International Journal of Scientific Research and Innovative Technology ISSN: 2313-3759 Vol. 5 No. 1; January 2018
Umbilical Cord Blood Banking and its Therapeutic Uses
, Imesha Rashmini Rathnayaka
, Rashida Shabbir
, Sasini Sandareka Wimalsinghe
J. A. Sumalimina Jayakody
, Mahisha Chandrasekaran
International College of Business and Technology, Biomedical Science Department, No 502A, R. A. De Mel
Mawatha, Sri Lanka
Fax: +94 11 4203170
Author Nivethika Sivakumaran E-mail: firstname.lastname@example.org,Mobile No. - +94771048206
Author Imesha Rashmini Rathnayaka E-mail: email@example.com, Mobile No. -+94775349616
Author Rashida Shabbir E-mail: firstname.lastname@example.org, mobile No. - +94774319976
Author SasiniSandarekaWimalsingheE-mail: email@example.com,Mobile No. - +94764359634
Author J. A. SumaliminaJayakodyE-mail: firstname.lastname@example.org, Mobile No. - +94768925901
Author MahishaChandrasekaranE-mail: email@example.com, Mobile No. - +94752970463
*Funding Organization: This Literature Review article is funded by International College of Business and
Technology,No 502A, R. A. De Mel Mawatha, Bambalapitiya, Colombo 04, Sri Lanka.
International Journal of Scientific Research and Innovative Technology ISSN: 2313-3759 Vol. 5 No. 1; January 2018
Umbilical cord blood (UBC) can be viewed as the most promising source of stem cells, in which collection
cost is minimal and its benefits are immense. The cord blood is used to treat malignant and nonmalignant
diseases; this is due to its progenitor characteristics know as stem cells.
Its properties of being, immunologically immature and high plasticity has made it superior to other sources of
stem cells. The stem cells collected from cord blood have neutral differentiation capabilities which allow
medical professionals to produce functional neural cells from these stem cells.
Cord Blood Banking (CBB) is the storing of the umbilical cord blood which is collected immediately after the
delivery of the baby. Great care and concern is needed for proper storage of these progenitor cells, hence
cord blood banks come into the play, they are of 3 types which are: public, private and direct donation banks.
Clinical trials are still at its very early stages having abundances to still be uncovered but results being
obtained have demonstrated high potential and more scope towards effective development therapies and
treatments for rare disorders.
Key words: umbilical cord blood, germ line layer, progenitor characteristics, cord blood banking, stem cells,
pluripotent, therapeutic uses
Abbreviations: UCB-umbilical cord blood; CBB- cord blood banking; EPCs- endothelial progenitor cells;
MSC- mesenchymal stromal cells; USSC- unrestricted stomatic stem cells; VSEL- very small embryonic-like
stem cells; MLPC- multi lineage progenitor cells; DNA- deoxyribose nucleic acid; HES- hydroxgethyl starch;
RCB- residual cancer burden; HLA - human leukocyte antigen; NC- natural killers; WBC- white blood cells;
NPBI- non protein bound iron; NC- natural cell; GvHD- graft vs host disease; MNCS- mono nucleated cells;
RBC- red blood cells; TNC- total nucleated cell; CD133,CD34,CD45- commonly used markers of
Hematopoetic progenitor cells and endothelial cell (Cluster of Differentitation; GMO- granulocyte
International Journal of Scientific Research and Innovative Technology ISSN: 2313-3759 Vol. 5 No. 1; January 2018
The umbilical cord is thin, long tube-like structure highly composed of muscle that is needed to form a
connection between the fetus and the placenta, in the mother’s uterus. To provide sufficient and effective
circulation of the blood to the growing fetus, the umbilical cord has one vein which carries oxygenated rich
blood and two arteries which carry deoxygenated blood. These 3 blood vessels coil around the vein in a helical
configuration to form the umbilical cord (Sadler, 2006)
After birth, the blood in the umbilical cord can be collected in two ways, either by a syringe or bag method
(Phuc Van Pham, 2014). The cord blood is used as an alternative to bone marrow to restore immunological
dysfunctions and for transplantations. This blood is found and collected from the umbilical cord in new born
infants (Weiss, 2006).
Present statistics have proved that nearly 80 diseases can be completely cured using umbilical cord blood stem
cells and over 50 000 transplants have been successfully carried out worldwide. Some of the diseases cured
are cancers and blood disorders which had so far always resulted fatal to many affected (Roura, 2015).
