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Frequently Asked Questions
- What is Cord Blood?
- What is a Stem Cell?
- What is an Embryonic Stem Cell?
- Why is Cord Blood so Valuable?
- What are the other sources of stem cells?
- What are the advantages of using cord blood stem cells as opposed to stem cells collected from either the bone marrow or circulating blood?
- Why should I store my baby’s cord blood stem cells?
- Is it true that doctors would not treat the child with his or her own cord blood because it would contain the disease?
- What about the future?
- Why should I store my baby’s cord blood at Cryosite?
- When is the cord blood collected?
- Is the collection procedure risky or painful?
- How is the cord blood collected?
- I am having a caesarian, can I still have my cord blood collected?
- What happens with a Forceps or Vacuum assisted birth?
- What happens after the cord blood is collected?
- How much blood needs to be collected?
- How is the cord blood stored?
- What happens when Cryosite receives the cord blood?
- How long can cord blood be stored for?
- Can I Donate my Child's Cord Blood?
- What are the advantages of private cord blood storage versus public cord blood banks?
- Is this an insurance against disease?
- How much does it cost?
- Are there any extra charges if my baby is born on a weekend or a public holiday?
- Are there any extra charges if I live in a remote area?
1. What is Cord Blood?
Umbilical Cord Blood is the blood that remains in the placenta and umbilical cord following birth. Until recently the placenta and umbilical cord were discarded after delivery as medical waste, but now research has shown that during pregnancy, cord blood becomes a rich source of blood (haematopoetic) stem cells, which can be collected, processed and frozen for potential future use.
2. What is a Stem Cell?
Stem cells have the ability to divide and give rise to specialised cells. Blood stem cells are the building blocks of everything in the blood and are responsible for producing all of the mature cells in our blood and immune system. They form the white cells that fight infection and produce immunity, the red cells that carry oxygen and platelets that promote clotting.
3. What is an Embryonic Stem Cell?
Human development begins when a sperm fertilises an egg. This fertilised egg is described as being totipotent, which simply means that it has the potential to form an entire organism. Approximately four days after fertilisation and after several cycles of cell division, the totipotent cells begin to specialise, forming what is known as a blastocyst (see diagram below). This has an outer layer of cells and an inner cell mass. The outer cells go on to form the placenta and other supporting tissues for fetal development in the uterus while the inner cell mass go on to form virtually all of the tissues in the human body.
These inner cell mass cells undergo further specialisation into stem cells that are committed to give rise to cells that have a particular function. Examples include blood stem cells that give rise to red blood cells, white blood cells and platelets and also to committed stem cells to produce the liver, lung, brain and kidney. These more specialised stem cells are called multipotent.
Embryonic stem cells are stem cells isolated from the inner cell mass of a developing embryo. They have the potential to be stimulated to develop into the whole embryo as well as specialised cells, and so may offer the possibility of a renewable source of replacement cells and tissue to treat a wide range of diseases, conditions and disabilities. We are not collecting embryonic stem cells.
Blood stem cells are multipotent stem cells that can develop to the cells of the blood and immune system.
4. Why is Cord Blood so Valuable?
Because cord blood is rich in blood stem cells, they can easily be collected and cryopreserved in case they are needed later in life. Cord blood stem cells have the ability to treat the same diseases as bone marrow or as blood stem cells collected from the circulating blood of children or adults. Transplants have already been used for treatment of such wide-ranging diseases and conditions as cancer and leukemia, sickle cell disease, various forms of anemia and severe combined immunodeficiency. Often, donor stem cells that match the patient are difficult to obtain. However, stem cells taken from your baby are a guaranteed match for your baby for his or her lifetime.
5. What are the other sources of stem cells?
Bone marrow: Stem cells can be collected from the bone marrow. However, the collection procedure is invasive, time-consuming, requires an anaesthetic and is painful for the donor. Perhaps the biggest hurdle in bone marrow stem cell transplantation remains the finding of a perfect match. This has proven to be quite difficult and sometimes impossible.
Peripheral Blood: The use of bone marrow has primarily been replaced by collecting stem cells from the circulating (peripheral) blood (often from adult donors as part of their treatment for their underlying disease).
6. What are the advantages of using cord blood stem cells as opposed to stem cells collected from either the bone marrow or circulating blood?
Tissue type is determined by a set of genes that make proteins called human leukocyte antigens (HLAs), which are found on the surfaces of all body cells (except red blood cells). The immune system recognises cells carrying the HLA proteins it has encountered since birth as normal, or belonging to the particular individual or "self". Any other HLA proteins are regarded as "non-self", or foreign and cells carrying them are quickly killed. There are six major HLA genes. Every person has two of each, one from each parent. For bone marrow transplants, doctors aim to match the six alleles that are most clinically relevant in transplantation. But cord blood stem cells are immunologically immature and can tolerate an element of mismatch, allowing doctors to use donor cord blood samples with a degree of mismatch. Cord blood stem cells have a number of significant advantages over bone marrow including:
· high rate of engraftment
· more tolerant of tissue mismatches
· results in a lower rate of rejection (graft-vs-host disease)
Furthermore, because cord blood is from a newborn and is unexposed to most diseases, transplant complications are less frequent.
