Umbilical cord blood is blood of a newborn baby, which remains, after cutting off the umbilical cord, in the placenta and the umbilical cord. As a biological waste, the umbilical cord along with the placenta is disposed. However, it contains rare stem cells, which are currently used to treat many serious diseases such as leukemia, lymphoma, cancer, and acquired or inherited disorders of hematopoiesis, immune system and/or metabolism, etc. Based on the results of intensive research and clinical studies the possibility of their use in modern medicine and the field of regenerative medicine is increasing.

During intrauterine development, the child's body develops from the primary – non-specialized cells, which are generally called stem cells. These cells gradually specialize in (through the process of differentiation / transformation) the cells of tissues such as nerve cells, muscle cells, skin epithelial cells or the cells of organs. Stem cells are currently used in many standard and experimental therapies. The source of stem cells is bone marrow, umbilical cord blood and peripheral blood, adipose tissue, etc.

Hematopoietic stem cells are partially differentiated / transformed cells that are able to divide extensively and transform (differentiate) to blood elements (red blood cells, white cells and platelets). During intrauterine development, the blood elements are produced in the liver, spleen and bone marrow, and even in bones, in which the elements are not formed later on. The bone marrow gradually forms all types of blood cells: red blood cells (they differ from erythrocytes that are formed right after the birth and in the adulthood), lymphocytes and platelets. The gradual development of medullar hematopoiesis leads to extinction of hematopoiesis in other organs. During the prenatal period, as a part of the blood circulation is the umbilical cord, which like the placenta, is richly interlaced with many blood vessels, in which at the time of birth of the child is lodged a portion of child’s blood that is rich in these stem cells - umbilical cord blood. After birth, most of blood elements are formed only from stem cells in the bone marrow.

Hematopoietic stem cells are partially differentiated / transformed cells that are able to divide extensively and transform (differentiate) to blood elements (red blood cells, white cells and platelets). During intrauterine development, the blood elements are produced in the liver, spleen and bone marrow, and even in bones, in which the elements are not formed later on. The bone marrow gradually forms all types of blood cells: red blood cells (they differ from erythrocytes that are formed right after the birth and in the adulthood), lymphocytes and platelets. The gradual development of medullar hematopoiesis leads to extinction of hematopoiesis in other organs. During the prenatal period, as a part of the blood circulation is the umbilical cord, which like the placenta, is richly interlaced with many blood vessels, in which at the time of birth of the child is lodged a portion of child’s blood that is rich in these stem cells - umbilical cord blood. After birth, most of blood elements are formed only from stem cells in the bone marrow.

Presently, the hematopoietic stem cells from umbilical cord blood are primarily used in clinical practice. Own umbilical cord blood can be used with a standard diagnosis for the so-called autologous (own) transplantation, particularly for diseases such as tumors in childhood (neuroblastoma, medulloblastoma), Aplastic anemia, autoimmune diseases, etc. With the focus on the experimental therapy in the U.S. and Germany, there are clinical studies, which involve using autologous umbilical cord blood to treat type 1 diabetes (diabetes mellitus). From the existing results, this treatment appears to be successful. Another known use of umbilical cord blood can be found for example here:

http://parentsguidecordblood.org/content/usa/medical/autocbt.shtml?navid=32

In the blood of the child and the adult are mature white and red blood cells and platelets. Besides these blood elements there are also stem cells in umbilical cord blood. Umbilical cord blood also contains hematopoietic stem cells and other stem cells such as cells able to differentiate (transform) to insulin-producing cells, osteocytes (bone cells), glial cells (supporting cells of the brain), heart cells, muscle cells, kidney cells and others. Some scientists believe that stem cells of umbilical cord blood are able to transform into almost any cell type.

Hematopoietic stem cells of an adult and hematopoietic stem cells contained in umbilical cord blood also vary. Like other cells of the body, hematopoietic stem cells in bone marrow of an adult gradually age over the span of human life and their ability to proliferate (divide) is reduced. Cells from umbilical cord blood are in the so called "zero" age and have maximum vitality and the ability to divide. Moreover, in case of either related or unrelated transplantation the cells do not cause such a strong post-transplant reaction as the hematopoietic stem cells of an adult donor (the reaction is called graft versus host reaction - Graft versus host disease).

