Scientists have found that newborn babies have stem cells similar to those in the bone marrow in their cord blood. In 1980s, it was suggested that the blood obtained from cord blood could be collected under certain conditions, stored by freezing and then thawed when needed and used for the treatment of certain diseases.

CORD BLOOD STORAGE
In life in the uterus, the baby is connected to the umbilical cord and the placenta. Placenta is the organ that provides the exchange of nutrients and oxygen between the baby and the mother. Immediately after birth, this organ is thrown out of the uterus by completing its task.

The blood remaining in the baby’s cord and placenta after birth is called ord cord blood ”. The characteristic of this blood is that it differs from the blood circulating in the veins of the baby and contains ”stem cells” which are involved in blood production. Stem cell sources used for stem cell transplantation include bone marrow and circulating blood (peripheral blood) outside the placenta.

The most important feature of stem cells is that they have the ability to transform into any tissue or organ when certain suitable environments are provided.

The purpose of cord blood collection and storage is that it is an important option for the treatment of most severe diseases in children, which may occur with age. Another, perhaps more important, objective is to create on cord blood banks iler in the future and to use these blood according to the tissue types of the people in need – with the consent of the root cell owners.

What does cord blood matter?
There are basically three main types of cells in human blood. These; red blood cells (erythrocytes), white blood cells (leukocytes) and clotting elements (platelets, platelets).

In fact; erythrocytes carry oxygen and carbon dioxide between cells, leukocytes are involved in the functioning of the organism’s immune system, platelets (platelets) are involved in the coagulation of blood with other clotting factors.

All three of these groups of cells arise from the differentiation of a kind of cell called a stem cell in the bone marrow. That is, stem cells in the bone marrow are capable of forming all kinds of blood cells, and this production continues continuously.
Childhood leukemia (blood cancer) and some blood and immune system diseases in the presence of bone marrow can not function as healthy.

On the other hand, treatments such as chemotherapy or radiotherapy used in the treatment of these diseases damage stem cells in the bone marrow. Depending on the type of disease and treatment, bone marrow transplantation is inevitable in some patients. In this case, it is aimed to regenerate healthy blood cells by giving healthy bone marrow and stem cells from a healthy donor which is compatible with the patient’s bone marrow. In such a case, the probability of finding a suitable donor among the patient’s own relatives or even siblings is around 25%.

In the early 1980s, scientists realized that the cord blood of newborn babies had stem cells similar to those in the bone marrow, which led to the idea that these cells from cord blood could be used for the treatment of certain diseases.

Realizing that the obtained cord blood could be collected and frozen under certain conditions and then thawed when needed, gerek Dr.David Harris dond frozen his son’s cord blood in his own laboratory in 1992.

Later, with the opening of this application to the public, the first cord blood bank in the world was established in 1994 in the USA.
In the following years, many cord blood banks were established in the world and the blood of thousands of babies was taken under protection in these banks.

How many types of stem cell transplantation are there?
In the past, the term “bone marrow transplant yerine was used instead of stem cell transplantation. Nowadays, the main name of the process is “stem cell transplantation, and bone marrow is one of the sources where only stem cells are obtained.

There are three types of stem cell transplantation:

1. Allogeneic transplantation: The collected stem cells can be used by another person.
2. Autologous transplantation: Stem cells collected during the healthy period of the patient can be used for future use.
3. Syngeneic transplantation: A patient can give his / her twin brother (single twin) stem cells.
   What is the benefit of storing cord blood?

The purpose of storing blood in cord blood banks is to treat the baby using its own healthy stem cells in the event that the baby develops a disease that requires bone marrow transplantation and thus eliminates the need to search for suitable bone marrow donors. In this way, bone marrow transplantation will not be necessary. In addition, tissue adaptation problem will not be experienced in this way.

Since 1994, only two of the autologous cord blood, which has been stored in cord blood banks around the world and estimated to be 160,000 in total, have been used for autologous transport. One of these two transplants was a failure of stem cell transplantation, a complication of stem cell transplantation, and the patient died of infection. Success was achieved in the other patient.

The reason why autologous transplantation is so rarely performed is that the baby has a chance of developing a genetic disease that can be treated using cord blood in about one thousandth of the future.
Perhaps the most important purpose of stem cell storage is that sayesinde cord blood banks ”can be created in various places thanks to the stored cord blood, and can be used for therapeutic purposes with the consent of the blood owners, if deemed appropriate for others. (Allogeneic transport)

After a certain period of time, perhaps bone marrow transplantation centers will be replaced by cord blood banks.

How long can cord blood be stored?

