabolic diseases. For many patients, umbilical cord stem cells are life-saving. Usually, the umbilical cord and placenta are discarded after birth.
If a mother chooses to have her cord blood collected, the health care team will do so after the baby is born. With a sterile needle, they'll draw the blood from the umbilical vessels into a collection bag. The blood is packaged and sent to a cord blood bank for long-term storage. Public umbilical cord blood banking is the recommended method of obtaining umbilical cord blood for use in transplantation, immune therapies, or other medically validated indications 6.
There are currently 28 public umbilical cord blood banks identified in North America Public banks promote allogeneic related or unrelated donation, which is analogous to the current collection of whole blood units in the United States. The National Marrow Donor Program maintains a list of participating hospitals that work with the network of public umbilical cord blood banks.
Every unit of unrelated donor cord blood to be transplanted in the United States must be licensed or covered under an investigational new drug application approved by the FDA Initial HLA typing of these units allows them to be entered into computerized registries so that when the need arises, a specific unit can be rapidly located for a patient.
Minority populations are significantly underrepresented in public and private banks. To ensure that there will be enough cells for transplantation, at least 40 mL of cord blood must be collected.
Collection can be performed before or after removing the placenta. In either case, thorough cleansing of a section of umbilical cord is performed, and blood is obtained from the umbilical vein by venipuncture and allowed to drain by gravity into a bag supplied by the bank.
Blood should be collected as soon as feasible after birth to minimize coagulation and maximize volume If the specimen is not sterile or is not of sufficient quantity, the bank will discard it. Umbilical cord blood collection is not part of routine obstetric care. For example, patients should be aware that delayed umbilical cord clamping significantly decreases the volume and total nucleated cell counts of cord blood donations.
Nonetheless, umbilical cord blood collection should not compromise obstetric or neonatal care or alter routine practice of delayed umbilical cord clamping with the rare exception of medical indications for directed donation The American College of Obstetricians and Gynecologists has identified additional resources on topics related to this document that may be helpful for ob-gyns, other health care providers, and patients.
You may view these resources at www. These resources are for information only and are not meant to be comprehensive. The resources may change without notice. Copyright by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.
Umbilical cord blood banking. American College of Obstetricians and Gynecologists. Obstet Gynecol ;e— This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of the treating clinician.
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