The main advantage of autologous umbilical cord blood is its immediate availability in case of transplantation and in case of autotransplantation, there is the absolute compatibility of blood characteristics; so there is no post-transplant graft versus host reaction. The stored umbilical cord blood can be used immediately; the patient may not be burdened with the bone marrow collection. If the patient does not have its own auto-transplant and is looking for a suitable donor, first in the family and then in the registry of bone marrow and umbilical cord blood, it is very hard to find one. Up to 50% of patients do not have a suitable donor.

The hematopoietic stem cell transplantation is a relatively simple method. Hematopoietic stem cells (bone marrow, umbilical cord blood, peripheral blood) are administered into the vein the same way as a transfusion is. Therefore, this is not a surgical procedure. Hematopoietic stem cells circulate in the bloodstream and find themselves a place in the bone marrow, where they settle. Prior to transplantation, and depending on the type of transplantation, the patient undergoes chemotherapy or a radiotherapy treatment in order to destroy diseased bone marrow, and thereby create a favorable environment for the attaching of new hematopoietic stem cells. However, this step is completed for the treatment of severe and life threatening diseases. The attending physician in collaboration with the transplant committee determines the need for transplantation and the source of stem cells.

A patient is completely cured when transplantation is successfully completed, only with some malignant and cancerous diseases does the original disease "returns" (this is so-called relapse). For patients who were transplanted with the hematopoietic stem cells of another person, some problems that were caused by the donor’s incompatibility may persist. When you are transplanted with your own hematopoietic stem cells, this problem is eliminated.

Yes. You may donate umbilical cord blood into a so-called public registry. In the Czech Republic, there is an umbilical cord blood bank (www.bpk.cz). If you want to donate umbilical cord blood, please contact the umbilical cord blood bank directly, which shall give you all the necessary information and requirements.

This is a new area of modern medicine. Currently there are no evident statistical data, which we can fully rely on, and therefore, we can just make certain estimation. The applicability of autologous (own) cord blood is determined by the number of autologous transplantations. American scientists have recently published results of the probability that someone will undergo an autologous transplantation during his or her lifetime. The probability is 1:400. These estimates are based on current experience. The probability that a person becomes ill during his/her lifetime and will suffer from a disease that is now commonly treated using a transplantation of hematopoietic stem cells is more than 15%. Because the research suggests that umbilical cord blood will have a much wider application in the future, this probability will likely become even higher.

The primary criterion for transplantation is compatibility. Siblings are compatible with the probability of 25%, which in the transplantology is a relatively high match, also called a 1:4 ratio. For a number of serious diseases the autotransplantation cannot be performed, especially in conditionally genetic or metabolic disorders of hematopoiesis, and therefore a transplant from another person must be used. Transplantations among siblings in such cases have significantly better results than transplantations from other (unrelated) donors, and therefore they are often performed.

Currently it is not possible. All hematopoietic stem cells from umbilical cord blood are fully utilized for transplantation. The more stem cells that are used, the faster the graft implant is attached and hemopoiesis restored and thus reducing the amount of time in which the patient’s life is most threatened.

No. Umbilical cord blood is collected from the placenta after the umbilical cord is cut off. Because the placenta and umbilical cord are essentially child's organs, after cutting off the umbilical cord they become a dead tissue. Thus, the collection of umbilical cord blood has nothing to do with the body of the mother or the child. However, the obstetrician must decide whether some possible birth complications and time allow him or her to collect umbilical cord blood. It is on the principal discretion of the obstetrician whether the collection is performed.

No. Umbilical cord blood is collected immediately after the birth, and after clamping and cutting off the umbilical cord, before the placenta is delivered. At this moment, your child is already in the care of a pediatrician or a midwife, who will perform the postpartum treatment and the examination of the baby. The collection of umbilical cord blood is quick and painless for both you and your child and in any way, it does not interfere in the normal course of delivery!

