until it was discovered that umbilical cord blood (SCU) was rich in stem cells, the cord used to be discarded along with the placenta.
Now, its incredible benefits to treat certain types of childhood cancer and its possible applications to cure other diseases in adulthood, have made the cryopreservation of the SCU, a very valuable possibility. We tell you what the law says about this practice, what needs to be done to save the SCU and what applications stem cells can have.
What are Stem cells?
These are cells that have two properties: they are able to renew themselves (produce more stem cells) and originate daughter cells (cell lines that will eventually become specialized cells).
This is explained in Xataka. They add that today we talk about curing with these 'magic' cells "genetic diseases, regenerate tissues damaged by blows or over time, create organs ready for transplantation or cure without even having to treat the disease in question."
In Babies and more A nine-year-old girl overcomes cancer thanks to stem cells taken from her umbilical cord bloodThe National Transplant Organization adds that years ago it was discovered that umbilical cord blood contains those cells, called 'blood stem cells', specialized in the renewal of all blood cells (red blood cells, white blood cells and platelets).
And that's it "In the 90s, stem cell transplants from umbilical cord blood (SCU) began to be performed on patients whose bone marrow was ill, verifying that clear therapeutic successes were obtained." Its main utility is transplants in patients with certain congenital or acquired diseases of the bone marrow, such as acute or chronic leukemia.
The Josep Carreras Foundation adds that "Umbilical cord blood contains enough stem cells to perform hematopoietic transplants in children, adolescents and low-weight adults."
Among its advantages, on bone marrow stem cells: they can be used successfully even if donor and recipient are not fully compatible, they are easily located and available almost immediately since they are stored frozen in umbilical cord blood banks.
What to do to conserve umbilical cord blood?
Normally the cord was discarded after the birth of the baby, but since the possibility of its use for transplantation was opened, the units began to be stored and thus the public SCU banks were created worldwide.
According to the ONT, in Spain there are seven public banks and after the approval of the old RD 1301/2006 (currently replaced by the RD Law 9/2014), 'which establishes the quality and safety standards for donation, obtaining, evaluation, processing, preservation, the storage and distribution of human cells and tissues', there are also private SCU Banks, where the blood of umbilical cords is preserved for possible autologous (own) use.
The SCU is collected after delivery and once the umbilical cord is cut, and does not pose any risk either to the newborn or to his mother. Once the baby is born, and after separating it from the mother's body, the umbilical cord is clamped and before the expulsion of the placenta the umbilical vein is punctured and the blood is stored in a sterile bag that will be labeled with the data of Mother.
The mother will also have two venous blood tubes drawn to perform tests that exclude the possibility that she is affected by infectious diseases transmitted by transfusion (hepatitis B and C, HIV, syphilis, etc.).
Cord blood units are transported immediately to the Cordon Blood Bank, where they undergo rigorous controls to discard samples that do not meet the strict quality standards that are needed for transplants to be carried out successfully.
Blood that passes these controls is analyzed and frozen for use in transplants. The one that does not comply with the regulations is destroyed or used for scientific purposes.
When preserving cord blood, speed is essential, since there is only a margin of 48 hours to extract it and complete the cryopreservation process in liquid nitrogen, maintaining maximum levels of quantity and quality.
Once extracted, the blood must be transferred without sudden temperature changes, or excessive heat or cold. They are then cryopreserved at 196 below zero.
Who can donate?
Any healthy pregnant woman over 18 can be a cord blood donor, with a normal pregnancy (not pathological) and a delivery that goes without complications.
To preserve the SCU, the weight of the neonate should be greater than 2,500 g, not show symptoms of infection, Apgar Test greater than 8 and with good evolution at 10 minutes.
In Babies and more, Nico is only six months old and urgently needs a bone marrow transplant to fight leukemiaHow to become a public bank donor?
When a pregnant woman wishes to be a donor of umbilical cord blood, she should go to one of the Cordon Blood Banks in Spain or to one of the maternity hospitals attached to the collection program of a public bank, where the gynecologist will report on how the process works .