The properties of stem cells remain unknown, but their importance is beyond description. The cells in the
umbilical cord are unaffected by the external environment, and can effectively differentiate into many types of
cells. Life threatening disorder such as thalassemia can be cured with this stem cell, around the world there are
27 million babies affected with blood disorders which can now be cured with the use of the umbilical cord
stem cells. The umbilical cord blood is used to cure disorders and diseases for an individual to whom the
umbilical cord belongs to, therefore it is assured that there is no mismatching or rejection by the body, like in
many cases, people with rare blood groups find it difficult to find a matching donor. This major problem is
solved when umbilical cord blood stem cells are used. There is no counter effect after the treatment. Another
important factor to consider is that, if harmful diseases are not cured over generations, the threat is higher and
become public concern. Resulting in the wide spreading of the diseases and increase in numbers affected.
When such a disease is cured with umbilical cord blood stem cells, the effect of it being passed on is reduced
and therefore works towards making the disease endemic (Carroll, 2015).
2. Extraction and preservation of umbilical cord blood
There are different methods for both preservation and extraction, but parents are not often given the choice of
choosing what they like. Whether it be donating for a government hospital or storing in a private cord blood
for personal medicinal purposes.
The sole purpose of processing is to separate stem cells from the cord blood so that a sample is produced that
can be used safely (Cord Blood Banking – How Baby’s Cells are Extracted & Stored? | LifeCell, 2017).The
separation and the processing of UCB samples that are present in a greater volume intended for storage in cord
blood banks use a partially automated system to make sure that the large numbers of samples are processed
efficiently. A closed system is usually used to reduce the risk of any bacterial infection due to a contamination.
This processing method allows the recovery of nucleated cells and progenitors adequately to enable the
engraftment procedure(Saunders Comprehensive Veterinary Dictionary, 2016).
Early studies have shown that the use of density gradient techniques to separate cord blood leads to the loss of
mononuclear cells. This proves that cord blood should be stored in an unseparated manner. Even though
reduction of volume is more economical and efficient. There are several different methods that are used to
reduce the volume so as to prevent loss of progenitor cells during cryopreservation (Saunders Comprehensive
Veterinary Dictionary, 2016). Such as, density gradient separation that is used for separating particles such as
DNA where the sample will be placed on a preformed gradient like sucrose or cesium chloride ,
sedimentation of red cells by gelatin, rouleaux formation induced by hydroxyethyl starch (HES) where the
volume of cord blood can be reduced by enhancing sedimentation of red cells by rouleaux formation that
is induced by a strong sedimenting agent like 6% hydroxyethyl starch (Hespan), centrifugation, and
differential centrifugation with expression of RCB and plasma.
Midwives who are trained in collecting cord blood, covering a period of 24 hours. At the time of delivery; sex,
weight and condition of the infant is normally learned. The cord is then being doubly clamped and transacted
within 10– 30 seconds after the delivery of newborns. To ensure sterility the free end of the cord is wiped in
betadine(Cord Blood Banking – How Baby’s Cells are Extracted & Stored? | LifeCell, 2017).
When the placenta is still inside the uterus, the umbilical vein is punctured, and cord blood is collected using
the gravity in the collection bag. If the birth of the baby is caesarean section or it is a multiple birth, the UCB
is collected from the placenta that is removed. No matter the birth type, always a maximum effort is taken to
obtain the highest possible amount of UCB. From the collected UCB, 20ml of the venous blood that was
obtained is frozen at−80°C. The other amount of UCB units that was stored in 4°C be transported, with all the
related paperwork and is processed within 24 hrs. The collected amounts of UCB units are then calculated
excluding the weight of the bags(Dı´az, 2000).
