Umbilical cord blood: myths and truth

Most families get to know about the opportunity to collect and preserve the umbilical cord blood of a newborn during preparation for the childbirth, so there is time to think it over and decide whether to store the biological material after childbirth. Some mothers, having learned about the collection of umbilical cord blood already after the birth of their children, regret that they have not contacted the cryobank earlier. Some, when planning a childbirth, doubt whether it is worth preserving the umbilical cord blood of newborns or absolutely reject this possibility, referring to common stereotypes. We will dispel myths that prevent families from making a vital decision.

Myth 1: umbilical cord blood collection is dangerous

Umbilical cord blood collection is an absolutely painless and safe procedure for both a mom and a newborn. At the time when cord blood is collected, the baby is already completely separated from the umbilical cord and placenta. A sterile needle is inserted into the umbilical vein of the cut maternal umbilical cord fragment, with the help of which the remainder of the blood in the umbilical cord flows into the sterile container. At this stage, it is important that the doctor or a midwife who carry out the cord blood collection follows all the rules to maintain the sterility of the biological material. The umbilical cord blood collection procedure is described in the order of the Ministry of Health of Ukraine No. 481 of July 10, 2014, according to which the personnel who have the right to collect biological material are well familiarised. There are no risks in the process of umbilical cord blood collection, this does not affect the future health of the child or the condition of the mother. In fact, the doctor collects into a sterile container what was simply disposed of several years ago.

Myth 2: if you collect umbilical cord blood, the newborn will “not receive” it

In the body of a newborn, the blood volume is about 5-8% of the body weight. Umbilical cord blood is collected after the umbilical cord is cut and the baby begins to breathe on its own. However, mothers are worried about whether the medical staff will rush to cut the umbilical cord to get more cord blood. This will not happen. If a woman has entered into an agreement with a cryobank for the collection and storage of umbilical cord blood, the umbilical cord will be cut in accordance with the order of the Ministry of Health. Some women in labor insist that the umbilical cord be cut only when it stops pulsating, but even in this case, cord blood can be collected. Doctors nevertheless insist that the cutting of the umbilical cord should be carried out in a period of time regulated by national and international regulatory documents. This is done in the entire civilized world, and cord blood is collected in all highly developed countries. If it were likely to cause any harm to the child, the procedure would not have been carried out in the United States and European countries, and dozens of cord blood banks — public and family — would not have been operated in these countries.

The volume of cord blood collected after the birth of a child can be different and averages 50-100 ml. These dozens of ml of blood are not “taken” from the baby, they simply remain in the umbilical cord, which will be disposed of if the mother has not concluded an agreement with the cryobank for the storage of the biological material. Collecting umbilical cord blood at birth is the only chance to provide the child with future access to autologous (own) stem cells – young, most active, collected in the first minutes of life, not yet exposed to the effect of environmental factors or bad habits. Indeed, even bone marrow stem cells obtained in adulthood will never be as young and active as those obtained from cord blood at birth.

Myth 3: cord blood can not be collected during cesarean section

Cord blood can be collected in most cases, whatever the mode of delivery. Planned cesarean section is not a contraindication for the collection of cord blood. The method of delivery is not reflected in the cost of collecting and storing cord blood. Cord blood collection is carried out regardless of the number of children born, but if twins or triplets are expected, the cost of cryobank services changes. There are practically no contraindications for the collection of cord blood, however, the decision on the possibility of blood collection is always up to the doctor, who proceeds from the real situation and the course of the birth.

Myth 4: collecting and storing cord blood is very expensive

It is not as expensive as it seems to those who have never displayed interest to its cost. Cryobanks usually offer significant discounts on payment for the entire biological material storage period provided for in the contract. Using a convenient calculator  on our website it is easy to calculate how much it will cost to collect and store cord blood at the birth of one child or in multiple pregnancy.

