Umbilical (UCB) has been attracting attention as

Umbilical cord is a connection between the fetus and mother during gestational period and this cord consist of rich blood-forming stem cells. Umbilical cord blood (UCB) has been attracting attention as a source of haematopoietic stem cells and progenitor cell for many decades . Nowadays the usage of UCB transplants is increasing world widely with 700,000 public units and 4 million private units from 1990 to 2017 . The significance of this blood is that the haematopoietic stem cells present in UCB is alternative to the bone marrow and peripheral blood.1 This was first introduced by Hal Broxmeyer, Judith bard, and the late Edward Boyse in the early 1980s. The discovery of UCB as a cryo preservative curing a patient with Fanconi anemia in 1988 was the first to undergo UCB transplantation.
As well as the patients (autologous) or healthy HLA-compatible (allogeneic) donors who are related or unrelated can be used for the harvest of blood-forming progenitor. The collection of cord blood from the umbilical vein can be either before the placenta is delivered (in vivo) or following placental delivery (in vitro).In vivo technique is preferred by most banks because it can be performed in the delivery room by birth-unit staff and does not usually require additional resources and even comparative studies3 suggest that it yields slightly higher volumes of cord blood and total nucleated cells compared to the ex utero technique. Closed collection system is used in order to reduce the risk of infection and maternal fetal fluid contamination. Double-clamping of umbilical cord is done and it requires approximately 5 to 10 minutes. The in-vitro is carried out by trained professionals in a separate room after delivery as soon as . This method allows birth-unit staff to focus on maternal and infant health, even though it requires additional trained staffs, resources, and cost.
The collected cord blood is stored in cord blood bank. The banks are of 3 types: public banks which involve allogeneic donation, private banks for autologous use for a child that develops a disease later in his/her life and directed-donation banks in which cord blood is collected at no charge to the patient and allows to utilize it in affected siblings if needed.
As cord blood is cryo-preservative, it is possible to keep them in a frozen state for many decades. Increasing or decreasing storage period doesn’t have any effect in neutrophil and platelet engraftment.
The primary goal is to spread the benefits of using cord blood in curing most of the possible disorders and thereby comprehend the after effect of it.
Lots of articles were reviewed in order to capture the main deficit information based on the effect of cord blood preservations and usage. Based on that some questions arises. The main point to be focused on was:
1. Why should we preserve UBC blood?
The main aim of the research is to spread out the benefits of preservations and in what all ways it helps individuals as well as different families.
2. Is there any cons in preservation?
Many couples or families step back from preservation as they have a misunderstanding for the process and preservation technique. There is no method or therapy without any cones. Still researchers have taken a great risk in minimizing the demerits for the human kind.
Inclusion criteria: In order to acquire the precise and valid information about UBC blood preservation, benefits of preservation is emphasized more. This was included to perceive the efficiency of haematopoietic stem cell in the oncoming field of medicine and also to know how reliable this method is. Other criteria which were included are post delivery issues, area and duration of preservations, storage procedures. Also the storage duration is analyzed to check whether duration cause any effect in this blood-forming cells.
Hematopoietic stem cells contain potential to reconstitute any blood cell type which can rescue children with malignancies and other types of life threatening diseases. cord blood has proven a great advantages over bone marrow and peripheral blood in many ways.
It is a lot more easier in collecting the cord blood as it is painless for both mother as well as the baby. And this can be easily extracted at the same time as the cutting of the umbilical cord after delivery. Whereas in bone marrow collection, it requires an invasive, surgical procedures and so one which is painful and also less effective.
Matching stem cell is required for a successful transplantation. This can be acquired from the public database but the chance of finding is low. Mostly the stem cells from the closely related family is better. And if the cord blood is preserved, a person can use his own stem cells.
One of the main complication is the Graft-versus-host disease(GVHD). This is one’s immune system recognizes the cells as foreign and they attacks the newly transplanted cells. Risk for developing such situation is low for cord blood.
Another striking advantage is the decreased risk of the transmission of infectious disease as umbilical cord blood is almost never contaminated by Epstein-Barr virus or cytomegalovirus.
Cord blood can also be used even if the donor is not found as it is cryo-preservative and can be readily available at any time.
Despite many benefits, the cord blood also has some disadvantages. Engraftment is one of the challenge that is faced in cord blood transplantation. The cord blood is having slow engraftment. One of the criteria for slow e engraftment is the cell dose. Cell dose is the volume of umbilical cord blood collected. Decrease in the volume of cord blood can be related for the low rate of stem cell present which is 10% less than of bone marrow. This is one of the most important disadvantage. Other than this is the limited use of an infant’s own umbilical cord blood stem cells later in its life (autologous transplant). The chance of usage is mostly low as in some cases such as leukemia, autologous cord blood stem cells cannot be used as it also contain premalignant cells.10
From the above, it is clear that the umbilical cord blood can be used for many purpose and it is one of the progressive method in modern medical field as it offers another method of definitive therapy for infants, children, and adults with certain hematologic malignancies and other metabolic diseases. Even though the cord blood is highly rich in stem cells and can be used in different therapies, it also contains some disadvantage. But the use and the value is never less and the usage is increasing at a higher rate in this era.

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Last updated: September 29, 2019


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