7. Why should I store my baby’s cord blood stem cells?
Blood stem cells including those from cord blood have already proven valuable in assisting with the treatment of certain types of leukemia, as well as a number of other life-threatening illnesses, including (but not limited to) Fanconi’s Anemia, Severe Combined Immune Deficiency Syndrome, thallassaemia, retinoblastoma, neuroblastoma and a range of blood related disorders. More recently blood stem cells have been used to help repair heart muscle after heart attack and injury.
Thankfully, the chances of your baby developing any of these conditions are small, but should your child ever require a transplant of stem cells to treat a specific illness, finding a compatible donor can take valuable time or at times be unsuccessful – however, the cells we store from your baby are immediately available.
The future of cord blood stem cell therapy is promising and those who store their baby’s cord blood will then be in a position to take advantage of the considerable advances being made in the area of stem cell research.
Many parents see the storage of their baby’s cord blood as a worthwhile investment for potential future treatment of diseases in children or adults. The knowledge that their child’s stem cells are stored and readily available gives enormous peace of mind and makes their decision to store their baby’s cord blood a highly satisfying one.
8. Is it true that doctors would not treat the child with his or her own cord blood because it would contain the disease?
No - thousands of autologous (ie using one’s own cells) stem cell transplants are carried out every year in both adults and children, for diseases such as leukemia, lymphoma, myeloma and many solid tumors. For some of the common forms of leukemia there is a preference today for using a sibling donor or other tissue matched donor. However, if no match is available, autologous cord blood stem cells have been used and offer many advantages as a transplant source, including no risk of graft vs. host disease (GVHD-a leading cause of death for transplant patients) and immediate availability,.
In April 2001, a ten-month-old baby in Canada received the first-ever autologous cord blood transplant to treat retinoblastoma (eye cancer) that had spread to his spinal cord. His parent's decision to save his cord blood at birth helped save his life. While chemotherapy successfully treated the cancer, it also destroyed his immune system – he required a stem cell transplant to save him. Fortunately, his very own cord blood stem cells were available and with no compatibility complications the transplant was a complete success. The stem cells quickly regenerated his immune system and he was soon allowed home with his very grateful parents.
9. What about the future?
Worldwide, the number of research projects on the use of stem cells in fighting a wide range of diseases is considerable, as leading medical and research talents at many major hospitals, institutions and universities recognise the potential that stem cells offer.
Blood stem cells have now been shown to change into liver, nerve, skin and heart cells and in just one of the many clinical trials taking place worldwide, they have been used to successfully treat severe angina. These advances are hugely important in understanding the potential that these stem cells offer and in the future these advances could be applied in the treatment of numerous diseases such as Parkinson’s disease, Alzheimers disease, spinal cord injury, heart disease, diabetes and some cancers.
10. Why should I store my baby’s cord blood at Cryosite?
When choosing a company to look after something as precious as your baby’s cord blood stem cells you need to ensure that the company complies with all the legal and regulatory requirements. General accreditation is not sufficient – the company should be licenced for each step of the process, ie maternal donor assessment, collection, processing, testing, storage and release. This means that the company has had their laboratory and their administrative procedures reviewed, inspected and validated and shown to be in compliance with the Code of Good Manufacturing Practice (Human Blood & Tissues), as regulated by the Therapeutic Goods Administration (TGA) of Australia.
Established in 1999, Cryosite is an Australian public listed company and an industry leader with an exceptional reputation. At this precious time we are committed to ensuring that your cord blood banking experience is as easy as possible, from your initial enquiry right through to the safe storage of your baby’s cord blood.
When you choose Cryosite to store your baby’s cord blood, you get the invaluable benefit of banking with the only private cord blood company in Australia to be licensed by the TGA.
We own our lab – other companies operating in Australia sub-contract out the critical tasks of processing and storage to a third party and are not responsible for these critical steps, so you may not know what will happen to your sample when the contract between the lab and the company expires. Unlike other companies, Cryosite has its own highly secure laboratory, dedicated to processing and cryopreserving cord blood stem cells. Our comprehensive service includes processing and storage onsite where we have multiple levels of backup in place to safeguard the integrity of your baby’s cord blood.
11. When is the cord blood collected? Is the collection procedure risky or painful?
Cord blood is collected from the umbilical cord immediately after the birth of the baby; either prior to the delivery of the placenta or while the placenta is still attached to the uterus. Collection can only take place at the time of delivery. There is absolutely no pain or risk to the mother or child during the collection process since the blood is collected from the cord once it is cut.
13. How is the cord blood collected?
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. The collection process is non-invasive and completely painless and does not present any risks to either mother or baby. Blood can also be drawn from the cord while the placenta is still attached to the uterus using the same procedure.