Several different tests should be run of the collected UCB; therefore, 3ml samples are taken for HLA typing,
Nucleated cell (NC) count, CD34+ cell count, Progenitor cell assays, Tests for fungal, aerobic and anaerobic
bacteriology cultures. The UCB unit will be transferred to a 150-ml bag and the HES solution will be directly
added to the collection bag under sterile conditions which has a proportion of 2:1 of washing the bag before
mixing it with the cord blood. The UCB units will be first centrifuged at 40 g for 5 minutes; because of this
the WBC (White Blood Cells)-rich supernatant is expressed by the NPBI (Non-Protein Bound Iron)Compomat
G4 system into the original collection bag. A second centrifugation will be done at 400 g for 10 minutes where
the plasma is discarded into a satellite bag. After these centrifugations, the remaining volume of UCB units
has a mean volume of 27 ml of WBC and plasma. The process is performed in a closed system with the use of
sterile connecting devices to reduce bacterial infections due to contamination. The NK (Natural Killer) and
CD34+ cell estimations are repeated using the pelleted fraction so that there is a monitoring of the quality of
the process. WBC amounts present in the collecting bag is transferred to a freezing bag(Dı´az, 2000).
Cryopreservation of the cord blood is done by cryopreservation of processed UCB units in an automated
microprocessor-controlled rate freezer. After the WBC is chilled the cold freezing cryopreservative solution
containing 60% DMSO is added drop wise for 15 minutes. Samples for quality control of cryopreservation
procedure is then extracted before freezing and cryopreserved into cryotubes with the bag. The cells will then
be immediately placed inside aluminium cassettes in the chamber of the cell freezer, that uses two
thermocouple probes placed in a sample containing the freezing solution (M-Reboredo N, 2000).
The cryopreservation methodology is by 1°C/min cooling down to −60°C, followed by a drop to −120°C,
At the end of the freezing procedure the cells are stored in liquid nitrogen freezer. Immunophenotyping of the
CD34+ cell estimation iscarried out on the whole blood before starting the processing and the volume
reduction. The CD34+ cell number is calculated on the amount of the WBC units present after the
3. Advantages of Cord Blood Treatment
The collecting procedure of cord blood is simple and has no medical risk to the mother or newborn baby. The
midwives and the responsible staff collects the cord blood from the placenta and then sends it for processing.
The cord blood is collected in advance therefore there is plenty of time to test it and for storage and make sure
that it is ready use when needed( Advantages and Disadvantages of Cord Blood Treatment, 2017)].
Perhaps one of the most important advantage is that cord blood transplantations do not require a perfect match
(HLA typing). Research studies have shown that cord blood transplants can be performed in cases that the
donor and the recipient are partially matched. This is because even the partially matched cord blood
transplants can be performed where cord blood increases the patient’s chance to find a more suitable donor.
An estimated number of example, that a national inventory of 150,000 cord blood units that would provide
acceptable matches for at least 80-90% of United States patients (Are there and unfavorable aspects of cord
blood? - National Cord Blood Program, 2017).
Umbilical stem cell cord blood promises to provide the solution to many critical medical conditions. Most
cord blood transplantation has been associated with lower rates of GvHD (Graft vs Host Diseases)(Are there
and unfavorable aspects of cord blood? - National Cord Blood Program, 2017).
4. Disadvantages of Cord Blood Treatment
The volume of cord blood collected is relatively small therefore the quality stem cells that are used for
transplantation much less than that in peripheral blood or bone marrow. If the average total nucleated cell dose
(number of nucleated cells per kilogram of the patient's weight) in a cord blood is less than about 1/10th of the
average bone marrow then as a consequence, the engraftment (the return of nucleated blood cells, red blood
cells and platelets) to the patient’s blood is slower with cord blood than with bone marrow transplants. This is
a major problem for adults and adolescents because they need more quantity of stem cells for transplantation
Cord blood transplantation can exposethe patient to one of the rarest genetic disorders of the immune system
or blood. This disorder is not detectable while testing the cord blood sample, but it remains (What are the
advantages of cord blood? - National Cord Blood Program, 2017).
The donor cord blood stem cells that are donated by a newborn baby are unavailable for an extra donation of
cord blood. Therefore, if by any chance the first cord blood unit fails, then a second unit should be obtained
from a different donor.
The American Academy of Pediatrics’ says that the chance of a baby needing its own stored cells is
approximately 1:1000 to 1:200,000. Therefore, private blood banking is a waste of money and resources
( Advantages and Disadvantages of Cord Blood Treatment, 2017).