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Yes. If the mother decides to collect the umbilical cord blood for her child's needs, the sampling can be done even during complications in pregnancy and complicated deliveries. Umbilical cord blood can be collected even in non-standard situations, such as premature delivery, post term delivery, caesarean section, or water birth. Even the epidural anesthesia, medications, or illness of the mother such as maternal gestosis (manifested mainly by swelling and high blood pressure) or diabetes are not serious obstacles when collecting umbilical cord blood. Umbilical cord blood cannot be collected if the life of the mother or the child is threatened, if the mother is infected with HIV, acute hepatitis B and C, syphilis and listeriosis.

No. The epidural anesthesia does not have a harmful effect on the umbilical cord blood.

If your doctor has prescribed you with a treatment, it is in your best interest and in the interest of your child to honor this treatment. For the auto-transplant, there are no restrictions for the collection of umbilical cord blood. There are very strict criteria for the donation of umbilical cord blood, mothers taking medication during pregnancy are not suitable donors, and thus, we avoid wasting resources on the preparation of the transplant, which could be deteriorated as a result of the prescribed medication.

Yes. As part of our service, we allow our obstetricians to perform training sample collections, so the success rate of collection is increasing as well as the quality of the collected material. Even if the collection is done without training, it is usually successful. If the collection is not successful, you will not pay any fee for the provided material and supplies used for the collection of the sample.

Unfortunately, the umbilical cord blood can only be collected at birth. If the collection is not successful, there is no alternative way for the preparation of the transplant for the newborn child. In this case, at least we make sure that you do not pay for the provision of material and supplies used for collection.

Yes. At present, there are no general methods in practice that would provide an additional increase in the number of stem cells and therefore it is necessary to collect the maximum amount of umbilical cord blood. Research shows that these methods will be put in general practice over the cource of several years. Thus, in the future the amount of collected blood will not be as important, as it is at present.

No. CBC CZ will provide all needed material and supplies for the collection, including the necessary instructions and the training material for the obstetrician.

To maintain the quality of umbilical cord blood, it is important that the umbilical cord blood is stored between 2°-22°C, optimally between 4°-15°C. In no case can it be allowed to freeze. The transport of empty and used sampling sets is provided directly by our own tissue laboratory, in collaboration with a reputable dispatching company. Storeroom temperature of stored umbilical cord blood is monitored and recorded first by specialized workers in the hospital, and then during the transport with a microchip placed in a transport container. Transport packaging is designed to maintain the proper temperature even in extreme situations.

According to published scientific studies in the first 48 hours, there is almost no damage or mortification of the cells. We consider it pertinent, that the processing of umbilical cord blood should be done within 72 hours of collection. After more than 96 hours from the collection, the number of dead or damaged stem cells is increasing. Our standards are therefore set so that the processing is performed within 48 hours from the collection of the tissue.

Many companies, due to the reduction of the financial cost for storage, isolate (separate) hematopoietic stem cells from umbilical cord blood. For this purpose, various methods are used. The disadvantage of these methods is that the number of hematopoietic stem cells lost is very high. Moreover, it is not certain that during these procedures, other stem cells will not be fully removed, and their importance, as it has been shown, will be very significant in the future. For this purpose, we tested all existing methods and yet, despite the higher costs, we decided to process and store all umbilical cord blood cells from the entire volume of collected blood. This method is used by the first and largest umbilical cord blood registry in the world, located in New York.

During the umbilical cord blood processing, we do not use any foreign biological material, neither human nor animal in origin. Often the human albumin is used for the processing. Just as it was in 1980´s, that many patients got infected with HIV from blood products (such as patients with hemophilia), such material prepared from the plasma of thousands donors could infect hundreds of blood transplants today with an unknown virus, respectively with unknown mutations of existing viruses. In our laboratories, we use the latest instrumantation and devices and our laboratory facilities hold the highest existing level of cleanliness. Although, the transplant can be processed by one person, it is our experience that every transplant is handled by two people, one of which has a mainly supervisory role. All laboratory workers are subject to a rigorous selection an before they begin to process the blood, they undergo rigorous training and long-term output tests. They are involved in the lifelong continuous educational training of health professionals.

