Stem cells donation

Stem Cell Reserve For Life

Since the founding of cell biology, scientists have been searching for the one “stem cell” as the cell of origin of all organs. The therapeutic use of stem cells is already a medical reality for a wide range of diseases.

For about 20 years now, it has been possible in several countries to store stem cells from umbilical cord blood for later medical applications for one's own child or to donate the cells to a public blood bank.

Umbilical Cord Blood

The advantages of these young stem cells can be seen in particular in their high vitality and proliferation capacity.

Basically, there are two different ways of storing stem cells from umbilical cord blood:

• Storage for your own child in a private cord blood bank (autologous)
• A donation to one of the six public blood banks (allogeneic)

Umbilical cord blood is characterized by a relatively high concentration of blood stem cells, a fact that is based on the switch of fetal hematopoiesis from the liver to the bone marrow. During the first umbilical cord blood transplant in 1988, a five-year-old boy with Fanconi anemia in Paris received the umbilical cord blood of his younger sister. The first public umbilical cord blood bank was founded in New York in 1991. There are now more than 50 different diseases that have been treated with stem cell transplants. These include hematological diseases (leukemia, chronic anemia, lymphoma), congenital immune deficiencies, severe metabolic disorders, and advanced stages of rheumatic diseases.

The cells obtained are not infinitely expandable stem cells in the true sense of the word. Rather, they are precursor cells of the leukocytic, erythrocytic, and thrombocytic series.

Cord Blood Donation Technique

Obtaining umbilical cord blood is very simple. After the baby's umbilical cord is cut, the umbilical cord blood is collected in a solution containing sugar and citrate using a sterile collection set. There are two different techniques:

1. The umbilical vein is punctured while the placenta is still in utero.
2. After the birth of the placenta, the blood is collected outside the delivery room in a designated laboratory unit. In this case, the volume yield is often lower due to the postpartum collapse of the placenta.

There are no health risks for mother or child with either technique. Using a second puncture needle included in the collection kit, the collection volume can be increased by an additional puncture. Since the donation takes place after the child's umbilical cord is cut, the cord blood preparation belongs to the mother from a legal point of view.

Umbilical cord blood is collected from healthy newborns after delivery. Genetic or acquired diseases of the lymphohematopoietic system must be ruled out. Likewise, umbilical cord blood should not be donated in cases of severe hematological, immunological, or infectious diseases or in cases of significant malformations or underweight (<1500 g) of the newborn. Testing of the maternal blood for anti-HIV, anti-HCV, HBsAg (hepatitis B surface antigen), and TPHA (Treponema pallidum hemagglutination assay) must be negative, and the mother's CMV status is documented.

Public Cord Blood Banks

There are now over 40 public cord blood banks worldwide. Around half of the products stored are in banks that are part of the international Netcord network. Until two years ago, most of the products were transplanted into children. The latest figures show that almost half of the cord blood products are now used in adults.

Commercial Cord Blood Banks

The basic idea is to store the umbilical cord blood as "life insurance" for the newborn in case it becomes ill during its lifetime. There is an uncontrolled proliferation of more than 100 profit-oriented companies worldwide, which apparently store around two million preparations.

The probability that a child will need its own cord blood donation is very low and is given as 1:2700 or 1:1400. In addition, many hematological diseases in childhood are associated with genetic changes that are already present in the stem cells of the cord blood donation.

Contrary to the guidelines of the German Medical Association, some commercial cord blood banks accept lower volumes and cell counts for storage.

Many expert bodies condemn the policy of commercial cord blood banking for the reasons mentioned above. In the UK, the Royal College of Obstetricians and Gynecologists has spoken out against the routine, commercial collection of cord blood, as the scientific basis for such a practice is currently insufficient. The Italian government banned the establishment of commercial cord blood banks in 2002. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, the Canadian Society of Gynecology and Obstetrics, and the French National Ethics Committee for Health and Life Sciences also condemn commercial cord blood banking. One of the reasons for the rejection is that reserve cells can be obtained from the patient's own bone marrow for future regenerative purposes. Private storage is therefore not recommended, but not expressly prohibited either. What is more important is objective information from independent experts, which is unfortunately not offered by commercial operators of stem cell banks.

Economic Aspects

Commercial cord blood banks store cord blood donations for a fee, which is usually paid by the parents. There are no costs for parents to store the cord blood in a public cord blood bank. These costs are borne by the cord blood bank and amount to around 1,500 euros for the initial processing, excluding staff and storage logistics. Blood stem cells from cord blood are a valuable alternative to stem cells from bone marrow and peripheral blood. This also applies to adult patients for whom no unrelated or related donor is available. Transplants after reduced-dose conditioning or the use of two cord blood units could be promising treatment strategies for elderly and frail patients who would otherwise not be candidates for stem cell transplantation.