5. Comparison between old and new methods of extracting and preserving umbilical cord stem cells
5.1. Early extraction methods
The collected cells were cultured in a dish and then transplanted into mice, ex vivo expansion and then in vitro
transplantation. Once the cells were grown, they were spun in a centrifuge in order to spin them down to
separate and extract them. A major limitation observed in this method was that too much plasma contents were
collected with not enough MNCs (Mono Nucleated Cells) and no reliable way to concentrate and isolate stem
5.2. Modern extraction methods
The modern methods derived by doing the similar steps in an automated way. The cord blood is first separated
into several layers such as a layer of RBCs (Red Blood Cells), a layer of plasma and an in between layer
which is known as the Buffy layer. Buffy layer is known to be rich with white blood cells and most essential
stem cells. Then a suitable processing method is used, to help better separation of cord blood into these
multiple layers, allowing for easier extraction of more stem cells (Hussain, 2012).
Five separation methods used are Plasma Depletion, Density Gradient, Hetastarch, PrepaCyte and Automated
centrifugal machine (Kawasaki-Oyama, 2008).
Currently the PrepaCyte is the latest and best used proprietary method. It is very similar to the closed method
but uses a machine (Basford, 2010).
As it is known umbilical cord blood (UBC) is a rich source of stem cells which can be used to treat diseases.
However, earlier, this cord waste discarded as waste material as its properties were hidden. For these stem
cells to come into use the umbilical cord blood has to be collected and stored for use when needed. These cells
can easily lose their differentiable properties by external conditions if not looked into carefully (Hua, 2013).
Shortly after the delivery of the baby, the blood from the umbilical cord is collected using a syringe and
cannula and collected into a bag containing antibiotics and other necessary elements for keeping the blood safe
until it is correctly preserved. This is called the closed technique of collection since the umbilical cord is not
cut or disturbed in order to collect the blood(Hussain, 2012).
Cryopreservation techniques are then used to store the blood in blood banks – public and private.
Cryopreservation is the use of extremely low temperatures maintained in order to preserve the structure of
intact living cells, along with creating a stable environment through which the cells can be preserved and
stored for future use. This method is considered most easy and reliable (Keiger, 2011).
In order to collect large number of stem cell the extraction process must be entirely or partially automated.
This closed system to its maximum extent prevents the possible happenings of bacterial contamination after
collection and before storage.
It is also needed that maximum number of nucleated cells and progenitors to enable engraftment. This was the
disadvantage seen in early separation techniques by density gradient techniques which resulted in the loss of
mononuclear cells; hence the modern methods derived which suggested that storing the cord blood before
separation. But this too is not the most ideal method as it is essential for minimum volume to be stored in cord
blood banks as only then will it be economical and efficient (Beeravolu, 2017).Yet, the modern methods are
being updated in order to reduce the volume to be stored along with reducing the loss of progenitor cells.
Some modern methods are density gradient separation; sedimentation of red cell by gelatin, rouleaux
formation induced by hydroxyethyl starch (HES) and centrifugation, and differential centrifugation with
expression of RCB and plasma (M-Reboredo N, 2000).
Finally having an optimal yield of mononuclear cells is the most important aspect of UCB collection. Along
with considering the factors which influence the amount of fetal blood which is actually remaining in the
placenta and umbilical cord after clamping and dissection (M-Reboredo N, 2000).
From this understanding it is easy to understand the advantages of modern extraction and preservation
methods. Firstly, currently the entire segment of the umbilical cord is stored, and this helps to preserve many
varied types of cells which can be used in future therapies including cell types such as mesenchymal stem
cells, endothelial cells, perivascular cell, growth factors and proteins and epithelial cells which all can be
found in parts of the stored segment. It also processes the cord blood after preservation and this helps is
treating a wider range of treatments and able to be used for more clinical applications as the stem cells will be
more accepted in such cases. Also, cord blood is stored in over 6 vials which helps in samples being thawed
independently at different times and also allows the potential for multiple therapeutic uses (Taghizadeh, 2017).
Since UCB is known to have higher frequency of progenitor cells, and higher number of early and committed
progenitor cells, their ability to form colony forming units’ granulocyte macrophage CFU-GMO is highest.
