FAQ for Expectant Parents

Cord blood is blood that remains in the umbilical cord following the birth of a baby and after the umbilical cord is cut. During pregnancy, the umbilical cord functions as a lifeline between mother and child. After a baby’s delivery, the cord blood present in the umbilical cord could offer hope for the child as well as members of the family. Cord blood contains a rich source of life-saving stem cells called Haematopoietic Stem Cells (HSCs).

Cord blood stem cells are also known as Haematopoietic Stem Cells (HSCs), which are responsible for replenishing blood and regenerating the immune system. These stem cells can be found within the umbilical cord following the birth of a baby and have the unique ability to differentiate into various cell types found in blood as depicted in the diagram below:

• Red blood cells - which transport oxygen
• White blood cells - which produce antibodies and fight bacteria
• Platelets - which assist in blood clotting

Red Blood Cells

Carry oxygen to all cells in the body

White Blood Cells

Fight infections

Platelets

Helps blood to clot in the event of injury

There are several advantages of storing your baby’s cord blood stem cells, such as:

• A guaranteed match for autologous transplants (where the donor and recipient are the same individual).
• Having a readily available supply of stored Haematopoietic Stem Cells (HSCs) as opposed to conducting a national or international search, which can be costly and time-consuming during a time-critical situation.
• Lower risk of Graft vs. Host Disease (GvHD) for autologous transplants, a situation where the transplanted tissue attacks the patient’s own tissue.
• Non-invasive collection procedure which is pain-free and risk-free to both mother and child
• Cord blood stem cells are younger, have a higher rate of engraftment and are more tolerant to tissue mismatches, compared to other sources of stem cells, e.g. bone marrow.

Lower risk of Graft vs Host Disease (GvHD) after stem cell transplant

Cord blood stem cells can:

• Replace and regenerate damaged or diseased bone marrow.
• Treat blood related cancers, solid tumours and immunodeficiency disorders.
• Correct genetic defects (sibling/allogeneic transplantation).
• Potentially be used for cellular therapy and regenerative medicine.

The purpose of a stem cell treatment is to reconstitute a patient’s blood and immune system.

For example, in the case of a cancer-related transplant, chemotherapy and radiotherapy will have to take place before the infusion of cord blood stem cells. The cord blood stem cells will be infused intravenously into the patient’s blood stream, where they will migrate to the patient’s bone marrow. Haematopoietic Stem Cells (HSCs), which can be found in umbilical cord blood will differentiate itself into three blood cell types – red blood cells, white blood cells and platelets, a process which initiates the regeneration of the patient’s blood and immune system.

Cord blood stem cells are currently being used as a standard form of treatment for over 80 diseases such as leukaemia, lymphoma, thalassemia and neuroblastoma, just to name a few. For the full list of treatable diseases, click here .

Apart from being a perfect match for your child, cord blood can also be used by family members. Unlike bone marrow which requires a perfect match between donor and patient, the probability of finding a match among family members using cord blood stem cells is higher. In addition, the chances of finding a suitable match within the family increases with the storage of every additional child’s cord blood¹.

Reference:
1. Parent’s Guide to Cord Blood FAQ. Parent’s Guide to Cord Blood Foundation website. https://parentsguidecordblood.org/en/faqs. Accessed November 11, 2019.

Immediately after the delivery of your baby, your child’s umbilical cord will be clamped and cut, and your child will be moved to the birthing area. The doctor then collects the umbilical cord blood by inserting a needle into the umbilical vein, draining the cord blood into a blood bag.

This procedure is non-invasive in nature, and is both painless and risk-free to mother and child. The process takes about 3 minutes and does not alter the birthing process in any way. It can be done with either a vaginal or caesarean delivery.

Please note that the final decision of whether the cord blood collection should take place will always reside with your OBGYN or Doctor whose first priority is to ensure the safety of you and your baby.

After the collection of your baby’s umbilical cord blood, a round-the-clock medical courier will collect and deliver your baby’s cord blood unit to Cordlife’s stem cell processing and storage laboratory within 24 hours.

Upon receipt of your baby’s cord blood unit, a Cordlife laboratory technician will start to isolate the stem cells – a critical step in cord blood banking – which will determine the number of stem cells that can be harvested or recovered from the cord blood.