As the body weight increases as the body weight increases, the number of stem cells in the cord blood is insufficient in the treatment. Therefore, cord blood storage is limited to a maximum of 15 years in accordance with current scientific data and can therefore be used only for the treatment of childhood and early adolescent patients. When people exceed 30-40 kg, these bloods become insufficient again.
Recently, although intensive scientific studies have been carried out for the propagation of stem cells in the laboratory, a routine method has not been found yet.

How is cord blood taken?

First of all, when the cord blood is decided to be kept, at least a few weeks before the expected birth, the relevant laboratory and the physician who will have the birth informed and the necessary preparations should be made. In this way, necessary equipment and documents can be kept ready at birth.
In the procedure, after the baby is born, the umbilical cord is tied and the blood in the first 10 minutes is collected into the bag with the help of a special system.

The collected 40-100 ml of blood is sent to the laboratory within 36 hours, where the stem cells are separated by special methods and stored in nitrogen tanks at -193 degrees.

Who is suitable for storing cord blood?

There are two different opinions regarding this new application.
Some researchers, including the American Association of Pediatrics, advocate this procedure only in infants of couples whose families have a history of disease that may require bone marrow transplantation.

Some researchers suggest that everyone should use this alternative considering the rapid development of stem cell studies. The possibility that future stem cells can be used in different ways in the laboratory supports this kind of approach.
Today, the main diseases that can be treated with cord blood are:

. Childhood leukemia and lymphomas
. Thalessemi (Mediterranean anemia) ***
. Aplastic anemia (absence of cell production in bone marrow)
. Sickle cell anemia
. Amegakaryocytic thrombocytopenia
. neuroblastoma
Since thalessemia is a congenital disease, cord blood of babies born with thalassemia cannot be used by transplanting them to the future. Only in allogeneic transplantations, that is, stem cells from a healthy person can be treated by transplantation to a baby with thalassemia. Stem cells from a healthy person can also be bone marrow.

As indicated in the advertising brochures of some commercial banks, cord blood has no use in the treatment of hereditary diseases (such as thalessemi = mediterranean anemia), in the treatment of hereditary immunodeficiencies (immunodeficiency syndromes) or in the treatment of a number of hereditary metabolic diseases. Because stem cells obtained from cord blood of a baby with hereditary disease cannot be used for treatment of this disease.
The most common area of ​​cord blood stored in childhood is childhood leukemia (blood cancer) and aplastic anemia. The majority of leukemias with an annual incidence of 5 per 100,000 can only be treated with chemotherapy. In addition, if leukemia would require stem cell transplantation to a child with cord blood stored, an allogeneic transplantation with tissue-matched sibling or other donor stem cells is considered as the first alternative for success. (Source: Turkish Hematology Association)
For all these reasons, the cord blood that will be kept is not an bir infant’s life insurance,, it should not be seen as “sine qua non maddi for everyone and can be considered as an alternative only in special cases. Therefore, we recommend that patients receiving the financial situation should keep their children’s cord blood, taking into account possible future scientific developments.

What can happen in the future?

Stem cells in the future are like manufacturing spare parts for an automobile; liver, heart, pancreas, brain, as well as many organs such as hands, arms, feet can be used in the formation of limbs such as limb losses, diabetes, liver, kidney, heart failure, neurological losses (stroke), Parkinson’s, Alzheimer’s disease, in many genetic diseases and cancer treatments, all treatment methods will probably change in this direction.

In the future, we physicians will try to tedavi treat the patient ”rather than tedavi treat the disease”. We are at the beginning of these developments that will take a process.

What are the centers operating with this application?
Cord blood banking has become a service given in our country in the last few years and related companies have started to operate. In this way, the fact that the blood stored in the banks is uygun suitable for autologous use ”, that is, it cannot be used to another patient in need is disadvantageous.

Some of the domestic and foreign corporate banks operating in our country for autologous cord blood banking are as follows:

ONKIM (Istanbul)
Cryobank (California Cryobank, USA)
BabyCord (New England Cord Blood Bank, USA)
Genkord (Istanbul)
Acıbadem Cord Blood Bank (İstanbul)
Life Bank (Ankara)
ATİBANK (Trabzon)
In our country, allogeneic stem cell banks have been established for the purpose of serving people who need tissue type without any commercial purpose. These banks;

Ankara University Faculty of Medicine
Hacettepe University Faculty of Medicine
Trabzon Technology Development Zone (ATİBANK)
How much does it cost to store autologous cord blood?
Cord blood storage is a relatively high cost application. According to the preferred laboratory, the cost of freezing varies between $ 1000-2500. Storage fees are around $ 90-100 per year.