Along with this property they also have non-hematopoietic stem cell and other cell type precursors (Basford,
Although UCB stem cells are known to have many benefits in transplantations one major disadvantage is the
low amount of total nucleated cell (TNC) number able to be collected from a single unit. Factors such as unit
size, number of previous pregnancies, age of mother, limited volumes available for collection from each
sample, and processing methods used, affect for the total collectable cell count. Hence, in order to actually
make cord blood banking a more practical option, more efficient processing method should be
7. Therapeutic uses of umbilical cord blood
Umbilical cord blood of human is a rich source of hematopoietic stem cells, totipotent cells and pluripotent
cells. These cells provide outstanding health treatments in medical industries. The stem cells in the cord blood
has the capability to develop into different type of cells so they can produce organ specific tissue in special
conditions, so cord blood is termed as regenerative medicine. UCB is a good hematopoietic source and
perhaps one of the most important cells that could be derived from UCB is Natural Killer cells. These cells can
kill different targets such as cancer or virally-infected cells without any prior activation(Lubin BH, 2007)
Umbilical cord blood is cryopreserved for future use related to most medical conditions and disorders due to
its lifesaving properties. It is also used for developing the therapies for incurable diseases. Some of the
diseases cured are cancers and blood disorders which are considered to be fatal diseases (Moghul, 2013).
Umbilical cord blood solves many problems in the medical field as there are no counter effects after treatment.
It also helps to recover from the harmful diseases which are not cured over generations as when these genetic
disorders are cured then they do not pass on to next generation. Diseases such as Alzheimer’s, Arthritis,
Asthma, Cancer, Diabetes, Heart diseases and Strokes can be completely eradicated from a family history if
cured using umbilical cord blood. It is a prevention method from the genetic disorder being passed down to
the following generations(Moghul, 2013).
Like cord blood, the cord tissue which is termed as Wharton’s jelly is found in the umbilical cord. This
Wharton’s jelly with Poly-Vinyl Alcohol is useful for mainly treating the skin wounds for humans
(Mothersofchange.com, 2012). There is so much difficulty and failure when therapies are used for healing the
chronic skin wounds. Examples for some conditions that treated with stem cells are mentioned in the Table 1
Table 1: Examples of Conditions Treated with Stem cell Transplants. The table provides a brief understanding
about different types of cancers, blood disorder, congenital metabolic disorders and immunodeficiencies
which can be treated using stem cell transplants.
Cancers Blood disorders Congenital metabolic
Sickle-cell anemia Adrenoleukodystrophy Adenosine deaminase
Fanconi’s anemia Gunther’s disease Wiskott-Aldrich’s
Thalassemia Gaucher’s disease Duncan’s disease
Evan’s syndrome Hurler’s syndrome Ataxia-telangiectasia
Neuroblastoma Congenital cytopeni
a Hunter’s syndrome DiGeorge’s syndrome
Hodgkin’s disease Aplastic anemia Krabbe’s disease Myelokathexis
Sanfilippo’s syndrome Hypogammaglobuline
Burkitt’s lymphoma Amegakaryocytic
Tay-Sachs’ disease SevereCombined
Wharton’s jelly serves as a good source to heal the wounds as they have the properties like high plasticity,
proliferative, differentiation capability, and also low immunogenicity.
This umbilical cord blood has the capacity to differentiate into blood due to the composition of increased
count of hemoglobin, hematocrit, leukocytes, reticulocytes, and nucleated (immature) red blood cells with
presence of immature white blood cells (G.H. Mamoury, 2003). Therefore, that the cord blood collected from
the newborn infants is used as an alternative to bone marrow in transplantations and to restore immunological
dysfunctions (Waller-Wise, 2011).
The hematopoietic stem cell is the main composition of the cord blood which has the capability to differentiate
into blood and also, they are known to have the antigens CD133, CD34 and CD45 they can be induced during
in vitro differentiate in too many linages such as erythroid, megakaryocytic and monocyticetc (Roura, 2015).
Mesenchymal stem cells derived from cord blood has high morphological and also molecular similarities
when compared to mesenchymal stem cells derived from the bone marrow. They are being used in medical
industry due to their potential of rapid multiplication (Roura, 2015). The mesenchymal cell is used for
growing in popularity due to its properties like immunomodulatory, anti-inflammatory and tissue regenerative
properties (Lubin BH, 2007).
Neurons cannot be regenerated but mesenchymal stem cells make it possible where it can regenerate or
replace the damaged neurons and also increases the myelination of axons. It mainly helps to reduce apoptotic
cell death by maintaining homeostasis. During transplantation people suffer due to rejection of the
transplanted organ by the body so this MSCs controls the immune cells and prevents the inflammation and
rejection caused due to transplantation. MSCs can also replace and repair the blood vessels so they are termed
as potential therapeutic remedy for the patients suffering from stroke (Hamad Ali, 2012).