Cell recovery rates are critical because a higher number of stem cells could enhance the success of cord blood transplantation or treatment. That's why Cordlife is the first family cord blood bank in Singapore to invest in the Sepax®2 automated stem cell processing technology, a Swiss-made and U.S. FDA-certified device that can recover as high as 99.88%¹ of Total Nucleated Cells (TNC) from cord blood. This fully automated closed end-to-end processing system also helps us to ensure the sterility of your child’s cord blood unit by eliminating exposure to air contaminants.

Once the stem cells have been isolated and stored in our U.S. FDA approved cryogenic storage pouch, it is placed into Smart-Max^TM, a fully automated cryoprotectant infuser, mixer and cooling device that helps to prepare the cells for cryopreservation. Smart-Max^TM ensures that the cryoprotectant is injected at a constant and pre-defined temperature, thus ensuring the viability of your baby’s stem cells.

Reference:
1. Cordlife umbilical cord blood processing data as of 14 March 2019

Your baby’s umbilical cord blood is stored within an U.S. FDA approved cryogenic storage pouch that consists of 2 dual compartments (20% and 80%) and is in compliance with AABB and FACT-Netcord standards. The dual compartments allows for the possibility of stem cell expansion programmes in the future. This means that 80% of the stem cells can be withdrawn for immediate use/treatment while the balance 20% is stored for future expansion.

Cordlife’s cryogenic storage pouch is made of a special material designed specifically to withstand temperatures of -150°C: the optimal cryogenic temperature for long-term stem cell cryopreservation.

At Cordlife, we use MVE Anti-contamination Vapour-phase Liquid Nitrogen Storage Systems for the storage of our clients’ umbilical cord stem cells. Vapour-phase storage is preferred over liquid-phase storage¹ as it eliminates the chance of cross contamination between cord blood units as compared with those stored in liquid nitrogen.

The MVE Anti-contamination Vapour-phase Liquid Nitrogen Storage systems are equipped with a high-grade monitoring system that scans for any out-of-range conditions to ensure that the temperature is maintained within the optimum range at all times. In addition, the system also operates perfectly even without electrical supply, making it 100% reliable and failsafe with no chance of robotic malfunction. Unlike other storage systems in the market, our tanks have never been recalled by the U.S. FDA or the manufacturer.

In the remote chance of an unexpected emergency, our laboratory is also equipped with an uninterrupted power supply.

Reference:
1. Pitt KE, Campbell L, Skubitz APN et al. Best practices for repositories I: Collection, storage, and retrieval of human biological materials for research.
   Cell Preservation Technology . 2005; 3(1):5-48.

Research has shown that cord blood which has been processed according to international standards and stored at cryogenic temperatures of between -135°C to -190°C can be stored indefinitely and still remain viable¹.

Reference:
1. Cells for life website. https://cellsforlife.com/how-long-can-cord-blood-stem-cells-be-stored/. Accessed November 25, 2019.

You may still continue to store your baby's cord blood (with additional consent given to Cordlife), or elect to discard the umbilical cord blood unit.

This is because Cordlife conducts two different tests for Hepatitis B virus (HBV) on maternal blood, namely:

• Hepatitis B Surface Antigen (HBsAg)
• Hepatitis B Core Antibody (Anti-HBc (Total))

Usually, the attending transplant physician will make the decision whether to use an umbilical cord blood unit where the maternal blood was tested positive for Hepatitis B for transplant, based on various factors particular to the patient, the cord blood unit intended for use, and the availability of other HLA-matched donor.

Cordlife Singapore’s processing and storage facility is MOH licensed and has received dual international accreditations from AABB and FACT-NetCord.

These accreditations ensure that Cordlife adheres to the highest standards of quality when it comes to the handling, processing and storing of your baby’s cord blood through regular and rigorous audits. It also ensures that your child’s umbilical cord stem cells remain viable should the need for transplantation ever arise.

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Contact us at our 24-Hour Hotline (65) 6238 0808 to make an appointment with our Cord Blood Banking Consultant.

*If you are due within the next 4 - 6 weeks, we strongly recommend you to contact us immediately for enrolment because this will ensure all necessary steps are completed before your baby's arrival.