Cord Blood Storage: The New Biological Insurance

By Brigitte Rozario, The Star, April 8, 2007

Financial help is a necessity under certain circumstances these days, when anything can happen at anytime. So for this reason, many individuals invest in one or more insurance policies to protect themselves in the case of emergency. There are many different types, from car and home insurance (for accidents, theft, fires), to health insurance (for medical). If we already have a society that is involved with insurance on a multitude of levels, why not “biological” insurance?

For those who worry about the future health of their family , stem cell banking and preservation offers exactly this opportunity.

Stem cells can be grown into a wide range of specialized cell types, since these cells retain the ability to renew themselves through cell division. Blood cancers and other disorders have already been successfully treated with stem cell treatment.

In the adult human body, stem cells are typically difficult to harvest and also rare. But in contrast, the umbilical cord holds an enormous amount of stem cells.

The umbilical cord blood can be harvested and stored along with the stem cells which reside in the blood.

Lymphomas, leukemias, thalassaemias, and other disorders can all be treated in the future using these cord blood harvested stem cells.

Explains hematologist Dr. Gong Swee Kim who works at a private cord blood storage facility, “As we grow and age, there is wear and tear in the tissues from usage and from injuries; we need to replenish our cells. So that is where stem cells come in.”

“Stem cells are capable of dividing and renewing themselves for long periods of time. There are various types of stem cells such as embryonic, adult and placenta/umbilical cord. To get the stem cells you have to harvest them and this is done in the operation theatre.”

Dr. Gong explains that previously, umbilical cords were discarded. If the cord blood is not harvested, the same takes place today. Thus, the stem cell rich blood along with its life saving potential is wasted.

“The doctor cuts the umbilical cord and then the baby is taken over by the nurse. Then the doctor can insert the needle into the cord to harvest the blood. The blood is collected into a bag and the bag is brought back to our laboratory by our logistics personnel. At our lab it is processed by qualified staff,” says Dr. Gong.

“The cord blood contains plasma, which is the liquid portion, and it also contains red blood cells. Not all the red cells are stem cells so we are strictly looking for the layer that is rich in stem cells and we will subsequently store it in small freezing bags,” he added.

Most obstetricians can perform the procedure of harvesting the cord blood given that the process is so simple.

The only stipulation is that the couple needs to inform the doctor in advance about their desire to preserve the cord blood so that storage preparations can be made.

After cord blood is harvested, it is transferred to a cord blood bank where it will be stored. There are a number of private and public banks that can facilitate this need.

When the blood reached the bank, it is typically identified and bar-coded. All the standard screening tests that a blood donor would be required to go through are also performed on the cord blood, which is also measured for weight.

The couple is informed of any positive test results or other complications, and a decision is made to store or not to store. But because there is the risk of infecting other samples, most banks will refuse to store infected blood.

Chemicals are added to the blood sample to settle the cells if the tests are all negative.

The sample is separated into layers by centrifuge. The layer of cells is retained, while the layer of additional red blood cells and liquid is discarded.

Another round of processing allows the portion that is very rich in stem cells to be separated, again reducing the volume of the sample.

The slow process of freezing begins after a final preservative is added to the remainder of the now stem cell rich sample. After it has reached the desired temperature, the sample is stored in an extremely cold liquid nitrogen tank.

As far as stem cell banks go, very few hospitals currently have their own facilities. An individual would have to store their sample in a private or public bank.

It is important to know that if individuals choose public banking, the sample cannot be specified for family use only, and the stem cells will be given to anyone that needs them. This is not the case with private storage.

Two storage options are available to couples; vials or bags.

“With vials we can split up the sample into five or six vials. So we can store half at our headquarters and half at an alternative site.”

“At the moment, if it is stored in bags, we cannot offer storage in two sites because there is only one bag and once it is frozen, you cannot take it out to refreeze it.”

“With bags there is less chance of contamination. Having said that, it doesn’t mean that vials will get contaminated. We practice aseptic techniques at all times. We even have a biosafety cabinet where there is a laminar flow system. All precautions have been taken to ensure there is no contamination.”

“I would say that the risk of contamination is low. But having said that, with vials you have one additional step of transferring the sample to other vials, and hence, there are additional risks of contamination.”

“With the bag, there is no transferring to other bags so there isn’t that risk of contamination,” explains Dr. Gong.

Because of the option to store in more locations, more couples seem to prefer vials she said. Then if the facility is compromised, there is no worry that the stem cells could be lost.

The safety of the baby and mother is a concern for some couples.

“The procedure is painless because we are harvesting the cord and by then the baby is already separated from the cord.”

“It is actually stated in our trust that should there be any instance where there is a danger because of complications during labor, then the doctor’s main aim is always the safety of the mother and the child.”

“If he feels it is necessary, he may even abandon the procedure altogether. If your life or your baby’s life is in danger the doctor will have to concentrate on you or your baby,” explains Dr. Gong.

Currently, stem cell treatments have been used to treat many different conditions. Stem cell treatment has been a popular option for certain types of cancer. But those cells have been derived from bone marrow in most cases.

“When you do a transplant, the stem cells will take over your marrow and produce the cells that are normal. But if you take your own marrow, because it’s a genetic disease, it will always keep producing this defective cell.”

“Those who should store cord stem cells are those with a family history of certain disorders. There is a list of about 70 conditions that are currently treatable such as cancers of the blood and immune deficiency,” says Dr. Gong.

She informs that currently stem cell research is being conducted all over the world for other diseases like Parkinson’s, stroke, diabetes, Alzheimer’s and heart problems. The therapy has shown promise in many cases and is gaining popularity with each successful result: despite the fact that the media and other parties have tried to suppress the positive news about adult stem cells while promoting embryonic stem cells research (which has proven to be a worthless endeavor thus far).

Given the chance, many people still do not opt for storage today. But as people become more educated about the benefits of storage, the numbers are steadily on the rise.

As more research is conducted it is expected that there will be a higher chance that the stem cells will be used.

“It’s a biological insurance. You might not use it, but those who are caught without it might regret it later. It’s the same as taking insurance,” says Dr. Gong.