Delayed Cord Clamping and Cord Blood Banking

To the Conscientious Parent, You Can Have it All

Umbilical cord blood stem cells are currently being used in the treatment of more than 80 diseases. In fact, given world-wide population growth, umbilical cord blood stem cells represent the largest, easily available stem cell source.[i] Just five years ago, 20,000 transplants were performed using UCB. Today that number has grown to 35,000.[ii] It’s amazing how the conversation has shifted from ‘should I bank’ to ‘which cord blood banking company should I choose.’ Umbilical cord blood banking has gained such traction that, to a large degree, parents have moved past measuring cord blood banking pros and cons and instead, knowing they will be storing their baby’s stem cells, concern themselves with cord blood banking costs and cord blood banking reviews.

Indications for Delayed Cord Clamping

The parents who make the decision to store their baby’s cord blood and cord tissue are thinking ahead, wanting to do right from the start (even before the start), and taking steps to do whatever they can to protect their baby down the road. Today, many conscientious parents are also considering delayed cord clamping (DCC), a practice in which the umbilical cord is not clamped immediately, but rather after it continues to pulse between an average of 30 seconds to 180 seconds. Though the ideal timing for cord clamping has not been established, DCC is most effective in cases of preterm infants as well as in births in underdeveloped countries where iron-deficiency anemia is commonplace.[iii] In a recent study published in JAMA Pediatrics, 263 children were followed from birth to four years of age. Half had undergone delayed clamping and the other half had immediate cord clamping. At age four, the children who had undergone delayed CC, compared with early CC, improved scores in their fine-motor and social skills, especially in boys. The study results suggest that even children born into a low-risk, high-income population, may benefit in neurodevelopment from delayed clamping.[iv]

Some circumstances will clearly dictate when stem cell banking for future therapeutic needs (e.g. family history of malignant genetic or immunological disorders) is preferable to infusing additional red blood cells to the infant at birth. A prolonged delay, will allow the blood in the cord to clot, and the opportunity to collect the blood for stem cells will be lost. Therefore, if clamping is delayed, it should not be more than two minutes.[v] Cord tissue is collected after cutting the cord is in no way impacted by delayed cord clamping.

(Umbilical cord tissue, able to be collected at the same time as umbilical cord blood, contains another type of stem cell called mesenchymal stem cells (MSCs). Mesenchymal stem cells have many unique functions including the ability to inhibit inflammation following tissue damage, to secrete growth factors that aid in tissue repair, and to differentiate into many cell types including neural cells, bone cells, fat cells and cartilage. MSCs are increasingly being utilized in regenerative medicine for a wide range of conditions including heart and kidney disease, ALS, wound healing and autoimmune diseases.)
It’s a delicate balance. What many consciousness parents don’t realize is that you can do both. Growing evidence supports the fact that parents can both delay clamping and store stem cells from cord blood, without choosing one over the other.

Not All Cord Blood Banks are Created Equal

However, not all cord blood processing methods are the same. And how your baby’s cord blood is processed is essential to being able to do both. In order to be able to take both steps, the manner in which the cord blood is processed becomes extremely important. Because of the delay in clamping, a smaller quantity of cord blood will be collected. The quality of that cord blood needs to make up for the decrease in quantity.

A defining study published in the International Journal of Stem Cells, examines different processing methods, i.e. the means by which the stem cells are separated out from the blood.[vi] PrepaCyte CB processing is the best method to ensure that you can collect your baby’s cord blood stem cells and delay cord clamping. Most cord blood banks don’t offer PrepaCyte CB processing, but Cryo-Cell International does.

Cryo-Cell’s PrepaCyte CB Processing

According to the study, PrepaCyte CB is “the only processing type unaffected by volume.” The implications of this on delayed cord clamping are significant: when the cord blood collection is processed through the PrepaCyte CB method, even if the volume of the collection is diminished (lower than the average volume collected with immediate cord clamping), it won’t negatively impact the effectiveness of the stem cells.

Cryo-Cell’s Premium processing method, PrepaCyte CB™, is the most advanced processing technology in the field. PrepaCyte CB yields the highest number of colony-forming units (CFUs) which currently is the most common method used to determine stem cell potency and the potential for stem cell engraftment.[vii] It gives the best possible readout for potential of the cord blood to be useful in the event a transplant is needed.[viii]

Conscientiousness is about making informed, well thought out decisions. It’s about foresight. “Knowing the decisions we are making in each moment (because everything is a decision whether active or passive) helps us to guide our lives”.[ix] And it helps us make wise choices. Cryo-Cell International embraces conscientiousness, always thinking ahead how best to protect the stem cells we collect, rather than following suit.

Cryo-Cell International is the first cord blood bank to adopt PrepaCyte CB premium processing. In fact, Cryo-Cell International was the first cord blood bank to separate and store stem cells and the first private cord blood bank to be awarded FACT (the Foundation for the Accreditation for Cellular Therapy) accreditation for voluntarily adhering to the most stringent quality standards in the industry. Since inception, 100% of Cryo-Cell International’s clients’ specimens have been viable upon thaw and no other cord blood company can make that statement. For the conscientious parent, the choice of cord blood banks is clear. Parents can both delay clamping and store stem cells from cord blood without choosing one over the other. But to get the best cord blood specimen, you need to choose the best processing method, Cryo-Cell’s PrepaCyte CB.
 
 
[i] Basford, Christina; Forraz, Nicolas; Habibollah, Saba; Hanger, Kendal; McGuckin, Colin. “The Cord Blood Separation League Table: a Comparison of the Major Clinical Grade Harvesting Techniques for Cord Blood Stem Cells,” International Journal of Stem Cells Vol. 3, No. 1, 2010.
[ii] Ballen, KK, Kurtzberg, J, Verter, F. Umbilical cord blood donation: public or private? Bone Marrow Transplantation 2015; 1-8.
[iii] Cryo-Cell International, Stem Cell Insider, issue 4.
[iv] Effect of Delayed Cord Clamping on Neurodevelopment at 4 Years of Age,” JAMA Pediatrics, May 26, 2015.
[v] "Parent's Guide to Cord Blood." FAQs for the Foundation. N.p., n.d. Web. 30 June 2015.
[vi] Basford, et al.
[vii] Yoo Kh, et al., “The impact of post-thaw colony-forming units-granulocyte/ macrophage on engraftment following unrelated cord blood transplantation in pediatric recipients.” Bone Marrow Transplant 2007;39:515-52. 
[viii] Basford, Christina et al.
[ix] Christianson, Lindsay Robin. “Conscious Parenting: It’s Not Just For Hippies.” The Huffington Post.com, 28 May 2015. Web. 30 June 2015.
 
Posted: 8/14/2015 9:10:51 AM by Valeria Arcila | with 0 comments