Written by Dr. Alagammai Ramanathan
Obstetrician and Gynecologist, Gleneagles Kota Kinabalu Hospital
What is cord blood?
This is the blood that remains in the umbilical cord and placenta once the baby is born when the cord is clamped. This is discarded as medical waste after the birth of the baby. Banking your baby’s umbilical cord blood means having it saved and stored for (potential) future use.
Why can’t we give all the blood to the baby instead of discarding it as medical waste?
It is given to the baby when it is deemed necessary, example in premature baby, anaemic and so on (delayed cord clamping) it is not advisable in all term babies as it does have its advantages and disadvantages which needs to be discussed on case to case basis.
Can I choose to do delayed cord clamping and cord blood banking?
Yes. Delayed cord clamping allows blood from the umbilical cord to return into your baby’s system, reducing the risk for iron deficiency. The World Health Organization suggests that delayed cord clamping for 1-3 minutes. Medical staff only need about 25% of umbilical cord blood for storage, and at 3 minutes, only half of the blood in your child’s cord has filtered back into their body. This means doctors can delay cord clamping for several minutes and your child should still have more than enough stem cells left over for banking.
What is cord blood storage and the cord storage? Is it the same?
Umbilical cord is made of 2 arteries, 1 vein and surrounded by the Wharton’s jelly. The blood (cord blood) is from the vessels, it is rich in Hematopoietic stem cell(HSC) and the Wharton’s jelly (from the cord lining) is rich in mesenchymal stem cells.
HSC has the potential to differentiate mainly into blood components as red blood cells, white blood cells, platelets which means it is used in diseases such as Thalassemia and leukaemia. These diseases are sometimes treated with high doses of chemotherapy, which destroy the immune system.
Cord blood transplantation or bone marrow transplantation is then used to rebuild the immune system. Cord blood is increasingly being used as an alternative to bone marrow transplantation. MSC has a potential to differentiate wide range of cells and tissues such as bones, nerves, liver and etc.it has a potential to treat heart disease, Parkinson’s and etc.
How much of blood will be collected?
About 80 to 100ml of blood will be collected.
If I opt to store it, is it a guarantee that it will be stored?
No, it depends at birth, if there is a medical emergency, the baby and mum will be given the priority. If the baby looks anaemic (lack of blood) this will be given to the baby as much as possible.
How is cord blood collected?
Collecting a baby’s cord blood is quick and painless. Immediately after the birth of the baby, the umbilical cord is cut and the baby separated from the placenta and mother. The placenta is delivered a few minutes later.
The portion of the umbilical cord still attached to the placenta is clamped and cleaned. A sterile needle is inserted into the umbilical vein and the placental blood is drawn into a sterile blood collection bag containing anticoagulant, which prevents the blood from clotting.
What are the options for storing cord blood?
In Malaysia there are two options for storing cord blood. You may donate to the public cord blood bank (kl) or pay for the services of a private cord blood bank.
In Sabah two options of private banking CryoCord and StemLife. Both collects the blood here and stores it in West Malaysia. You have the options to store stem cells either in bags or vials then store in a vapour phase liquid nitrogen tank at -190°C in West Malaysia.
Is it available in the government?
Yes, it is available in the government set up but it is decided by the doctor in charge....if the need be, the patient is to be sent to Kuala Lumpur and delivery has to be there at a government set up, blood will be stored at the public blood bank. This is only done on special occasions and with the doctor’s approval.
On rare occasions, a hospital will collect and store a baby’s cord blood for a family member who has a medical condition that can be treated with cord blood transplantation.
Can I do cord collection in government and store it at the private cord banking?
Yes, but is also on case to case basis, which needs the attending doctor’s prior approval and counselling.
How long can I store cord blood cells?
Researchers believe cord blood cells will remain useable indefinitely. The longest-stored unit of
cord blood is several decades old, and the cells are in perfect condition.
If I have multiple children, should I save cord blood for each?
Yes. Your children can use each other’s stem cells for treatment, and having access to more cells means you have a greater amount of treatment options in the future.
If my family has a good medical history, should I still store cord blood?
It depends on the family. With new treatments emerging every year, your family has a chance of using cord blood cells during their lifetime. Even with a perfect medical history, choosing to bank your child’s cord blood is still a safe decision. Certain illnesses, like leukaemia, are not hereditary and can happen at any time.
How does cord tissue banking work?
After cord blood is taken from your baby’s umbilical cord, up to 8 inches of cord are cut and stored in a medical container. This piece of tissue travels – along with the cord blood – to a storage facility, where the cells are removed and put into cryogenic storage.
Which treatments use cord tissue?
Cord tissue specifically works in the spinal cord, brain and cartilage. Clinical trials are currently underway for treatments using cord tissue, and new therapies may only be a few years away. However, most research for cord tissue is still untested.
FACTS TO CONSIDER
a) Many experts insist that it is very unlikely that anyone in your family will ever need your baby’s cord blood. Dr Sarah Buckey, Australian GP estimates the likelihood of low-risk children needing their own stored stem cells is 1 in 20,000. So it is like an insurance... you can get it and hopefully not use it for our own. The exception is those families who already have a child with an illness that could be treated with cord blood from a newborn sibling.
b) Cost of treatments: Approximately RM70,000 for the blood diseases which can be done in Malaysia’s semi government hospitals.
c) However, apart from blood disorders, the use of cord blood for other diseases is not a routine clinical modality and remains a major challenge for the stem cell community. Storing your baby’s cord blood is a personal decision that only you can make.
For more information about Cord Blood Banking or related to pregnancy and birth, you may contact Dr.Alagammai at Gleneagles Kota Kinabalu Hospital. Call 088-518 888 or visit them at Sembulan@Riverson.
Learn more about the endless benefits of your baby's stem cell and cord blood by contacting our Cord Blood Bank partner at StemLife Berhad. Call 03-2166 3636 (Kuala Lumpur) or 016-832 9392 (Lisa, StemLife Consultant based in Kota Kinabalu)
For more information on StemLife, visit www.stemlife.com