Cord Blood Bank - North Cyprus - Onkim

The umbilical cord is a structure that is expelled together with the placenta immediately after birth; throughout pregnancy it nourishes the child and provides all communication between mother and child. Its diameter is 1–2 cm and its length varies between 10 and 50 cm. It is made of a firm, jelly-like tissue (Wharton’s jelly), through which 3 blood vessels pass: one vein and two arteries.

Why Are Umbilical Cord Cells Important?
The umbilical cord is firm in structure and consists of a substance called Wharton’s jelly. It contains 2 arteries and one vein. Wharton’s jelly is rich in mesenchymal stem cells (MSCs).
MSCs make the cells needed for bone, muscle, cartilage, nerve and connective tissue, and play a role in their renewal.
MSCs also have another very important function: they play a role in regulating the immune system. They do this through the chemical substances they secrete.
After blood, tissue and organ transplants, there is a risk of graft-versus-host disease. When tissue rejection occurs in the body, graft-versus-host disease (GVHD), which can be very serious and fatal, develops. When MSCs are given to such patients, their regulatory effect on the immune system reduces the occurrence and severity of the rejection disease. They are already used in this field today.
Research is also being conducted into autoimmune diseases that develop later in life. (Autoimmune = diseases caused by immune substances that the body mistakenly develops against its own tissues, e.g. certain allergic diseases.)
MSCs are being intensively investigated to determine whether they have therapeutic effects in diseases such as Type I diabetes, rheumatoid arthritis, multiple sclerosis (MS), systemic lupus erythematosus (SLE) and osteogenesis imperfecta (brittle bone disease), as well as in neurological diseases such as cerebral palsy, autism, Alzheimer’s and Parkinson’s, in heart disease, in hearing loss in children and in regenerative medicine.

In Which Diseases Are Mesenchymal Stem Cells Obtained from the Umbilical Cord Used?

They can be used in the treatment of diseases resulting from damage to tissues and organs that develop from mesenchymal cells, such as bone, cartilage, fat tissue, nerve and connective tissue. Their use in organ transplants to prevent the body from rejecting the new organ has been approved by all authorities, including the FDA. In addition, it is thought that they may be used in the treatment of cerebral palsy, autism, hearing loss in children, Type I diabetes, nervous system damage such as Parkinson’s, and autoimmune diseases such as MS (multiple sclerosis), rheumatoid arthritis and osteogenesis imperfecta, and many FDA- and EMA-approved clinical research studies are being conducted in Turkey and abroad to investigate this.

How Long Is the Umbilical Cord Stored?

Although it is known that the umbilical cord can be stored for very many years in a liquid nitrogen tank at -196 °C, no regulation has yet been issued on this. However, given that embryos and other cells can be stored for very many years without deteriorating, the umbilical cord will also be able to be stored for the same length of time.

Why Should We Store the Umbilical Cord?

As well as storing umbilical cord blood, storing the umbilical cord itself provides an advantage, because they contain different types of cells and provide treatment for different diseases. Since the jelly-like substance that makes up the umbilical cord does not contain the blood-forming (haematopoietic) stem cells found in cord blood, it is not used in blood diseases such as leukaemia and lymphoma. On the other hand, mesenchymal stem cells (MSCs) can be used in the treatment of diseases other than those treated with cord blood (for example, the diseases mentioned above, graft-versus-host disease in particular).

MSCs are also present in cord blood, but in much smaller quantities than in the umbilical cord. Obtaining MSCs from bone marrow requires a surgical procedure under anaesthesia that can be painful. MSCs in cord tissue are obtained in the easiest, safest and most painless way compared with other sources. It is enough for part of the umbilical cord to be collected and stored after birth.

Most importantly, the mesenchymal stem cells in the cord are young and have not yet come into contact with harmful environmental factors. (Click for environmental effects)
Since it will increase the chance of use in wider areas in the years to come, storing the cord itself together with the cord blood is a very good approach.

How Does ONKİM Process the Umbilical Cord?

At ONKİM, the umbilical cord is stored using a method accepted worldwide. The mesenchymal stem cells obtained from the cord are produced using a method developed in our laboratory and inspected and approved by the Turkish Ministry of Health. An operating licence has been obtained from the Turkish Ministry of Health for umbilical cord storage and the production of mesenchymal stem cells from the cord.

What Is Circumcision?

Circumcision is the removal of the foreskin by appropriate surgical methods for medical, cultural or religious reasons. Studies on the foreskin, which under normal circumstances is discarded as medical waste immediately after the operation, have shown that it contains a large number of stem cells.

Why Is the Foreskin Important?
The foreskin contains many different types of cells. These are fibroblasts, stromal cells, progenitor (precursor) cells and different types of stem cells. These cells are more advantageous because they are younger than stem cells obtained from adults and have not been exposed to environmental factors.