In practice, it turns out that a mobile phone, a car insurance or an annual gym membership is comparable in price to the cost of collecting and processing of the biological material to obtain unique stem cells that can save lives in the future. During childbirth, you can collect other tissues – the umbilical cord and the placenta, from which stem cells are also isolated, and from the placenta a valuable multifunctional extract can be made. The collection, processing and storage of all biological materials is really more expensive, but the minimum that will give an opportunity to provide the child with the necessary stem cells in the future is umbilical cord blood, the collection and storage of which is quite affordable. In addition, it is worth to recall the cost of donor material. In Ukraine there are no public cord blood banks and insurance medicine, thanks to which it would be possible to receive a transplant for free if necessary. Unfortunately, in our realities, if there are no stored own stem cells, we have to buy this material for transplantation. The cost of a bone marrow donor transplant makes about 40,000 euros, and it is not always possible to find immunologically compatible biological material. The cost of cord blood cells from a foreign public cord blood bank will make  about 20,000 euros. Having calculated the cost of collecting and storing umbilical cord blood, placenta and umbilical cord, you will understand that cryobank services are 10-20 times cheaper than buying donor stem cells, depending on the number of children and the type of the stored biological material.

Myth 5: it is safer to store the cord blood abroad than in Ukraine

Ukraine has stringent legislation governing the operation of cord blood banks. This is a resolution of the Cabinet of Ministers of Ukraine dated 02.03.2016 No. 286 “On approval of the Licensed Conditions for the performance of business activities of cord blood banks, other human tissues and cells.” Here you can read the list of requirements and documents necessary for a cord blood bank to obtain an appropriate license. The processing of biological materials for the isolation of stem cells and their consequent cryopreservation in the Institute of Cell Therapy Cryobank are carried out using the same methods as in the most modern and progressive biobanks of the world. Only the Cryobank of the Institute of Cell Therapy in Ukraine complies with the ISO 9001:2015 standard, which means that all the procedures are carried out in accordance with international quality standards. Even if you plan to move permanently to another country, the cord blood stem cells stored in Ukraine, in particular, in the Cryobank of the Institute of Cell Therapy, can be transported for storage to a cryobank in another country, and also, if necessary, used abroad for treatment. If the family does not plan to leave the country in the coming years, it is inexpedient to organize an expensive transportation of biological material to another state in order to receive there the services of a cord blood bank of the same level as in Ukraine. However, when choosing the Ukrainian cryobank, it is necessary to pay attention to the availability of international certificates and accreditations, which in the future will allow, if necessary, to transport biomaterial for storage or use in another country. In more detail about the criteria for choosing a cord blood bank, we wrote here

Another advantage of storing umbilical cord blood in the Ukrainian cryobank is the ability to deliver the collected biological material to the laboratory in a timely manner for processing and preparation for long-term storage. Our own logistics service allows you to control all stages of the biomaterial transfer to our Cryobank from any settlement on the territory of Ukraine. But ensuring timely delivery of blood to a foreign bank is not so simple. The longer umbilical cord blood is on the road, the less stem cells can be isolated from it. When transporting blood abroad, time is spent not only directly on delivery, but also on the preparation of documents for the export of biological materials, without which legal transportation is impossible. In the case of illegal transportation, it is difficult to even imagine whether the temperature will be observed on the road and whether by the time of delivery it will be possible to maintain the quality of blood necessary for the isolation of stem cells in a foreign biobank.

Myth 6: diseases in which umbilical cord blood cells may be needed are so rare that it makes no sense to pay for its storage.

To the question of which diseases umbilical cord blood can help, an exhaustive answer cannot be given today: annually discoveries are made in the world and clinical trials of stem cell preparations are carried out for various diseases, so this list is constantly updated. In 2006 and 2010, the European Association for Blood and Bone Marrow Transplantation declared the cord blood to be equal to the bone marrow as a source of hematopoietic stem cells. These cells, in accordance with officially approved international protocols, are used in the treatment of blood diseases (leukemias, lymphomas, myelodysplastic syndrome), congenital immunodeficiencies, and genetically mediated metabolic diseases. There are also many scientific reports on the effectiveness of cord blood cells in treating autism, cerebral palsy, the consequences of stroke, coronary heart disease, cardiomyopathy, diabetes, cirrhosis and many other diseases. However, the treatment of these pathologies today is carried out in the framework of clinical trials. Unlike pharmaceutical companies, which have large financial resources and quickly conduct large-scale multicenter clinical trials on the effectiveness of drugs, cord blood banks go this way much longer. This is due to more modest financial opportunities, and to the number of patients who can take part in research – because stem cell treatment is often used for fairly rare diseases.

