Stem cell collection from the umbilical cord What are stem cells?

Stem cell collection from the umbilical cord
What are stem cells?
The blood flowing from the placenta through a baby’s umbilical cord is rich in stem
cells. Stem cells are early versions of blood cells. These cells can potentially be
used to replenish supplies of red blood cells, white blood cells and platelets and
possibly many other different types of cells.
What are the benefits of collecting stem cells at birth?
For a very few families, there is a medical reason why stem cell collection could be
helpful. They may have a family history of a genetic disorder, or a sibling may have
a blood or immune disorder that could improve with stem cell transplantation.
Collection of stem cells from the umbilical cord can be offered to selected individuals
on a case-by-case basis by doctors within this NHS Trust. It is important to establish
that the potential benefits outweigh the risks before going ahead with this procedure.
Recently, commercial companies have been promoting stem cell collection in healthy
families with no history of genetic disease. The stem cells are collected and stored,
with the potential to be used in the future if the child or a sibling develops a treatable
illness. A Royal College of Obstretrician and Gynaecologists expert panel has
recently concluded that there is currently insufficient evidence to support this
practice. Despite this lack of evidence, emotive literature produced by companies is
driving many families to enquire about this service.
What are the potential risks of stem cell collection?
Collection of stem cells needs to occur within minutes of the baby being born. This
is a potentially risky time for both mother and baby. Their health requires the full
attention of the attending staff. It is important that the process of labour and delivery
of the placenta proceed in the usual manner. At this time, some cord blood may be
needed for clinically proven blood tests, such as oxygen levels in the baby or to
detect blood type incompatibility (Rhesus disease).
The introduction of extra needles to withdraw cord blood adds a health and safety
risk for the staff conducting the procedure. A considerable volume of blood is
Issued: February 2011
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required, and care must be taken to ensure that it is not contaminated. It is therefore
a complex procedure which must be undertaken by a competent individual, who is
not involved in the care of the mother or baby.
What is the Trust’s position on the collection of stem cells without
medical justification?
Unless there is a medical reason for stem cell collection, Trust staff will not
have any involvement in, or responsibility for the stem cell collection. This is
because of the unwanted effects explained above and also because this procedure
is not considered to be necessary for the vast majority of families.
If you are committed to arranging this procedure at your own cost, then the Trust will
not prevent this from happening. You will need to engage the services of an
independent company who will provide a fully trained and licensed person to take the
cord blood sample. The Trust’s position is explained in detail in the full guideline,
which can be obtained from your midwife. This document lays down strict criteria
that your independent company must follow when carrying out this procedure. It also
highlights the fact that the procedure may have to be abandoned if an urgent medical
need takes priority.
You will be asked to sign to say that you have understood the Trust’s position. Your
independent company will be wholly responsible for the collection, storage and all
future management of the blood sample.
Where can I find more information?
Royal College of Obstetricians and Gynaecologists. 2006 Cord Blood Banking:
Information for Parents RCOG: London.
Royal College of Midwives: Cord Blood banking: the facts.
August 2008.
Approved by the Obstetrics and Gynaecology Patient Group, Feb 2009
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