- What happens if the baby is born during weekend or on a holiday?
Naturally, there are people on duty even on these days in our Institute and, consequently, handing over, receiving, processing and freezing of samples is done exactly in the same manner as on workdays.
- Can samples be mixed up?
A multiple coding system prevents samples from being mixed up. Each and every sample is placed in a separate ‘drawer’, thus, it is impossible to mix up samples.
- What happens to the prepaid amount of money if the sample collection does not succeed?
If the sample collection does not succeed and the sample cannot be frozen, the client has to pay only the first payment. If for any reason even the collection of UBC, UC did not occur and the collection kit is untouched and remained sterile, we pay back the first payment.
- When and how do clients receive information on the collected samples?
After receiving samples, the biologists perform quantitative and qualitative tests. In the case of UCB, they measure the samples’ volumes and temperatures as well as check the presence of blood cloths. In the case of UC, they measure the dimensions of the tissue and grade its state. If they find that everything is in order, clients will receive a ‘UCB reception and grading protocol’ by mail. Estimated time interval: 1 week.
A data sheet (‘Results of UCB sample processing’) will be filled in regarding the quality (number and viability of stem cells, results of virologic and bacteriological tests) and the processing of the collected umbilical cord blood sample.
In what concerns the quality of the tissue, a ‘UC tissue processing, testing and freezing protocol’ will be drafted. If the biologists of the Institute find that everything is in order, this will be sent by mail to the client together with a cover letter and the data sheet on the blood sample. Estimated time interval: 2 to 3 months.
If certain anomalies are found concerning the pathogens for which the screening was done, we ask for an expert opinion elaborated by a specialist, who is not the Institute’s employee. The results shown by this expert opinion will be discussed with the parents and a common decision will be made regarding the further storage or destruction of the sample.
- Is it true that the whole amount of blood that has been collected will be processed?
Of course. If the UCB sample is large, it will be stored in two bags, however, the client will not be paying an additional amount of money for this.
- What happens with the deep frozen samples in case of power failures?
As opposed to household refrigerators, electricity plays a minute role in the system used for deep freezing and storage. There is no need for continuous electricity supply, because samples are stored in vapours of liquid nitrogen. Nevertheless, the entire system is connected to an uninterruptible power supply.
- Only stem cells will be frozen or the entire amount of blood?
The KRIO Institute Ltd., using the procedure accredited by the AABB, isolates the white blood cell content of UCB, which is rich in stem cells and freezes only this array of cells. The manual technology applied by the Institute allows for a higher rate of cell isolation than semi-automated or fully automated cell isolation procedures.
- Some stem cell banks claim that 99,9% of collected stem cells will be stored. How is this possible?
This is possible because in such cases the entire amount of blood is being frozen without isolating the stem cells. In such samples, the number of stem cells is higher in the beginning, however, after unfreezing them the survival rate of cells is much lower, because red blood cells tolerate the stress caused by freezing and unfreezing to a lesser extent and disintegrate during defrost.
Stem cells and red blood cells should be frozen differently. If the two types of cells are frozen together, disintegrating red blood cells generate substances, which damage white blood cells and stem cells alike and, consequently, cell survival rate is lower. All leading stem cell banks in the world isolate stem cells. Freezing the entire amount of blood is the less advanced technology of the 1990s.
- Why should the collected umbilical cord blood be processed before storage instead of freezing the entire amount of blood?
The basic rule applied by stem cell banks in the USA, Europe and Japan is to process the collected umbilical cord blood samples before storage in order to eliminate the superfluous blood plasma and red blood cells. If umbilical cord blood is processed before storage, no significant manipulation is needed after defrost and, in most cases, the sample can be transplanted even immediately. UCB samples containing red blood cells, because these have not been eliminated before storage, require further treatment after unfreezing and before transplantation. ‘Washing out’ red blood cells from the sample often leads to a 25% loss of cells, moreover, centrifugation might cause the loss of the entire sample, too.
Freezing and storing the entire blood without preliminary treatment was a procedure used by a small number of laboratories 20 years ago. From these, only a very few still continue using the practice. This procedure is considerably less expensive than the solution involving preliminary treatment. Another drawback is that the transfusion of untreated blood provoked severe negative reactions by patients. This is the reason why, in June 2010, the Committee of the International Bone Marrow Transplant Registry issued a warning to all practicing physicians concerning the transplantation of samples containing the entire blood.
- Is it true that by drawing blood from the placenta as well as from the umbilical cord, one can double the amount of blood that can be collected?
No. The blood in the umbilical cord stems from the placenta as well. There are, on average, 200 ml of blood in the placenta and, in optimal cases, one can obtain 100–150 ml of blood. If one wanted to draw blood from the placenta as well, (s)he should wait for the expulsion of the latter. In such cases, the risk of infections is far greater (it can rise to 10% even), while the amount of blood, which can be collected, can by no means be doubled. If one did not wait for the expulsion of the placenta, and used the so-called closed (intrauterin) procedure for sampling only the umbilical cord, the risk of infections would be kept as low as roughly 1%.