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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?
- Current research into cord blood stem cells
- What does “autologous” mean?
- 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.
Umbilical cord blood contains blood stem cells1, called Haematopoietic stem cells. Haematopoietic stem cells reside in the bone marrow and mature into blood cells that carry oxygen to our tissues (red blood cells) and make up our immune system (white blood cells). Chemotherapy and other cancer treatments can destroy these blood stem cells. When these stem cells are destroyed they need to be replaced. Putting stem cells back into the bone marrow is called “Haematopoietic Reconstitution”.
“Cord blood transplantation is widely accepted for use in the paediatric transplant community.” “Umbilical cord blood has been used successfully in related transplants for both malignant and non-malignant diseases.” Ballen 20052
“Human umbilical cord blood, with its real abundance, simple collection procedure and no serious ethical dilemmas, represents a valuable alternative to the use of other stem cell sources.” Ruhil et al. 20083
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.
1. Geissler K, Geissler W, Hinterberger W, Lechner K, Wurnig P. (1986) Circulating committed and pluripotent haematoopoietic progenitor cells in infants. Acta Heamatologica 75(1):18-22
2. Ballen KK (2005) New trends in umbilical cord blood transplantation. Blood 105:3786-3792
3. Ruhil S, Kumar V and Rathee P. (2009) Umbilical Cord Stem Cells: an overview. Current Pharmaceutical Biotechnology 10(3):327-34
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 bank my baby’s cord blood stem cells?
“Cord blood transplantation is widely accepted for use in the paediatric transplant community.” “Umbilical cord blood has been used successfully in related transplants for both malignant and non-malignant diseases.” Ballen 20052
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.
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.
2. Ballen KK (2005) New trends in umbilical cord blood transplantation. Blood 105:3786-3792
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 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.
9. Current research into cord blood stem cells
*Customers should be aware that by law in Australia your child’s cord blood is only available for autologous use for haematopoietic reconstitution.
Umbilical cord blood is the subject of a significant amount of scientific research in Australia and internationally. Here is what stem cell scientists are currently reporting in peer reviewed journals (references are listed below):
Dr Harris and Dr Rodger report that “The identification and isolation of the populations of pluripotent stem cells within cord blood represents a scientific breakthrough that could potentially impact every field of medicine, via their use in regenerative medicine. Thus, CB stem cells are amenable to treatment of a wide variety of diseases including cardiovascular, hepatic, ophthalmic, orthopaedic, neurological and endocrine diseases.” 4
Dr Hutson and colleagues “support previous reports that cells capable of differentiating into bone-forming osteoblasts exist in full-term umbilical cord blood”. 5
Dr Shmidt and colleagues reported “the successful in vitro engineering and maturation of biologically active heart valve leaflets using umbilical cords as the only prenatal cell source.” 6
Dr Korbling and colleagues report that “preliminary data suggest umbilical cord blood derived tissue specific cells generated in the liver, pancreas, CNS and endothelium.” 7
Dr Denner and colleagues “showed that several primitive lineages of cord blood-derived stem cells could be engineered to produce insulin.” 8
Dr Li and colleagues’ “observations suggest potential [of cord blood stem cells] as an alternative to hepatocyte transplantation for cellular therapy of liver failure.” 9
Dr Yu and colleagues said “A growing number of studies highlight the potential of systemic delivery of HUCB cells as a novel therapeutic approach for stroke“. 10
Dr Cho and colleagues “suggest that umbilical cord blood neurally induced progenitor cells might be a therapeutic resource to repair damaged spinal cords.” 11
Dr Koike and colleagues have reported that “that Cord blood cells can differentiate into Retinal Nerve Cells”. 12
4. David Harris and Ian Rogers. (2008) Umbilical Cord Blood: a unique source of pluripotent stem cells for regenerative medicine. Current Stem Cell Research and Therapy 2(4):301-9
5. Hutson EL, Boyer S, Genever PG. (2005) Rapid isolation, expansion and differentiation of osteoprogenitors from full-term cord blood. Tissue Engineering 11(9-10):1407-20
6. Schmidt D, Mol A, Odermatt B, Neunschwander S, Breymann C, Gossi M, Genoni M, Zund G and Hoerstrup S. (2006). Engineering of biologically active living heart valve leaflets using human umbilical cord derived progenitor cells. Tissue Engineering 12(11):3223-3232
7. Korbling M, Robinson S, Estrov Z, Champlin R and Shpall E. (2005) Umbilical cord blood derived cells for tissue repair. Cytotherapy 7(3):258-261
8. Denner L, Bodenburg Y, Zhao J, Howe M, Cappo J, Tilton R, Copland J, Forraz N McGuckin C and Urban R. (2007) Direct engineering of umbilical cord blood stem cells to produce C-peptide and insulin. Cell Proliferation 40(3):367-80.
9. Li S, Sun Z, Lu G, Guo X, Zhang Y, Yu W, Wang W, Ma X. (2009). Microencapsulated UCB cells repair hepatic injury by intraperitoneal transplantation. Cytotherapy 11(4):1-9.
10. Yu G, Borlongan C, Stahl C, Hess D, Ou Y, Kaneko Y, Yu S, Yang T, Fang L and Xie X. (2009). Sytemic deliver of umbilical cord blood cells for stroke therapy: a review. Restorative and Neurology and Neuroscience 27(1):41-54.
11. Cho S, Yang M, Yim S, Park J, Eom Y, Jang I, Kim H, Park J, Kim H, Lee B, Park C, Kim Y. (2008) Neurally Induced umbilical cord blood cells modestly repair injured spinal cords. Neuroreports 19(13):258-61
12. Koike N, Adachi Y, Minamino K, Iwasaki M, Nakano K, Koike Y, Yamada H, Mukaide H, Shigematsu A, Mizokami T, Matsumura M, Ikehara S. (2007). Human cord blood cells can differentiate into retinal nerve cells. Acta Neurology Exp 67(4):359-65.
10. What does “autologous” mean?
A transfusion or transplant of tissues or cells which originate from the patient’s own body.
11. Why should I bank my baby’s cord blood at Cryosite?
Proven expertise – when you are making such an important decision as saving your baby’s cord blood, it is vital that you know about the company that you are dealing with. Cryosite is a publicly-listed Australian company, established in 2000 to provide specialist ultra-low temperature and cryogenic storage services to a wide range of clients including the research, medical, pharmaceutical and biotechnology industries. The cord blood service was established in 2001 and its cord blood laboratories and cryogenic storage facilities are fully licensed by the Therapeutic Goods Administration (TGA) of Australia.
We own our lab – other companies operating in Australia sub-contract out the critical tasks of processing and storage to third parties, 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 laboratories, dedicated to processing, cryopreserving and storing 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.
Cryosite is the only private cord blood service in Australia to own and operate fully licensed cord blood bank laboratories.
Cryosite is the industry leader with an exceptional reputation and 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.
12. 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. Such storage ensures that the stem cells are immediately available 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 is invaluable when someone is already immunodeficient and at high risk of a fatal infection.
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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