Multipotent non-hematopoietic stem cellsare the final type of stem cells found in the cord blood. These cells
can differentiate in cell surface markers and various other cells which represent the three germ layer cells
The umbilical cord blood banking is used mainly in order to treat the genetic diseases caused which cannot be
cured by the normal treatments. Many diseases are treated using the cord blood stem cells because these cells
have the potential to transform into the differentiated cells needed by treating these cells in specialized cell
culture medium so that, it can even develop into a specific organ tissue needed. This is the main reason for the
banking of the umbilical cord blood (Hua, 2013).
When there is a disease in the first-born baby then the cord blood obtained from the birth of next baby can
help to overcome the disease likewise that cord blood obtained can be also used for the same child if there is
any inherited genetic disorder, so the banking of the umbilical cord blood plays an important role. As this cell
has the potential to differentiate into non-hematopoietic tissue such as cardiac, neurologic, pancreatic and skin
tissues due to the presence of pluripotent stem cells so it can be used to treat the diseases like bone marrow
failure, hemoglobinopathies, immunodeficiency, and also the inborn errors of metabolism. This is the main
therapeutic use of UCB banking in the clinical or medical field (B. Anthony Armson, 2015).
There is both public and private banking to preserve or to store the umbilical cord blood. Mostly public bank
is recommended by the clinicians as there is no fee required for the public cord blood banking and it does not
work for any profit. Also, unrelated transplantations are possible to help the people who are actually in need of
it. Public cord blood bank is considered to be easily accessed by the public and also involves direct donations
of cord blood (CryoCell International, 2017) (Virginia P. Studdert, 2011).
Even though private bank is not mostly recommended it also plays an important role in some aspects. It can be
mainly accessed only for family use also it is suggested as a good choice to get rid of hereditary diseases. This
is not easily assessable for public so it can be preserved for related transplantations because only the donor has
all the rights on their cord blood unit (Wharton’s Jelly: Miracle Tissue, 2017).
The umbilical cord blood was discarded as a waste material but today it is considered to be a regenerative
medicine in order to produce the organ tissues (Hua, 2013) This cord blood collected from the umbilical cord
is composed of mesenchymal stem cells, hematopoietic stem cells and also multipotent non-hematopoietic
stem cells which has therapeutic uses as these stem cells are used to treat cancers, blood disorders, congenital
metabolic disorders and immunodeficiencies (Roura, 2015). Cord blood also contains some non-hematopoietic
stem cells like EPCs (endothelial progenitor cells), MSC (Mesenchymal Stromal Cells), USSC (Unrestricted
Somatic Stem Cells),VSEL (Very Small Embryonic-Like stem cells), MLPC (Multi Lineage Progenitor
Cells), and neuronal progenitor cells. Mostly the transplantations of bone marrow require surgery to obtain
from the donor and also causes rejection but when the transplantation is performed with umbilical cord blood
then it prevents the rejection of transplanted organ and also no need of surgery to obtain the cord blood
Like umbilical cord blood Wharton’s jelly is also derived from the umbilical cord blood which is a rich source
of mesenchymal stem cells. Wharton’s jelly is a gelatinous tissue within the umbilical cord which forms the
umbilical cord matrix in order to cover the veins and arteries of umbilical cord. This Wharton’s jelly is used in
healing of chronic injuries (Zoe, 2016) Cryopreservation is followed to preserve cord blood and Wharton’s
jelly as it is an easy and reliable method (Basford, 2010).
The collection of the cord blood is the important process in the banking of umbilical cord blood which takes
only some minutes. The collection of the cord blood is done during the delivery by clamping the umbilical
cord. Once when the umbilical cord is clamped it is wiped with an antiseptic and then a needle is inserted in
order to obtain 60 ml of the cord blood early clamping should not be followed as it leads to anemia (Pegg,
There are two different types of umbilical cord blood bank banks which is very familiar they are public cord
blood bank and private cord blood bank. There is also another one as direct donation cord blood bank
(Wharton’s Jelly: Miracle Tissue, 2017).
The cord blood has a small chance to be used by the donor so it is better to store it in a public bank as it can
save a life. In addition, many legal and ethical aspects must be considered in private cord blood banking. It is
said to be a biological insurance stored for the future family use as it is regarded as the once in a life time
opportunity many of them chose this option(Buatovich, 2016).