And, as the Josep Carreras Foundation explains, not all maternity hospitals are prepared for the collection of umbilical cord blood units, since it is a process that requires specialized personnel and the necessary technical means.
The mother will sign an informed consent, which will be accompanied by:
A detailed medical history with possible infectious, haematological or other diseases that contraindicate the use of cord blood.
The realization to the mother at the time of delivery of a blood test to rule out any infectious process that could be transmissible to cord blood, especially the hepatitis B and C, HIV and syphilis tests, among others.
A clinical examination of your baby at birth and optionally after three months performed by a pediatrician.
This is explained by the National Donor Organization, and adds that any pathological outcome that results in studies conducted on the occasion of donation of cord blood, will be communicated to the mother by the responsible doctor.
"The umbilical cord blood will be cryopreserved and eventually used to perform a transplant to any anonymous patient in the world who needs it, without financial compensation for the family."
And it is that the altruistic and public donation of SCU implies that all the cords stored in these banks are available for use in the transplantation of any compatible patient who needs it.
In addition, research is currently being carried out (always with the consent of the donor mother) with those SCU cells that are not useful for transplantation and in the future these investigations could have repercussions in the treatment of non-hematological diseases.
In Babies and more What you need to know before deciding to keep cord stem cellsIn Spain, the Spanish Registry of Bone Marrow Donors of the Carreras Foundation (REDMO) searches for both bone marrow donors and cord blood units, in coordination with the National Transplant Organization and SCU banks.
Altruistic donation or private bank
Data from the Josep Carreras Foundation against leukemia, indicate that Spain is the fifth country in the world in number of cryopreserved cord blood units: more than 45,000, thanks to more than 140 authorized maternity hospitals.
The collection process, and subsequent analyzes that must be carried out, as well as the freezing process and its maintenance, are fully funded by the National Health System. The only condition that public health puts is that The cord unit should be available to any patient who may need it.
But you can also choose to keep the SCU in private banks for family use (also called banks for autologous use). It differs from the public, in that cord blood is saved for the case in which the donor himself may need it later.
According to Dr. Josep Carreras, the most useful of these banks are families with children who suffer from diseases that may require a transplant of their own cells.
The Royal Decree of 2006 established that these banks could be in Spain as long as they ensured the same quality controls as the public and made the cryopreserved units available to REDMO.Currently, any private cord bank based in Spain must transfer the information about the umbilical cords that it has stored and, in the event that a Spanish or foreign patient needs a unit, they must transfer it completely free of charge.
Hence, when families decide to save umbilical cord blood for private use, they usually turn to foreign companies that are not legislated by these regulations.
Its price is usually around 1,800 euros. If this is the option, you just have to contact one of them and they will be in charge of your transfer and conservation, in coordination with the maternity. Some private health insurances also offer this option.
Delayed umbilical cord cut
Parents can also choose not to preserve umbilical cord blood. In this case, to maximize its benefits, it is advisable to follow the instructions of the WHO and let that blood rich in stem cells pass to the baby, between one and three minutes before cutting.
Late cord clamping is not only basic for premature babies, but it is also very beneficial for all newborns. While the cord continues to beat, it allows more blood to reach the baby, which means more iron, more hemoglobin, a greater antioxidant effect and a decrease in inflammation in cases of induced births.
In Babies and more The benefits of waiting a few minutes to cut the umbilical cord are seen even years laterOther studies also point to significant long-term advantages: children whose cords were cut three minutes after birth have a better neurological development.
But you can even get the newborn to benefit from late cutting of the cord if the stem cells are to be donated or preserved.
When cutting the umbilical cord in a maximum time of one minute after delivery, there is still the option to collect the blood that remains inside it.In doing so, the baby can get the right amount of blood and can keep the blood stem cells in the cord in a public or public bank.
If you have questions or need more information about the SCU, you can consult the Umbilical Cord Blood Donation Guide.
Photos | iStock and Philms on Flickr
