Cord blood stem cells

[poppyseed1663]

Morning!

I am due in April and my DH and I are trying to decide whether or not to store or donate the blood stem cells from the umbilical cord. I have heard from some people that the baby can benefit at birth from having the blood from the cord and that delayed cord clamping is better. Others say that the stem cells should be stored ( and only used by the baby) and others say that storing is over priced and donation is better.

She is due to arrive in a hospital that can store/ donate cells but I wondered if anyone had any experience of this decision or any advice on the topic?

Many thanks for any tips or advice.

I wanted to donate but they don't give me the option in Oxfordshire. I think like eating your placenta the research says it's an expensive waste of time but definitely worth looking into it. Personally I think the science just isn't there yet to justify the cost. I would absolutely donate though.

Morning poppy! I'm also due in April I've thought about doing this due to my son having leukaemia.
However his main care hospital won't store them so we'd have to look into paying to have them stored privately. They also say siblings are usually a pretty good match.

When I asked the midwife she couldn't really advise me very well. So need to do more reading up. If we can't afford to do it however I will think about donating as well as I know how important these things can be to other families!

Thank you for the advice. I think we will look into donation. We only have until February to make a decision. I'm just worried that early clamping of the cord might deprive her of some blood that might be good for her just after birth. Decisions are hard..

I'm sorry to hear about your son, Sunshine. You make an excellent point about donation. It would be wonderful if we could help another family.

@poppyseed1663 oh - in order to donate they have to clamp the cord early? I had no idea..!

I donated to the Anthony Nolan Trust, very easy, unfortunately collection is only offered at a very small number of hospitals.

As pp have said you can only donate in a very small number of hospitals: Barnet Gen, Northwick Park, Luton & Dunstable, Watford Gen, St George’s & UCH with NHS and St Mary’s Manchester, King’s London, Leicester RI and Leicester Gen with Anthony Nolan.

Virgin do a fairly good cord blood prep and storage service for under £2,000. They keep it for 25 years and then if unused the kid decides what to do with it, e.g. Continue to store, bin etc. I think you have to pay for someone to come and take it from the cord though.

Hello, as someone that has worked with banking cord blood and cord tissue for a number of years I can help a little here.

Collection of cord blood and tissue is a quick, non-invasive process that is done once the baby has been safely delivered. It takes less than 15 minutes, and uses material that would otherwise go to waste.

A good company will send a phlebotomist to collect the sample and send it to a lab for the stem cells to be extracted.

Your child's stem cells have a high chance of being able to be used by their siblings and even their parents.

It is important to collect the tissue from the umbilical cord as well as the blood, this is the future of stem cell treatments.

I'm happy to recommend a couple of places if anyone is interested also happy to answer any other questions people might have.

Dan

"Collection of cord blood and tissue is a quick, non-invasive process that is done once the baby has been safely delivered. It takes less than 15 minutes, and uses material that would otherwise go to waste"

How soon after the baby has been safely delivered. The baby being born is not the end of the birth process! There's a further stage where the placenta is delivered and yes, without early clamping and a non-drug assisted delivery of the placenta, baby continues to enjoy oxygen assisted breathing from the placenta for as long as the cord is pulsing, AND they absorbed through just natural transfer a whole load of that super rich blood that's sitting in the placenta and cord.

When exactly is it done (I'm interested to learn).

That would depend on the individual. I would always say to follow your birth plan.

You can choose delayed cord clamping AND have cord blood and tissue collected.

If you decided to have delayed cord clamping and want the cord blood collected - I would advise no more than a minute of cord clamping (which is similar to what most hospitals recommend), any longer than that and you would risk not having enough cord blood for a viable sample (cord blood isn't as easy to culture).

I don't know if Dan can corroborate this but when we made an altruistic donation to the Anthony Nolan bank we were told that even a very small sample collected after delayed clamping was valuable, as it could be used for research even if it wasn't enough for therapeutic use.

This might of course not apply if you are arranging private collection and storage.

Yes, if you are donating to a public bank, any sample is incredibly valuable.
I would also bank any sample, no matter how small, if you are using a private bank. The way bio science is going, a sample that is deemed unusable now could be used in a few years time.

So essentially if you want to collect the right sample size, inevitably cord clamping is a necessary 'evil' so to speak (!) as after a minute it's unlikely the cord would have already stopped pulsing - is that right?

