Practical Blood Bank. Cord Blood. Lab 11. Umbilical cord. In placental mammals, the umbilical cord is the connecting cord from the developing embryo or fetus to the placenta. During prenatal development, the umbilical cord is physiologically and genetically part of the fetus
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In placental mammals, the umbilical cord is the connecting cord from the developing embryo or fetus to the placenta.
During prenatal development, the umbilical cord is physiologically and genetically part of the fetus
In humans normally contains two arteries (the umbilical arteries) and one vein (the umbilical vein), buried within Wharton's jelly.
The umbilical vein supplies the fetus with oxygenated, nutrient-rich blood from the placenta. Conversely, the fetal heart pumps deoxygenated, nutrient-depleted blood through the umbilical arteries back to the placenta.
Wharton's jelly is a gelatinous substance within the umbilical cord, largely made up of mucopolysaccharides (hyaluronic acid and chondroitin sulfate). It also contains some fibroblasts and macrophages.
As a mucous tissue it protects and insulates umbilical blood vessels.
Wharton's jelly is a potential source of adult stem cells (also see the more common method of storing cord blood).
A lowpH (less than 7.04 to 7.10) means there are higher levels of acids in the baby's blood. This might occur when the baby does not get enough oxygen during labor. One reason for this could be that the umbilical cord was compressed during labor or delivery.
A bloodculture that is positive for bacteria indicates septicemia.
High levels of blood sugar (glucose) in the cord blood may be found if the mother has diabetes. The newborn will be watched for hypoglycemia (low blood sugar) after delivery.
A cord sample (about 5 to 10 mls) should be taken from the babies of RhD negative women, women with knownantibodies or in cases where there is insufficient documentation of maternal blood group or antibody status.
The cord sample should be tested for blood group and direct antiglobulin test.
Haemoglobin and bilirubin estimation should also be performed if DAT is positive.
When the cord blood is RhD negative, it is recommended that testing for the presence of the weak RhD antigen by the indirect antiglobulin test be performed. If positive, RhD immunoglobulin is indicated. If the direct antiglobulin test is positive, it may indicate fetomaternal incompatibility
Antibody elution from the neonatal red cells can be performed to confirm the identity of the antibody coating the cord red blood cells.
When haemolytic disease of the newborn is suspected, Hb, blood group, direct Coombs and bilirubin must be checked. Otherwise cord blood samples are not routinely tested though some collect the samples and store them for up to a week at 4°C in case they should be needed.
When the direct Coombs is positive, Rh typing must be confirmed and the coating antibody identified.
The initial Rh typing will sometimes be found to be incorrect when the direct Coombs is positive, due to interference by the antibody.
Most hospitals routinely collect cord blood for testing at birth, since it is relatively convenient and the onlytime possible to collect such blood.
Besides cord blood testing, cord blood can be used to treat certain types of bone marrow-related cancers. Some parents may choose to save (bank) their child's cord blood for this and other, future medical purposes.
Cord blood banking for personal use is done by privatecompanies, which charge for the service. Cord blood can also be donated to your local blood bank for use by others as needed to treat leukemia and other cancers.
Cord blood is rich in potentially life-saving stem cells. When they are transplanted, those stem cells are effective for the treatment of patients with diseases of the immune system (e.g., immunodeficiencies), blood (e.g., leukemia and sickle cell anemia) and selected metabolic disorders.
The umbilical cord, placenta, and the blood they contain have no function after birth and they end up in waste. If exploited, this resource can be used for the good of the whole community.
Stem cells in the cord blood similar to those found in bone marrow. This is why cord blood can be used for transplantation as an alternative to bone marrow.
Stem-cell transplants have advantagesover bone marrow transplants in the treatment, with a lower risk of tissue rejection. The collection process is noninvasive, and involves a simple blood transfusion.
The most common disease category has been leukemia. The next largest group is inherited diseases (of red blood cells, the immune system and certain metabolic abnormalities.)
Patients with lymphoma, myelodysplasia and severe aplastic anemia have also been successfully transplanted with cord blood.
It is not known how long cord blood can be stored in liquid nitrogen and its cells remain viable.
NCBP's earliest units were stored in 1993. In checking the viability of cells in cord blood units that will not be used for transplantation, they did not detect any deterioration in the quality of the cells in cord blood units stored for up to 16 years.
Units stored for up to 13 years have been used in transplants and the outcomes have been similar to those of newly collected units.
The Cord Blood Bank is responsible for collection of the blood.
However, the related authorities (delivery doctors, nurses) must be aware of the mothers’ wish to donate or store Cord Blood after the birth.
Minutes after a child’s birth and after the umbilical cord is cut, the placenta and its attached portion of the cord are delivered With maternal assent to collect the cord blood,
staff move the placenta to an adjacent laboratory, where they collect the cord blood into a sterile plastic bag, much like those used for blood transfusion.
Because they collect cord blood from the delivered placenta, no risk is incurred by mother or child.
explains all aspects of the Program to the mother and requests her consent to donate the cord blood. Donation of the blood from a single placenta becomes a unique cord blood unit.
The volume collected varies but usually ranges from 50 to 200 ml (about one-half to one cup).
The cord blood is frozen and stored in liquidnitrogen freezers designed especially for cord blood units.
The BioArchive is a robotic freezer that controls and monitors the rate of freezing, then stores the unit in liquid nitrogen and provides quick access to stored units
whenever needed, all under computer control and with complete documentation.
When a transplant center requests a matched cord blood unit for a patient, the available inventory of cord blood units is “searched” for matches to the patient. The best matching unit (or units) can be selected, reported, confirmed and delivered rapidly upon request.
Each cord blood unit is frozen (one at a time) in an individual “controlled-ratefreezer” module within the BioArchive™ system. We use a freezing rate documented to maintain cellviability. A record of the freezingcurve is printed and maintained in the BioArchive™ computer memory.
Several studies indicate that cord blood transplants do not need to be as perfectly HLA-matched to the recipient as bone marrow transplants do. However, patients have a better chance to survive and regain health if the cord blood graft is better matched (6/6 or 5/6) and provides cell doses of 20 million nucleated cells per kg or more.
Cord Blood Unit Match Reports: An individual Match Report gives detailed information about the cord blood unit, including number of total nucleated and CD34+ cells, ABO and Rh blood groups and results of other laboratory tests.
The match referred to is required between the donor’s and recipient’s HLA antigens. The closer the match is, the better is the body’s chance of accepting the new stem cell.
Cord and mother’s blood samples are kept, frozen, and may be used in the future, even years after the baby’s birth. We must plan for the possibility that new tests for infectious or genetic diseases will be developed for which the cord blood must be tested in order to protect a transplant recipient from risk.