The placenta is a fascinating organ responsible for the nourishment and development of a growing baby within utero. There are several components of the placenta that come from the maternal (mother) and other components that originate from the fetal (baby) side. Since the placenta is comprised of stem cells from varying origins, some view the placenta as valuable to mother and baby after birth.
Some private cord blood banks offer parents the option to store placenta tissue for future use. However, the question remains - is it worth it? To answer this question, we have compiled research on placental stem cells and tissue storage, the ways in which it is used, and why we choose not to add it to our services at this time.
The Placenta, A Hodgepodge of Stem Cells
As mentioned, the placenta is made up of portions that represent stem cells of both maternal and fetal origin. The fetal side includes the umbilical cord, amnion, and chorion. The maternal side is known as the decidua basalis. The maternal side functions to provide oxygen and nutrients to the baby and eliminate waste products from the baby's blood which is delivered through the blood vessels in the umbilical cord. The placenta is comprised of many stem cells that are also found within cord tissue. However, umbilical cord tissue-derived stem cells are purely fetal stem cells, whereas the placenta contains a combination of fetal and maternal cells.
The most popular type of stem cell used in clinical applications, especially in regenerative therapy exploration, are mesenchymal stem cells (MSCs). While MSCs can be found in other tissue sources besides placental, (i.e., adipose-derived, bone marrow-derived, and umbilical cord-derived), studies confirm the preferential use of umbilical cord-tissue derived MSCs. One study’s results revealed that both fetal and maternal MSCs share a similar phenotype and differentiation potential. Still, fetal MSCs (such as those in cord tissue) show a significantly higher expansion capacity, lower immunogenicity, and higher immunosuppressive capability than their maternal MSCs counterpart. Likewise, results from another study demonstrated that umbilical cord tissue stem cells had been shown to yield the highest number of MSCs.
Placental Stem Cells Studies Are Less Widespread
A recent review of clinicaltrials.gov indicates that there are tenfold more trials involving cord tissue cells compared to placental tissue cells, highlighting the prominence of the former in current research and medical studies.
Stem cells found within cord tissue have been utilized in various clinical studies to test the safety and efficacy in the treatment of other degenerative diseases such as Alzheimer’s, multiple sclerosis, osteoarthritis, cartilage injury, spinal cord injury, stroke, and many other conditions. One publication notes that while there are a limited number of studies researching fragments of placental tissue, most of these studies lump these cell sources together, making it hard to isolate placental cells specifically. Furthermore, the article notes that, “references on the application of placental fragments are rarely found in the international scientific literature databases.” The challenges that arise with other placental cell sources are also noted, i.e., these cells can be more difficult to acquire under sterile conditions, unlike cord tissue stem cells.
The number of clinical trials using placental MSCs is smaller in comparison to cord blood and cord tissue cells, which continue to be regarded with a high level of interest among stem cell researchers. Since the interest in research with placenta extracts is still relatively low, there is not enough widespread clinical data to suggest its usefulness in the possible treatment of certain conditions in which cord tissue stem cells have been used. The short and long-term effects of placental stem cell therapies will need to be further explored with additional studies.
What About Placental Tissue?
The amnion and chorion tissue found in the placenta have demonstrated their efficacy in ocular repair and wound healing. This tissue contains a limited amount of human growth factor, minimizing the risk of an immune response upon grafting. Moreover, the amniotic membrane is rich in nutrients, anti-fibrotic agents, and anti-inflammatory cytokines, rendering it a clinically viable treatment option for burns, ocular damage, and skin necrolysis.
Challenges and Concerns
It's important to note that the placental tissue is different from the placental stem cells. Placental stem cells are extracted from the placental tissue and these cell extraction techniques vary greatly. Some labs may use enzymatic or chemical dissociation to extract cells from connective tissues, while others may use chemical or mechanical extraction techniques. These methods are successful at freeing viable cells from the tissue; however, none of these cells have been approved for use. It is important to note that while some might refer to these cells as treatment-ready, these cell extractions cannot be used outside of a clinical trial. Therefore, choosing a company that claims their placental cell extraction method is superior and will be used to cure a disease sometime in the future is more of a gamble than a solid investment.
Why? The result of the previously explained extraction process is not currently an FDA-approved product. FDA regulations state that cell and tissue products for family utilization must be minimally manipulated and for homologous use only. Anything outside of these parameters, such as the extraction of cells from the placental tissue is currently considered an investigational, unlicensed drug. Since these extracted cells are classified by the FDA as a manufactured drug, these cells cannot be legally used by a U.S. licensed physician in the treatment of any medical condition outside of a clinical trial or legally exported for use by stem cell clinics outside of the U.S.
These are a few of the issues that explain why we offer cryopreservation of cord tissue instead of placental tissue at Cryo-Cell. We are very careful to only minimally manipulate your cord tissue prior to storage, which allows for a variety of future processing and extraction methods acceptable for specific therapeutic applications.
Secondly, during our research into the inclusion of placental tissue banking in our services, we discovered numerous cryopreservation amniotic membrane third-party companies, such as Amniogen® and Bio-Tissue, that offer readily available placental tissue products on the market today. Extensive research indicates that these products offer a low immune response, making them a viable substitute when using tissue from an unrelated donor.
These tissue products are often covered by insurance and can be conveniently stored at room temperature, allowing doctors to have them readily accessible in their offices, surgery centers, or hospitals. This accessibility proves invaluable in emergency situations, reducing the time required for surgery or skin graft procedures. Practically speaking, it is wise for the medical community to opt for one of the approved amniotic tissue products.
Cryo-Cell's Position on Placental Tissue Banking
In summary, we have two key findings: Firstly, stem cells extracted from placental tissue is classified as an investigational and unlicensed drug. Secondly, there is a wide array of amniotic membrane (part of the placenta) tissue products readily accessible. We believe there are still many unanswered questions regarding the use of one's own placental tissue, necessitating further clarification before we would offer placental tissue storage to our clients as an additional out-of-pocket expense.
Cryo-Cell has been helping parents bank their baby’s cord blood stem cells for over three decades. As the world's first cord blood bank and one of the most highly-accredited, we aim to provide our families with the best banking options in the industry.
 Rojczyk, E., Kitala, D., Łabuś, W., Smętek, W., & Kucharzewski, M. (2020). Preparation of placental tissue transplants and their application in skin wound healing and chosen skin bullous diseases ‐ Stevens‐Johnson syndrome and toxic epidermal necrolysis treatment. International Wound Journal, 17(2), 491-507. https://doi.org/10.1111/iwj.13305