The transplant is frozen and stored at - 196°C in liquid nitrogen vapors. Under normal temperature conditions biochemical reactions persistently take place in cells, different molecules mutually interact – some die and new arise. These processes are collectively called cell metabolism. The faster the metabolism is, the faster the cells age. Chemical reactions can take place in the cell due to the movement of individual molecules in a cell fluid; they crash into each other and mutually interact. The fluid is water. When the water in the cell under certain conditions freezes, the metabolism is virtually stopped. However, the cell remains aging. The molecules are still moving relatively quickly, while their kinetic energy is still relatively high and may lead to the breakdown of complex molecules. The temperature is a measure of the kinetic energy of molecules. This means that the lower temperature is, the slower the molecules move. Absolute zero is the temperature, at which the molecules do not have any momentum, therefore, they do not move and its temperature is approximately -273.15°C. This means that the molecules at a lower temperature in the cells break down more slowly and at a temperature of nearly -200 degrees Celsius, there is almost zero probability of breakdown. The life in a cell has virtually stopped and throughout the storage time the cell is not changing at all. Therefore, even after defrosting of cells they are actually as old as they were when they were frozen, even though it was many years ago.

Based on the recent findings it is suggested that the umbilical cord blood could be frozen in liquid nitrogen vapors for a long time for several decades, at least. The relevant institutions abroad monitor the storage of biological materials (FDA, EMEA, WHO, SIDC, or the umbilical cord blood registry itself) and, there are no restrictions on the applicability period of stored umbilical cord blood. In contrast, the State Office for Drug Control of the Czech Republic (SIDC) insists on the introduction of the applicability time of transplant from umbilical cord blood. This could not be established empirically (from experience), because there are no long-term data available. Therefore, we submitted many scientific papers and studies (citations) and the theoretical calculation of the expiration date (durability, serviceability) of the transplant to the SIDC. A mathematical model calculated this period for 69 years. Despite the presentation of this mathematical model calculation and our and the worldwide experience from general practice, we were advised by the SIDC that the transplants should indicate only a limited expiration period, and this was a period of 15 years. This time was conditioned by the SIDC from the available general experience and it is possible to extend this period after the given expiration date, in connection with a submission of new prospective studies. In any case, this does not mean that after a period of 15 years your transplants will be deprecated or designated as unsuitable! They can easily be effectively used for transplantation at the clinical facility after this period.

In case you need a prepared transplant from umbilical cord blood, please contact us as soon as possible. All written communication for the issue of the graft for the transplantation from any transplant center in the Czech Republic, is conducted directly by us with the relevant transplant center, and tissue bank, according to the approved protocols. Nevertheless, we will need your written statement for the issuance of the transplant from the long-term storage. Based on the decision of the State Institute for Drug Control, which issued a permit for tissue distribution, we provide specialized transportation of the prepared transplant directly from our tissue transplant facility in the transplant center. We can fully assure 100% quality of the transplant until the time of handing it directly to transplantation team. This specialized transportation in the Czech Republic is provided to you free orcharge.

No. The transplants are stored in biological containers containing a supply of liquid nitrogen. The fumes of liquid nitrogen maintain temperature near -196°C in the container. This system is fully independent from any electrical power or other forms of energy. The amount of liquid nitrogen and the temperature in the container is controlled by the monitoring system on a daily basis and by our trained staff. The monitoring system is automatically indicating the fill up of liquid nitrogen from a storage tank, which is regularly refilled by a contracted supplier of liquid nitrogen.

The transplant of umbilical cord blood has no other use, except for the scientific research, other than the transplantation itself. If anyone ordered the theft of the umbilical cord blood, he or she would have to steal a minimum of 100 000 transplants in order to have a real chance that at least one transplant would fit the customer. The exceptions to this are the siblings of the child, the child's parents and the child’s children. For these people there is a real chance that the transplant will be sufficiently compatible. Yet we do not suppose that anyone would want to steal the transplant. The storage rooms are equipped with a security and surveillance system that are connected to telecommunication equipment, protecting the facilities against intrusions by unauthorized persons and provides information about a possible disruption. We have also prepared inter alia the insurance against theft or destruction of transplants for each processed umbilical cord blood.