Stem cell collection

FAQ

• Who collects the samples?

  Collection must be performed by a trained and licensed healthcare professional. This could be a private obstetrician or midwife or an assigned phlebotomist.

  The Human Tissue Authority (HTA) requires the person who performs the collection to be appropriately trained in the Smart Cells collection process and hold a valid Third-Party Agreement to do so. Smart Cells can arrange for a fully trained and qualified medical professional to carry out the collection at your birth.

• Can I still have my stem cells collected if I have a home birth?

  Yes, Smart Cells has a fully trained team of phlebotomists* who are able to visit your home to collect the sample during a home birth. They will discuss your options with you and make sure they have a safe and sterile area to collect your samples.

  *Specific to the United Kingdom only.

• Can I wait for the placenta to deliver naturally?

  You can either wait for the placenta to deliver naturally or the delivery may be induced via an injection. Either method does not prevent Smart Cells from collecting your sample.

• What is an HLA test and how is it used?

  “HLA” is short for Human Leukocyte Antigens, which are proteins in the immune system that determine whether a patient will react against a donor transplant or if the donor transplant cells will react against the recipient. A very good basic tutorial about HLA types is on the Stanford Website, and the national Be The Match program (aka NMDP) has more info on the role of HLA type in transplants of stem cells from bone marrow or cord blood.

  The HLA type of cord blood is always assessed by public banks at the time of storing cells, and then the type is listed on a registry that can be searched for patients worldwide who need a transplant. Family/private banks typically do not measure the HLA type at the time of banking, as the actual test specification varies depending on the proposed clinical use and the testing can always be checked later using a testing segment of the stored cells.

  In the case of sibling transplantation, individuals have 25 per cent chance of having a sibling who is HLA matched.

• Do I need to store the cord blood and tissue stem cells in the country I intend to use it?

  No. After cord blood and/or tissue is collected at birth, the samples are delivered, processed, and stored in the Smart Cells UK laboratory. If you ever need the cord blood or tissue for therapy, the product will be shipped in a constant temperature monitored frozen state in a special container designed for the purpose of international cell shipment. Cord blood can travel anywhere in the world with no loss of viability because it travels frozen. It is only thawed at the clinic where it will be used immediately prior to infusion. Smart Cells have successfully shipped samples within the UK and to Europe, USA, India, and the Far East.

   

• Why do Smart Cells volume reduce process cord blood before storage?

  Most UK and international cord blood banks, both public and private, process cord blood to reduce levels of the plasma and the red cells, and cryo-preserve the remaining buffy coat portion which contains mononuclear cells. This mononuclear cell fraction contains the critical CD34 positive stem cells. It is valid for cord blood storage banks to use volume reduction techniques as such units are clinically preferable to whole blood, red cell replete products. This is based on large cohorts of international data from respected and accredited transplant centres who use cord blood regularly as a therapeutic tool. The plasma and red cells in cord blood are not deemed to be useful clinically. By reducing the volume of the sample, while retaining the critical stem cells, it is possible to minimise the volume of cryoprotectant solution required in the freezing process. The cryoprotectant contains a substance called DMSO that can cause reactions in patients so it is sensible to reduce the volume as much as possible.

  The reduction of red blood cell content is very important as it is well recognised that red blood cells burst or lyse during the freezing process. This results in release of free haemoglobin and red cell debris which can cause complications to patients at the time of infusion.

  There are whole cord blood units in-store that was mostly banked before preference for volume reduction became a factor and some of these are used for transplantation if there is no better match available in the volume-reduced format. Under these circumstances, key worldwide organisations which issue standards of practice recommend washing the units to remove lysed red blood cell material to avoid clinical complications. However, this can result in the loss of some stem cells.

  Information taken from the following sources:

  The Joint Accreditation Committee-ISCT (Europe) & EBMT (JACIE) : The Hematopoietic Cellular Therapy Accreditation Manual 6th Edition which accompanies the FACT-JACIE International Standards for Hematopoietic Cellular Therapy Product Collection, Processing, and Administration.

  The National Marrow Donor Program® (NMDP), ( USA)

  Transfusion. 2012 Jan; 52(1): 207–208

  The Circular of Information for the use of cellular therapy products (AABB publication) http://www.aabb.org/aabbcct/coi/Pages/default.aspx Ballen et al. Biol Blood Marrow Transplant. 2015 Apr; 21(4): 688–695.

  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359657/#!po=0.617284

• Does my hospital allow me to have stem cells collected?

  The majority of maternity hospitals allow Smart Cells to perform this service for you. If you would like to discuss your individual hospital, then please contact the Smart Cells.

   

• Does it matter if the birth is caesarean section or natural delivery?

  No. If you have a Caesarean the collection can take place after the delivery of the placenta, as it would with a natural birth. Either birthing scenario is fine for the collection of cord blood and cord tissue stem cells.

   

• Does cord blood and tissue collection hurt?

  No. Cord blood and tissue collection is painless, convenient, and safe for both mother and new-born. The cord blood and tissue samples are collected after your baby is born and the umbilical cord has been clamped and cut. The samples collected are normally discarded after birth as medical waste.

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Liaise with them directly to ensure they attend the hospital to take the cord blood sample from the umbilical cord after birth. 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