faq - frequently asked questions

1. What is Cord Blood?

Umbilical Cord Blood is the blood that remains in the placenta and umbilical cord following birth. Until recently the placenta and umbilical cord were discarded after delivery as medical waste, but now research has shown that during pregnancy, cord blood becomes a rich source of blood (haematopoetic) stem cells, which can be collected, processed and frozen for potential future use.

2. What is a Stem Cell?

Stem cells have the ability to divide and give rise to specialised cells. Blood stem cells are the building blocks of everything in the blood and are responsible for producing all of the mature cells in our blood and immune system. They form the white cells that fight infection and produce immunity, the red cells that carry oxygen and platelets that promote clotting.

3. What is an Embryonic Stem Cell?

Human development begins when a sperm fertilises an egg. This fertilised egg is described as being totipotent, which simply means that it has the potential to form an entire organism. Approximately four days after fertilisation and after several cycles of cell division, the totipotent cells begin to specialise, forming what is known as a blastocyst (see diagram below). This has an outer layer of cells and an inner cell mass. The outer cells go on to form the placenta and other supporting tissues for fetal development in the uterus while the inner cell mass go on to form virtually all of the tissues in the human body.

These inner cell mass cells undergo further specialisation into stem cells that are committed to give rise to cells that have a particular function. Examples include blood stem cells that give rise to red blood cells, white blood cells and platelets and also to committed stem cells to produce the liver, lung, brain and kidney. These more specialised stem cells are called multipotent.

Embryonic stem cells are stem cells isolated from the inner cell mass of a developing embryo. They have the potential to be stimulated to develop into the whole embryo as well as specialised cells, and so may offer the possibility of a renewable source of replacement cells and tissue to treat a wide range of diseases, conditions and disabilities. We are not collecting embryonic stem cells.

Blood stem cells are multipotent stem cells that can develop to the cells of the blood and immune system.

4. Why is Cord Blood so Valuable?

Because cord blood is rich in blood stem cells, they can easily be collected and cryopreserved in case they are needed later in life. Cord blood stem cells have the ability to treat the same diseases as bone marrow or as blood stem cells collected from the circulating blood of children or adults. Transplants have already been used for treatment of such wide-ranging diseases and conditions as cancer and leukemia, sickle cell disease, various forms of anemia and severe combined immunodeficiency. Often, donor stem cells that match the patient are difficult to obtain. However, stem cells taken from your baby are a guaranteed match for your baby for his or her lifetime.

5. What are the other sources of stem cells?

Bone marrow: Stem cells can be collected from the bone marrow. However, the collection procedure is invasive, time-consuming, requires an anaesthetic and is painful for the donor. Perhaps the biggest hurdle in bone marrow stem cell transplantation remains the finding of a perfect match. This has proven to be quite difficult and sometimes impossible.
Peripheral Blood: The use of bone marrow has primarily been replaced by collecting stem cells from the circulating (peripheral) blood (often from adult donors as part of their treatment for their underlying disease).

6. What are the advantages of using cord blood stem cells as opposed to stem cells collected from either the bone marrow or circulating blood?

Tissue type is determined by a set of genes that make proteins called human leukocyte antigens (HLAs), which are found on the surfaces of all body cells (except red blood cells). The immune system recognises cells carrying the HLA proteins it has encountered since birth as normal, or belonging to the particular individual or "self". Any other HLA proteins are regarded as "non-self", or foreign and cells carrying them are quickly killed. There are six major HLA genes. Every person has two of each, one from each parent. For bone marrow transplants, doctors aim to match the six alleles that are most clinically relevant in transplantation. But cord blood stem cells are immunologically immature and can tolerate an element of mismatch, allowing doctors to use donor cord blood samples with a degree of mismatch. Cord blood stem cells have a number of significant advantages over bone marrow including:

Furthermore, because cord blood is from a newborn and is unexposed to most diseases, transplant complications are less frequent.

7. When is the cord blood collected? Is the collection procedure risky or painful?

Cord blood is collected from the umbilical cord immediately after the birth of the baby; either prior to the delivery of the placenta or while the placenta is still attached to the uterus. Collection can only take place at the time of delivery. There is absolutely no pain or risk to the mother or child during the collection process since the blood is collected from the cord once it is cut.

8. How is the cord blood collected?

Immediately after the birth of the baby, the umbilical cord is cut and the baby separated from the placenta and mother. The placenta is delivered a few minutes later. The portion of the umbilical cord still attached to the placenta is clamped and cleaned. A sterile needle is inserted into the umbilical vein and the placental blood is drawn into a sterile blood collection bag containing anticoagulant, which prevents the blood from clotting. The collection process is non-invasive and completely painless and does not present any risks to either mother or baby. Blood can also be drawn from the cord while the placenta is still attached to the uterus using the same procedure.

