Cord blood is blood that remains in the umbilical cord following the birth of a baby and after the umbilical cord is cut. During pregnancy, the umbilical cord functions as a lifeline between mother and child. After a baby' delivery, the cord blood present in the umbilical cord could offer hope for the child and maybe members of the family.

Cord blood is a rich source of Haematopoietic Stem Cells (HSCs), which are primarily responsible for replenishing blood and regenerating the immune system. They have the unique ability to differentiate into various cell types found in blood as depicted in the diagram below:

• Red blood cells - which transport oxygen
• White blood cells - which produce antibodies and fight bacteria
• Platelets - which assist blood clotting

• A guaranteed match for autologous transplants (where the donor and recipient are the same individual)
• A readily available supply of stored haematopoietic stem cells. This compares well to having to do a national or international search which is costly and time-consuming in an already time critical situation.
• Lower risk of Graft vs. Host Disease (GvHD) for autologous transplants, a situation where the transplanted tissue attacks the patient' own tissue.
• Ease of collection, which is pain-free and risk-free to both mother and child.
• Umbilical cord blood stem cells are younger, have a higher rate of engraftment and are more tolerant to tissue mismatches, compared to other types of stem cells, e.g. bone marrow.

• Replace and regenerate damaged or diseased bone marrow
• Treatment for blood cancers
• Correct genetic defects (sibling/allogeneic transplantation)
• Potential for cellular therapy and regenerative medicine

• Stem cell rescue reconstitutes a patient' blood and immune system
• This is carried out after chemotherapy and radiotherapy which destroy blood cells
• Stem cells are infused intravenously into the patient' blood stream
• Once in the blood stream, they migrate to the bone marrow
• They then differentiate into three blood cell types - red, white and platelets
• The differentiation initiates the regeneration of the patient' blood and immune system

The list of diseases treated by stem cells can be found here.

Immediately after the delivery of your baby, the cord is clamped and your baby separated from the cord and moved from the birthing area. The doctor then collects the umbilical cord blood by inserting a needle into the cord vein, and draining the blood into a blood bag.

This procedure is painless and risk-free to both you and your baby. It takes about 3 minutes and does not alter the birthing process in any way. It can be done with either a vaginal or caesarean delivery.

Please note that the final decision of whether the cord blood collection should take place will always reside with your caregiver whose first priority is the safety of you and your baby.

Stem cell isolation is a critical step in cord blood banking. It affects the number of stem cells that can be harvested or recovered from the cord blood. Cell recovery rates are critical because a higher number of stem cells could enhance the success of the transplant or treatment. That's why Cordlife has invested in the advanced AXP® II System to process cord blood. AXP-processed cord blood units have nearly the same total nucleated cells (TNCs) and contain more mononuclear cells (MNCs) than conventionally processed units.¹

This U.S. FDA-cleared device is capable of recovering more than 97% of viable CD34+ stem cells, higher than other available processing systems.² A higher recovery of CD34+ stem cells from your baby's cord blood is important, as they are correlated with a higher chance of a successful transplant.^3,4

References

1. Harris DT. Collection, processing, and banking of umbilical cord blood stem cells for clinical use in transplantation and regenerative medicine. Laboratory Medicine. 2008;39(3):173-178. doi: 10.1309/64QG394K1M639L8A.
2. Rubinstein P. Cord blood banking for clinical transplantation. Bone Marrow Transplantation. 2009;44(10):635-642. doi:10.1038/bmt.2009.281.
3. Yoo KH, Lee SH, Kim HJ, et al. The impact of post-thaw colony-forming units-granulocyte/macrophage on engraftment following unrelated cord blood transplantation in pediatric recipients. Bone Marrow Transplantation. 2007;39(9):515-521. doi:10.1038/sj.bmt.1705629.
4. Purtill D, Smith K, Devlin S, et al. Dominant unit CD34+ cell dose predicts engraftment after double-unit cord blood transplantation and is influenced by bank practice. Blood. 2014;124(19):2905-2912. doi:10.1182/blood-2014-03-566216.

Cordlife uses the U.S. FDA approved cryogenic storage pouch. This multi-compartmentalised cryobag has 20% and 80% compartments. This cryobag also has 2 integrally attached segments which are in compliance with AABB and FACT-Netcord standards. This dual compartment addresses the stem cell expansion programmes in future. That means that when this stem cell expansion technology is commercially viable, you can withdraw 80% of the stem cells for immediate use /treatment while continuing to store the 20% balance for later expansion.

The integral segments also provide the safety and assurance that additional product testing is performed on the associated unit thereby eliminating testing and cord blood unit mix ups. This is to allow for additional testing of the sample should it be required in the future, or for viability testing prior to a transplant. This storage pouch is made of a special material designed specifically to withstand cryogenic temperatures.

Your baby' cord blood is stored in vacuum insulated cryogenic storage tanks, and are designed to remain at optimal cryogenic temperature of below -150° for cell storage over long periods. Cordlife uses MVE Anti-contamination Vapour-phase Liquid Nitrogen Storage System for long-term stem cell cryopreservation.

Vapour-phase storage is preferred over liquid-phase storage¹ as it eliminates the chance of cross contamination between cord blood units as compared with those stored in liquid nitrogen.

The MVE Anti-contamination Vapour-phase Liquid Nitrogen Storage System operates perfectly, even without electrical supply, and is 100% reliable and failsafe with no chance of robotic malfunction. Unlike other storage systems available in the market today, our tanks have never been recalled by the U.S. FDA or the manufacturer.

Over 99% of private cord blood banks also use only vapour-phase freezers. Presently, the majority of stem cell transplantations used cord blood units stored in vapour freezers.

Reference

1. Best practices for Repositories I: Collection, Storage, and Retrieval of Human Biological Materials for Research

Theoretically, the shelf-life of cells stored at liquid nitrogen temperatures has been estimated to be of 1,000 years¹.

In recent studies, it is found that there is efficient recovery from cord blood stem cells cryopreserved up to 21-23.5years².

Reference:

1. Jens O.M. Karlsson, Mehmet Toner, Long-term storage of tissues by cryopreservation: critical issues. Biomaterials 17 (1996) 243-256.
2. Hal E. Broxmeyer, Man-Ryul Lee, Giao Hangoc, et. al., Hematopoietic stem/progenitor cells, generation of induced pluripotent stem cells, and isolation of endothelial progenitors from 21- to 23.5- year cryopreserved cord blood. Blood 2011 117:4773-4777. Doi:10.1182/blood-2011-01-330514

You may still continue to store your baby's cord blood (with additional consent given to Cordlife), or elect to discard the umbilical cord blood unit.

This is because Cordlife conducts two different tests for Hepatitis B virus (HBV) on maternal blood, namely:

• Hepatitis B Surface Antigen (HBsAg)
• Hepatitis B Core Antibody (Anti-HBc (Total))

Usually, the attending transplant physician will make the decision whether to use a cord blood unit where the maternal blood was tested positive for Hepatitis B for transplant, based on various factors particular to the patient, the cord blood unit intended for use, and the availability of other HLA-matched donor.

Cordlife Singapore' processing and storage facility is AABB-accredited and MOH-licensed. This ensures that Cordlife adheres to the highest standards for private cord blood banking.

Please call us at +84 28 7300 3919 or email info.vietnam@cordlife.com for more information.

Contact us at +84 28 7300 3919 so that we can direct you to our Singapore team.

*If you are due within the next 4 - 6 weeks, we strongly recommend you to contact us immediately for enrolment because this will ensure all necessary steps are completed before your baby's arrival.