How Is the Foreskin Collected?

Although circumcision can be performed at any age, the earliest it is done is in the period following birth, before the baby leaves hospital. The skin removed after the operation is collected into special solution bottles prepared under sterile conditions. Once collection is complete, the foreskin is transferred to a special transport kit, delivered to our centre and processed for storage.

What is the processing method for the foreskin?

Foreskins delivered to the laboratory under suitable conditions are put into culture following the necessary quality control procedures. Culturing continues for approximately 6–8 weeks until cells are observed. After culturing, the cells are placed into long-term storage. In line with the family’s and the physician’s request for use, foreskin stem cells expanded to the required number are transferred to the relevant centre under suitable conditions.
How Long Is the Foreskin Stored?

Foreskin stem cells, isolated using a special separation method, are stored for years in nitrogen storage tanks at -196 °C once the necessary quality control tests have been completed, unless the family states otherwise.

Birth is the only chance to store cord blood and the umbilical cord.

Today, stem cell clinical research and application studies are being conducted in hundreds of diseases. Those attracting the most interest include Type 1 diabetes, heart disease, hearing loss, forms of blindness, brain damage, burns and jawbone damage in childhood, and Parkinson’s, Alzheimer’s, diabetes, rheumatic diseases and cancer in adults. For these studies to be usable in treatment, they must be carried out using accepted methods whose scientific reliability has been proven. Results from these studies are expected over the coming decades. In that case, not only the child to whom the blood belongs but also their family, relatives and other people will be able to benefit.
 
You can find detailed lists of the diseases for which stem cell treatment is given and on which research is being conducted at the links below:
 
http://parentsguidecordblood.org/en/diseases
http://stemcellfoundation.ca/en/toward-treatments
https://clinicaltrials.gov

In the event of illness, finding blood and bone marrow with a full tissue match sometimes requires a search lasting months. If the child’s own cord blood is available, however, there will be no such waiting period, because the tissue match is complete.

Storing the baby’s cord blood gives you the chance to access it immediately when needed.

No mother or father wants their child to be ill. The thing they are most sensitive about is their child’s future. By storing cord blood, there is a chance today, albeit in a small number of cases, of restoring the immune system in some important blood cancers, anaemia, tumours and certain diseases in which the immune system is deficient. Furthermore, if stem cell research produces positive results, it will be possible to use it in many diseases in the years to come.

When stem cells are needed from another donor, tissue matching becomes a problem. In bone marrow transplant treatment, an 8/8 match between recipient and donor according to the HLA system is required. Otherwise, tissue incompatibility occurs. This leads to a very serious illness in the recipient, which is very difficult to treat and most often results in death.
 
Finding an 8/8 compatible donor for a bone marrow transplant can take months. Sometimes there are waits of up to 8–9 months. During this waiting period, some patients face adverse outcomes because they cannot be treated. The child’s own cord blood, however, is ready for use and, if needed, can be made ready for use within 30 minutes at most. Another baby’s cord blood can also be used in treatment. This is a unique advantage of cord blood.

The definitions and working methods of cord blood banking are laid down in legal regulations. Cord blood banks are subject to strict inspections. Cord blood banking is carried out in 2 ways.
 
Autologous blood bank: Blood collected from a person is stored solely for use by that person. It is regarded as the person’s property and, as required by the regulations, is secured by a contract. These are more commonly known as private blood banks and operate within the legal framework.
 
Allogeneic blood bank: A blood bank open for use by everyone. The blood is obtained from people through donation.
 
How many cord blood units have been used at ONKİM?
 
14 cord blood units have been used at ONKİM. One of them was used for a tumour (neuroblastoma) and the others for blood diseases. Those used for blood diseases were the cord blood of siblings conceived through IVF.
 
Our wish is this: may no baby ever develop a disease that creates a need for this stored blood. And if the need does arise, may it at least offer hope for some diseases.

The probability of a baby needing to use its own blood is reported in different sources as 1:2000 – 1:20000. It is estimated that, as the number of diseases that can be treated with stem cells increases in the years to come, these blood units will be needed more and more.

How Much Cord Blood Should Be Collected?
 
At least 60 millilitres of cord blood must be collected.
 
Does the Type of Delivery Affect Cord Blood Collection?
 
Collection can be carried out in both vaginal and caesarean deliveries.

In recent years it has been reported that cord blood stored for 20 years has been used in treatment. Theoretically, it is assumed that blood and tissue products frozen in liquid nitrogen at -196 °C can be stored for at least 50 years, or even longer. Tissue freezing techniques are still a new branch of science. The first cord blood freezing procedure was carried out in 1992, and the first cord blood bank was established in 1994. It has been found that stem cells in allogeneic (open for general use) blood stored for 20–23 years remain viable.