14. I am having a caesarian; can I still have my cord blood collected?
Our collection pack is theatre sterile and can therefore be brought to theatre at the time of your delivery. The method of delivery (ie vaginal vs caesarian) has no impact on the collection process. Once your baby has been delivered and the umbilical cord the baby is removed from the field of delivery, the cord blood collection can then take place as previously described.
15. What happens with a forceps or vacuum assisted birth?
The method of vaginal delivery (ie forceps or vacuum assisted) has no impact on the collection process. Once your baby has been delivered and the umbilical cord the baby is removed from the field of delivery, the cord blood collection can then take place as previously described.
16. What happens after the cord blood is collected?
Once the collection is complete, the specimen is packaged and, sent to Cryosite's laboratory for processing and long-term storage at ultra low temperatures. A maternal blood sample is also collected for infectious disease analysis. The sample is then processed to remove the red cell component and isolate the plasma component containing the umbilical cord blood stem cells. Once processing is complete, the cord blood is then frozen in dedicated bags, developed to withstand low temperatures without damage. During freezing, formation of large ice crystals inside of cells can cause irreversible damage. However, the use of a cryoprotective chemical solution such as 10% DMSO, together with the careful control of the rate of freezing, reduces such risks of damage and therefore protects the cells during freezing.
17. How much blood needs to be collected?
It is important to ensure that as much cord blood as possible is collected at the time of birth. One of the critical factors in determining the success of a transplant is the number of stem cells transplanted and this correlates to the volume of cord blood collected.
Typically 60-150ml cord blood can be collected with a minimum volume of approximately 40ml required before processing can begin. This is to ensure a sufficient quantity of stem cells in the final frozen product.
Researchers are looking at ways to expand the number of stem cells that have been collected and already there have been some significant successes and several stem cell expansion protocols are in human clinical trials. The ability to expand the number of stem cells present in a cord blood sample is now a real possibility and gives hope that one day cord blood stem cells will be expanded and used for a variety of different therapies.
If a low volume of blood is collected, we will process the blood for storage only if you have given authority in the Cord Blood Storage Agreement for us to proceed with low volume storage. Otherwise we will not go ahead with the storage, and refunds will be made as set out in the schedule of fees.
18. How is the cord blood stored?
Following the slow controlled rate freezing of the blood, the cells are transferred to liquid nitrogen for long-term storage.
19. What happens when Cryosite receives the cord blood?
When the blood sample arrives in our laboratory it is carefully measured and tested for sterility, viability and cell count. The stem cells are separated and protected with a chemical solution, which allow the cells to withstand very low temperatures. Upon completion of the cryopreservation process, the cells are stored in liquid nitrogen. To assure that your child's cord blood will be safe for future use, the following tests are done:
Cord Blood – Sterility, Cell Count, Presence of stem cell markers
Maternal Blood – Hepatitis B and C, Syphilis, HIV, HTLV and CMV
20. How long can cord blood be stored for?
Our storage agreement with you, the parents, as legal guardians, will continue for a maximum period of 18 years. We are happy to continue to store the cord blood thereafter, but will require your child to enter into a new storage agreement with us.
21. Can I donate my child's cord blood?
Yes. The Australian Federal Government has committed $9 million to establish a national cord blood bank in Sydney, Melbourne and Brisbane with additional banks being developed in other states. Patients who deliver at participating hospitals may donate their baby's cord blood to the public bank for use by any individual who needs a stem cell transplant. However, once donated, there is no assurance that the cord blood would be available if it were ever needed within your family.
22. What are the advantages of private cord blood storage versus public cord blood banks?
Private cord blood storage allows expectant parents to store their baby's cord blood stem cells for potential future use within their own family. Such storage ensures that the stem cells are immediately available to your family if they are needed for treatment, therefore eliminating the often time consuming search for a compatible donor. This is especially valuable if there is a pre-existing family history of certain health conditions (including Leukemia, and other malignant blood disorders). Ultimately, early treatment of many diseases can significantly decrease the progression of the disease and having compatible stem cells readily available for treatment when someone is already immunodeficient and at high risk for a fatal infection is invaluable.
23. Is this an insurance against disease?
No. Insurance represents a guarantee, and the storage of cord blood stem cells cannot offer a guaranteed cure for any disease. However, what storage does offer is the immediate availability of your child's stem cells should they ever be required for transplantation.
24. How much does it cost?
There are three components that make up the cost of the service
1) Registration Fee
2) Processing Fee
3) Storage Fee
These costs (set out in more detail in our registration form) include specialist shipping from anywhere in Australia, at any time of the day or night, and at any time of the year (including public holidays). There are no surcharges payable regardless of where in Australia you live or when your baby is born.
25. Are there any extra charges if my baby is born on a weekend or a public holiday?
Our costs include specialist shipping from anywhere in Australia, at any time of the day or night, and at any time of the year (including public holidays). There are no surcharges payable regardless of when your baby is born.
26. Are there any extra charges if I live in a remote part of Australia?
Our costs include specialist shipping from anywhere in Australia, at any time of the day or night, and at any time of the year (including public holidays). There are no surcharges payable regardless of where in Australia you live.
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