USA pioneered in the umbilical cord blood banking. USA has twenty-eight Public cord blood banks and
twenty-nine private cord blood banks (Disadvantages of Cord Blood Banking, 2017). UK also implement both
Private and Public Cord Blood banking and there are two public Cord blood banks and six Private cord blood
banks in UK. There are no any Public cord blood banks in the Egypt all of them are private cord blood banks,
there are five private cord blood banks in Egypt which are established by other countries such as UK,
Switzerland and India. Whereas there is an Egyptian private cord blood bank named as cell safe bank
(Disadvantages of Cord Blood Banking, 2017). South Africa being prominent country in African continent,
has three private UCB Banks.Singapore a well-developed country in Asian continent has only one public cord
blood banks. India, as a developing country plays a major role in cord blood banking. India has four public
cord blood banks and fourteen private cord blood banks (Seah, 2014). Sri Lanka is about to establish a Cord
Blood Bank. This will be available at National Blood Centre under the guidance of Dr.
Only 0.04% of the stem cell used by the same donor and only 0.07% is used for the familial usage such as for
siblings. Even though this reduces 50% of the risk of graft versus host diseases private bank cost additional $
1,374,246 for each year . More than 600000 UCB units have been stored in world wide. But only >30000
transplants have been performed. Even though there are more than 20 million Adult volunteer donors
registered in National Marrow Donor program (Karen K. Ballen, 2013).
International College of Business and Technology (ICBT) No. 36, De Kretser Place, Bambalapitiya, Colombo
04, Sri Lanka and the Department of Biomedical Science at ICBT is gratefully acknowledged for all the
Support and Encouragement.
1. Advantages and Disadvantages of Cord Blood Treatment. (2017). Retrieved December
2. Are there and unfavorable aspects of cord blood? - National Cord Blood Program. (2017). Retrieved
December 20, 2017, from ationalcordbloodprogram.org:
3. Basford, C. F. (2010). The Cord Blood Separation League Table: a Comparison of the Major Clinical
Grade Harvesting Techniques for Cord Blood Stem Cells. International JournalofStemCells,3(1),32-
4. Beeravolu, N. M.-C. (2017). solation and Characterization of Mesenchymal Stromal Cells from
Human Umbilical Cord and Fetal Placenta. Journal of Visualized Experiments,. 122. .
5. Buatovich, M. (2016, December 17). Beyond the Dish. Retrieved June 29, 2017, from Hematopoietic
stem cells: https://beyondthedish.wordpress.com/tag/hematopoietic-stem-cells/
6. Butler, M. a. (2011). Umbilical cord blood banking: an update. ournal of Assisted Reproduction and
Genetics, 28 (8), 669-676. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170109/
7. Carroll, P. a. (2015). New and underutilized uses of umbilical cord blood in neonatal care. Maternal
Health, Neonatology and Perinatology, 1
8. Chang, Z. H. (2014). Umbilical Cord Wharton’s Jelly Repeated Culture System: A New Device and
Method for Obtaining Abundant Mesenchymal Stem Cells for Bone Tissue
9. Cord Blood Banking – How Baby’s Cells are Extracted & Stored? | LifeCell. (2017). Retrieved
Decmber 20, 2017, from Lifecell.in.: https://www.lifecell.in/blog/cord-blood-banking-%E2%80%93-
10. CryoCell International. (2017). Retrieved December 20, 2017, from Cord Blood Processing-Why the
processing method for cord blood matters: https://www.cryo-cell.com/why-bank-stem-cells/the-
11. Detamore, M. Human umbilical cord mesenchymal stromal cells in regenerative medicine. Stem Cell
Research & Therapy, 4 (6), 142.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029508/
12. Dı´az, N. M.-R. (2000). Collection, processing and cryopreservation of umbilical cord blood. Nature ,
13. Disadvantages of Cord Blood Banking. (2017). Retrieved December 20, 2017, from Epigee.org:
14. Fadel, H. E. (2009). Cord Blood Banking: Ethical Considerations. Journal of the Indian Medical
Association , 42.https://www.jima.imana.org/article/download/5197/pdf_13
15. G.H. Mamoury, A. H. (2003). Cord Hemoglobin in Newborns in Correlation with Maternal
Hemoglobin in Northeastern Iran. International Journal of Molecular Sciences, 28 (3), 166-
16. Hamad Ali, F. A.-M. (2012). Defining umbilical cord blood stem cells. Stem Cell Discovery, 2, 15-
17. Hettiarachchi, K. (2012). NBTS infuses new blood. Retrieved June 29, 2017, from The Sunday Times:
18. Hua, J. G. (2013). omparison of different methods for the isolation of mesenchymal stem cells from
umbilical cord matrix: Proliferation and multilineage differentiation as compared to mesenchymal stem
cells from umbilical cord blood and bone marrow. Cell Biology International, 38 (2), 198-
19. Hussain, I. M. (2012). New approach to isolate mesenchymal stem cell (MSC) from human umbilical
cord blood. Cell Biology International, 36 (7), 595-600.