Nevertheless, in 2012, the Ministry of Health of Ukraine officially approved the developed by the Institute of Cell Therapy method of treatment of acute pancreatitis and lower limbs ischemia using cord blood stem cells and umbilical cord tissue. And in October 2019, Ukrainian scientists, as part of the International Medical Forum in Kiev, presented a new technology for the growth of bioimplants from stem cells for the whole world. Of these, cardiac surgeons will be able to create a heart valve or other necessary fragment of a damaged organ during surgery. The technique involves the use of cord blood stem cells or adipose tissue. If such bioprosthetics are performed in childhood, the implant will literally grow with the patient, and its replacement, as in the case of artificial tissue implantation, will not be needed.

Preserved umbilical cord blood gives great benefits in cases where hematopoietic stem cell transplantation is necessary for malignant blood diseases. When selecting a bone marrow stem cells donor, the probability of immune matching, unfortunately, is very low and sometimes amounts to 1:1,000,000. However, if the parents stored the umbilical cord blood at childbirth, if necessary, the child at any age will have access to autologous (own) stem cells that do not cause rejection after transplantation. Necessary cells will not need to be searched for in the registries of donors, none of those close ones, whose bone marrow cells may be suitable will not have to undergo a painful operation (and sometimes more than one) to obtain bone marrow stem cells. The medicine will always be available, and it will be incomparably cheaper than donor cells of bone marrow or umbilical cord blood.

Cord blood stem cells preserved at childbirth can literally save a life in the future and maintain its high quality. Those who needed cord blood for treatment saved a lot of money on treatment, as buying donor stem cells costs, as mentioned above, tens of thousands of euros.

Myth 7: only a child whose blood is collected can use stem cells from the collected umbilical cord blood.

Preserved stem cells can be used by a child whose blood was collected and stored at birth, with a high probability – one of his siblings too. There is a chance that the cord blood cells of the child will match one of his parents. Sometimes the question arises, “if the cells are not needed for treatment, what should be done with them?” They can be used in anti-aging therapy programs, that is, to rejuvenate the body. If anti-aging therapy is carried out using stem cells, this can reduce the development of many diseases that occur with age, including tumors occurence. We wrote about this in one of our publications.

Myth 8: stored umbilical cord blood may be unusable.

The collection, processing and storage of umbilical cord blood is a technologically complex process that is regulated by national and international laws, requires highly qualified personnel, the use of quality materials (for example, cryoprotectants that protect cells from destruction during freezing and storage). If a mistake is made at any stage, this can really negatively affect the quality of stem cells obtained after defrosting. That is why the biobank must be chosen carefully, being interested in all aspects of the processing and storage of cord blood, certificates, licenses and accreditations of the bank. For example, the technology used at the Cryobank of the Institute of Cell Therapy provides up to 96% of viable cells after cord blood defrosting.

Myth 9: one should save only the umbilical cord blood, and the placenta and umbilical cord can be disposed of.

In fact, all of these biological materials — umbilical cord blood, placenta, and umbilical cord — can be the source of different types of cells. In addition, a valuable placental extract is made from the placenta, which is used in various fields of medicine and cosmetology. We wrote more about the opportunities that a family that stores the placenta after the birth of a child gets  in one of our materials.

Cord blood is a special source of stem cells, because it is comparable to bone marrow in terms of transplant quality. That is, these are the hematopoietic cells of umbilical cord blood that can be used to treat malignant blood diseases, primary immunodeficiencies, and genetic metabolic diseases. The placenta and umbilical cord contain another type of stem cell – mesenchymal stem cells, which began to be studied only in the last decade. However, mesenchymal stem cells are already used in the transplantation of hematopoietic stem cells to improve their engraftment and reduce immunological rejection reactions. These are the mesenchymal stem cells that are actively used in clinical trials in the treatment of multiple sclerosis, Crohn’s disease, ulcerative colitis and other diseases. These cells are able to restore the tissue of the myocardium, liver, lungs, cartilage and bone tissue. Therefore, the storage of stem cells of the placenta and the umbilical cord is the same logical and wise step as the storage of umbilical cord blood. Unlike hematopoietic stem cells, which are 100% suitable only for the child from whose umbilical cord blood they were obtained, the mesenchymal stem cells of the placenta and umbilical cord can be safely used without risk of rejection or other unwanted reactions for relatives of the child.