9. What happens after the cord blood is collected?

Once the collection is complete, the specimen is packaged and, sent to Cryosite's laboratory for processing and long-term storage at ultra low temperatures. A maternal blood sample is also collected for infectious disease analysis. The sample is then processed to remove the red cell component and isolate the plasma component containing the umbilical cord blood stem cells. Once processing is complete, the cord blood is then frozen in dedicated bags, developed to withstand low temperatures without damage. During freezing, formation of large ice crystals inside of cells can cause irreversible damage. However, the use of a cryoprotective chemical solution such as 10% DMSO, together with the careful control of the rate of freezing, reduces such risks of damage and therefore protects the cells during freezing.

10. How is the cord blood stored?

Following the slow controlled rate freezing of the blood, the cells are transferred to liquid nitrogen for long-term storage.

11. What happens when Cryosite receives the cord blood?

As soon as the blood sample arrives in our laboratory it is carefully measured and tested for sterility, viability and cell count. The stem cells are separated and protected with a chemical solution, which allow the cells to withstand very low temperatures. Upon completion of the cryopreservation process, the cells are stored in liquid nitrogen. To assure that your child's cord blood will be safe for future use, the following tests are done:

12. Can I Donate my Child's Cord Blood?

Yes. The Australian Federal Government has committed $9 million to establish a national cord blood bank in Sydney, Melbourne and Brisbane with additional banks being developed in other states. Patients who deliver at participating hospitals may donate their baby's cord blood to the public bank for use by any individual who needs a stem cell transplant. However, once donated, there is no assurance that the cord blood would be available if it were ever needed within your family.

13. What are the advantages of private cord blood storage versus public cord blood banks?

Private cord blood storage allows expectant parents to store their baby's cord blood stem cells for potential future use within their own family. Such storage ensures that the stem cells are immediately available to your family if they are needed for treatment, therefore eliminating the often time consuming search for a compatible donor. This is especially valuable if there is a pre-existing family history of certain health conditions (including Leukemia, and other malignant blood disorders). Ultimately, early treatment of many diseases can significantly decrease the progression of the disease and having compatible stem cells readily available for treatment when someone is already immunodeficient and at high risk for a fatal infection is invaluable.

14. What is the probability that my child could develop a disease that could be treated with cord blood stem cells?

The probability of a child needing its own cord blood stem cells is small; statistics vary but range from an estimated 1 in 10,000 (according to the New York Blood Centre) to 1 in 200,000 (according to the National Institutes of Health in the US) babies who will develop a disease such a leukemia or lymphoma that could be treated their own cord blood stem cells. However, because early treatment of many diseases can slow the disease progression, if the stem cells are needed it is reassuring to know that they are stored ready for immediate potential use.

15. Is this an insurance against disease?

No. Insurance represents a guarantee, and the storage of cord blood stem cells cannot offer a guaranteed cure for any disease. However, what storage does offer is the immediate availability of your child's stem cells should they ever be required for transplantation.

16. How Much Does it Cost?

See our Schedule of Fees page.

17. How do I enrol?

If you are interested in receiving the enrolment forms please see our Forms Page or contact us. We will send you an information package together with the necessary enrolment forms. These should then be completed and returned to Cryosite, either by fax or by mail.

18. The Future.

Until recently, there was little evidence that multipotent cells such as blood stem cells could be induced to produce skin cells, liver cells or any cell other than a blood stem cell or a specific type of blood cell. However, in animals, in recent experiments researchers have now succeeded in turning blood stem cells into brain stem cells. Further animal studies have succeeded in producing liver cells from bone marrow stem cells. These results suggest that even after a stem cell has become multipotent and has begun to specialise, it may be more flexible than previously thought.

The recent controversy over funding for embryonic stem cell research has created an amazing level of awareness about the power and value of stem cells. Since stem cells collected from cord blood are non-controversial and do not involve embryos they have now emerged as an attractive source of stem cells for research and clinical applications.

19. How long can cord blood be stored for?

Stem cells can be stored for prolonged periods at cryogenic temperatures. While transplantation using cord blood stem cells is a relatively new process and research has yet to demonstrate the exact length of time over which stem cells can be stored and remain viable, there is evidence to demonstrate viability and cell recovery in cord blood stem cells frozen for at least 10 years.

20. How much blood is usually collected?

Typically 60-150ml of cord blood can be collected. A minimum volume of 40ml is required before processing is begun. This is to ensure a sufficient quantity of stem cells in the final frozen product. Occasionally, even with all techniques in place, the minimum volume is NOT collected. In such circumstances, the fees paid less the registration fee will be refunded.

21. History of Cord Blood.

Transplantation of umbilical-cord blood was successfully performed for the first time in 1988 to treat a boy with a rare and fatal blood disease. The donor, the boy's newborn sister, was a perfect HLA match. Today the boy is still disease free and living a healthy life. Since then, the advantages of cord blood as a source of haematopoetic stem cells for transplantation have become clear and about 1500 transplants using stem cells from cord blood have been performed worldwide to treat a number of diseases.