20. Kawasaki-Oyama, R. B.-B.-B. (2008). Blood mesenchymal stem cell culture from the umbilical cord
with and without Ficoll-Paque density gradient method. Scientific Library Online, 1 (1).
21. Keiger, D. (2011). How to: Harvest Stem Cells from Cord Blood. Johns Hopkins Magazine
22. Lubin BH, S. W. (2007). Cord blood banking for potential future transplantation. Pediatrics, 119 (1),
23. Maslova, O. N. (2015). Umbilical Cord Tissue-Derived Cells as Therapeutic Agents. Stem Cells
International , 1-10.https://www.hindawi.com/journals/sci/2015/150609/
24. Moghul, S. N. (2013, December 12). mportance Of Umbilical Cord Blood. Retrieved June 29, 2017,
25. M-Reboredo N, D. A. (2000). Collection, processing and cryopreservation of umbilical cord blood for
unrelated transplantation. Bone Marrow Transplantion, 26 (12), 1263-
26. Pegg, D. (2007). Principles of cryopreservation. In Methods in Molecular Biology (Vol. 368, pp. 39-
57). New York: Springer.
27. Phuc Van Pham, N. B.-B.-T.-T. (2014). Good manufacturing practice-compliant isolation and culture
of human umbilical cord blood-derived mesenchymal stem cells. Journal of Translational Medicine,
28. Public Cord Blood Banking. (2017). Retrieved June 29, 2017, from Parentsguidecordblood.org.:
29. Rakhawy, M. J. (1981). Illustrative embryolog (31 ed.). New York: MCGW – Hill.
30. Roura, S. P.-M.-G. (2015). The role and potential of umbilical cord blood in an era of new therapies: a
review. Stem Cell Research & therap, 6 (123).
31. Sadler, T. a. (2006). Langman's medical embryology (12 ed.). Philadelphia: Wolters
32. Saunders Comprehensive Veterinary Dictionary. (2016). The free dictionary . Retrieved
33. Seah, I. (2014, February 10). Current and Future Applications of Umbilical Cord Blood
34. Should You Bank Your Baby’s Cord Blood. (2005). Retrieved June 27, 2017, from WbeMD:
35. Singh K, S. A. (2009). Evaluation of four methods for processing human cord blood and subsequent
study of the expansion of progenitor stem cells isolated using the best method. .Cytotherapy, 11 (6),
36. Stanevsky A1, G. G. (2009). Umbilical cord blood transplantation: pros, cons and beyond. Blood
Reviews, 23 (5), 199-204.
37. Taghizadeh, R. a. (2017). Banking Stem Cells From Umbilical Cord Tissue For Future Regenerative
Medicine Applications. Retrieved December 26, 2017, from Parentsguidecordblood.org.:
38. Waller-Wise, R. (2011). Umbilical Cord Blood. Journal of Perinatal Education, 20 (1), 54-
39. Weiss, M. a. (2006). Stem cells in the umbilical cord. Stem Cell Reviews, 2 (2), 155-
40. Wharton’s Jelly: Miracle Tissue. (2017). Retrieved June 29, 2017, from
41. What are the advantages of cord blood? - National Cord Blood Program. (2017). Retrieved December
20, 2017, from nationalcordbloodprogram.org.:
42. Zoe. (2016, August 5). Umbilical Cord Tissue Stem Cells – more valuable than you think. Retrieved
December 23, 2017, from Cells4Life: http://cells4life.com/2016/08/umbilical-cord-tissue-stem-cells-