^The benefits of delayed cord clamping for the baby include a normal, healthy blood volume for the transition to life outside the womb; and a full count of red blood cells, stem cells and immune cells. For the mother, delayed clamping keeps the mother-baby unit intact and can prevent complications with delivering the placenta. During fetal life, the baby’s organs only need a small flow of blood while the placenta performs the role of lungs, kidneys, gut and liver for the baby. This is why a significant portion of the baby’s total blood volume is in the placenta at any given time. The blood circulating the placenta and cord is not ‘extra’ blood or waste – it belongs to the baby. Immediately after birth, the cord pulsates as the placenta continues to provide essential oxygen and nutrients, and begins to deliver blood back to the baby. This transfer of blood is called placental transfusion and it is a vital part of the birth process. Placental transfusion is the system that provides the baby with red blood cells, stem cells, immune cells and blood volume. Delayed cord clamping allows time for the placental transfusion, ensuring safe oxygen levels and blood volume in the baby. The World Health Organisation states the “optimal time to clamp the umbilical cord for all infants regardless of gestational age or fetal weight is when the circulation in the cord has ceased, and the cord is flat and pulseless (approximately 3 minutes or more after birth).” Large studies have shown that immediate cord clamping can result in lower iron stores in the baby for up to 6 months after birth. While not all the implications of a reduced iron status are understood, iron deficiency in the first few months of life is associated with neurodevelopmental delay, which may be irreversible. Early cord clamping can cause complications for the mother, too. There is some evidence that early clamping increases the risk of post-partum hemorrhage and retained placenta by engorging the placenta with the baby’s blood. This makes it harder for the uterus to contract and expel the placenta. While the cord is pulsating, placental transfusion is supplying the baby with oxygen, nutrients and an increased blood volume to support the transition to life outside the womb."

Just for interest as there are several aspects to cord clamping that people might want to explore to help in their decision-making around harvesting cord blood.

Thanks for the replies. I spoke to my midwife and she suggested delayed cord clamping and then said they can donate the placenta, which can then be used to take stem cells from. I think I will probably do that. So many decisions!

Best of luck poppyseed!

Yes that is right. You can still delay the clamping for a minute or so and collect the cord blood sample but the cord usually takes between 3 to 5 minutes to stop pulsating. I would always say to follow your own personal birth plan. As I'm sure you're aware there are lots of different views on delayed cord clamping, its benefits, how long, etc.

My field is stem cells, and stem cell banking. But my opinion, for what it's worth, would be a mixture of the two. I can absolutely see the benefit in delayed cord clamping, my sister did it with both her children for a few minutes after the births but didn't collect the blood and tissue (she didn't know about it at the time but will collect them for her next child!).

I see such huge benefit from banking cord blood and tissue. I haven't had children as of yet but when I do I will absolutely bank the cord blood and tissue.

I think the place people get a little lost with banking cord blood & tissue is the difference between donating the CB&T to a trust or charity and banking it privately. It does get a little complicated.

If donate your CB&T to a trust or charity (say a blood cancer charity), a small sample gets taken to be researched on and the vast majority is banked to be used by someone else that has a (human leukocyte antigen) match to your child's stem cells. Obviously you then don't have access to the stem cells anymore but if your child needed treatment for blood cancer and if they are available then you could use them.

If you bank your stem cells privately, at some banks a tiny portion is used for research but 99.9% gets stored for your child, their siblings and even you and your partner. These are then available for you anytime you need.
The amount of cord blood usually collected could be used for one treatment, possibly two, dependant on the size. Cord blood contains an abundance of HSC's or haematopoietic stem cells which can become red and white blood cells and platelets.
Cord tissue on the other hand, I/we see as the future. It can be cultured up (grown) to provide lots more than 1 or 2 treatments and contains a lot more MSC's or mesenchymal stem cells, which can become bone, tissue, muscle, fat, cartilage.
So it is really important if you bank your child's stem cells to bank the cord blood and tissue (some companies only bank cord blood).

There is more to go into but if you do want to bank your stem cells there are 1 or 2 companies in the UK that I would avoid, for a number of reasons. I'm happy to let anyone know who they are privately.

I hope that covers most things, happy to answer any other questions when I get a chance.

I donated my placenta's each time, in my eyes I had no use for it after so was happy to help anyone who can get any use.