Umbilical cord blood
Umbilical cord blood is the blood that remains in the rest of the umbilical cord and the placenta after birth. Normally, only a few millilitres of this blood are used to measure the baby's pH value and the rest is disposed of with the placenta. The umbilical cord blood can be removed from the umbilical cord without risk to mother and child and stored in an umbilical cord blood bank.

Stem cells
Umbilical cord blood and umbilical cord tissue contain an above-average number of stem cells. Stem cells are not yet specialised cells that have the ability to develop into various specialised cells. The so-called haematopoietic stem cells (blood stem cells) from the umbilical cord blood can develop into cells of the blood and immune system and are comparable to the stem cells of the bone marrow. The mesenchymal stem cells of the umbilical cord tissue can develop into various tissues. Stem cells are used in the treatment of leukaemia, as well as rare hereditary diseases of the metabolism and immune system. The use of stem cells for tissue regeneration is also being investigated as part of research projects in the field of regenerative medicine.

Umbilical cord blood/stem cell transplants
A distinction is made between autologous and allogeneic transplants. In an allogeneic transplant, the umbilical cord blood/stem cells come from a person other than the person to be treated. In autologous transplantation, the umbilical cord blood/stem cells come from the same person. It is important to know that cells donated from a healthy person are often preferable to the patient's own cells, as the patient's own cells can be carriers of genetic or acquired diseases.

Collection and use of umbilical cord blood
At the parents' request, the umbilical cord blood can be collected after the umbilical cord has been cut and the stem cells isolated from it for storage in a blood bank. Before storage, the blood is tested for infectious diseases and the tissue characteristics are determined (HLA typing). The stored umbilical cord blood can later be matched with a potential recipient and used for stem cell therapy. The advantage of this is that the stem cells from the umbilical cord blood are still immature and therefore rejection reactions occur less frequently in the event of a donation and the tissue characteristics of the donor and recipient do not have to be matched as closely. The disadvantage is the small quantity of stem cells, which means that adults are rarely considered as recipients and usually only children. In recent years, it has sometimes been possible to combine two suitable umbilical cord blood donations for a transplant and thus use them for an adult person.

Private umbilical cord blood banks
There are a large number of cord blood banks in Switzerland that offer both cord blood storage and the storage of umbilical cord and placental tissue. If parents are interested in storage, they must contact the private providers during the pregnancy. The costs are to be borne by the parents and vary according to the extent of the storage and the duration. The umbilical cord blood from the private banks can be used for an autologous or a directed allogeneic transplantation (usually donation within the family).

Public umbilical cord blood banks and umbilical cord blood donation
The University Hospitals of Geneva and Basel operate public blood banks. Expectant parents can donate umbilical cord blood after the birth in various university hospitals. There are no costs involved. The donation undergoes the necessary tests and is then stored pseudonymised and registered in a globally networked blood stem cell register database. The umbilical cord blood from the public banks is usually used for an allogeneic transplant. In Switzerland, a pilot project is also underway at the Inselspital Bern to set up a so-called hybrid umbilical cord blood bank. The umbilical cord blood is stored privately but registered in international databases. If a recipient is found, the parents can decide whether to donate the umbilical cord blood and then have the costs reimbursed.

Sources:
www.nabelschnurblutspende.ch
www.bag.admin.ch
Recommendations of the Council of Europe on the storage of umbilical cord blood, guide for parents. The document is also available in English and French.
www.blutstammzellspende.ch