Parents bank on umbilical cords

Umbilical cord blood is rich in stem cells swissinfo.ch

Banking the cell-rich blood from babies' umbilical cords is a growing business in Switzerland.

However, researchers are still trying to answer the ethical and legal concerns surrounding the procedure.

Two public banks in Basel and Geneva already hold about 600 samples. In 2002, the health authorities granted permission for the first private bank to operate in Switzerland. Other companies are now planning to break into the Swiss market.

Lifeline

Cord blood is the blood which remains in the umbilical cord and placenta following birth and is routinely thrown away.

First used in transplants in 1988, umbilical cord blood is a rich source of stem cells which manufacture blood and disease-fighting immune cells.

These stem cells can be extracted at the time of birth and stored for potential medical use.

“The stem cells from cord blood are an alternative to bone marrow stem cells and much easier to obtain,” said Wolfgang Holzgreve, professor and chairman at the University Women’s Hospital in Basel.

“They can be used to treat certain diseases such as cancer of the blood, leukaemia or some genetic disorders.”

About 100 millilitres of cord blood is collected after the baby is born and the umbilical cord has been clamped and cut. The stem cells are isolated from the blood and frozen in liquid nitrogen until they are needed.

Biological insurance

Should they choose to store their child’s cord blood, parents are confronted with the choice of doing so either in a public or private bank.

Public banks serve everyone. Commercial companies serve those who pay and the blood is stored only for potential use by a family member.

“Private banking is almost like a private life insurance,” Holzgreve told swissinfo. “You store your own cells in case you should ever develop a disease where you need a transplantation.”

“On the other hand, the so-called allogeneic approach involves storing the blood anonymously and having all the tissue types and characteristics on computer so that if somebody needs a transplantation in Sweden they could get the cells from Italy.”

Valuable resource

Currently, there are about 120,000 samples of cord blood banked at storage facilities worldwide. Cord blood has already been used in about 2,500 transplants with a high rate of success.

So far, banked cord blood has been used only to treat blood disorders.

New research suggests that cord blood cells may be able to form nerves and other tissues but these studies are at an early stage.

“There could be stem cells in there that are still able to be differentiated into different tissue like bone or muscle,” said Holzgreve.

Such a prospect could offer researchers the potential to treat heart disease, Parkinson’s or Alzheimer’s.

Playing on fear

Umbilical cord use, collection and storage raise many controversial issues. The decision hits expectant parents at a vulnerable time and they are forced to weigh the cost against the slim likelihood of actually needing the blood.

“From the scientific point of view, it’s very problematic,” said Basel-based theologian and bio-ethicist, Ulrike Kostka.

“Company advertisements play on the fears of pregnant women and their families. When you read an advertisement which says you can get a biological insurance for your child and it will be cured from chronic diseases in future, of course, you are under pressure.”

Europe’s first private cord blood bank, Vita 34, holds about 12,000 samples in Leipzig, Germany, and is applying for permission to collect in Switzerland.

“We tell parents that the probability that their will children suffer from a severe disease that requires stem cell therapy is very, very low,” said Erich Kunert, head of customer services at Vita 34.

Vita 34 charges €1,800 (SFr2,640) for the preparation of cord blood stem cells and 20 years’ storage.

Meanwhile, there are concerns that a lack of financial resources could leave the concept of an international network of public banks stillborn.

“There is a danger of running into a two-tier system, if society decides to improve the possibilities for private banking and not improve the possibilities for public banking,” said Christoph Rehmann-Sutter, president of the Swiss national advisory commission on biomedical ethics.

Cryogenic storage

Private companies defend their position, arguing that not banking cord blood amounts to throwing away a valuable resource that could be used by that child later in life.

“The cord blood of a baby is so rich in high potential stem cells that it’s really a pity to put it in a waste bin in a clinic,” said Kunert.

“We don’t know today the potential of cord blood stem cells but there’s universal agreement that it might be of great potential.”

swissinfo, Vincent Landon

Key facts

Cord blood public banks are based in Basel and Geneva and currently hold 600 donations.
Cryo-Cell Switzerland, based in Pfäffikon, is Switzerland’s first private bank.
120,000 donations are stored worldwide.
There have been 2,500 cord blood transplants.