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2. SACHITA KHADKA RUPA SHRESTHA RASHMI GAUTAM RAMA PARIYAR RANJANA BC RADHA THAPA MAGAR RASHNA MAHARJAN RACHANA RAI RUBINA RAI PRATIVA KHADKA 7/29/2014 2 HOPE INTERNATIONAL COLLEGE PCL NURSING 3rd / 3rd BATCH 3. 7/29/2014 3 4. UMBILICAL CORD The part of placenta that delivers nutrients to a fetus. It help fetus to survive during intrauterine period. 7/29/2014 4 5. INTRODUCTION o Cord blood banking involves collecting blood left in newborns umbilical cord and placenta and storing it for future medical use . o Cord blood contains potentially lifesaving cells called STEM CELL. 7/29/2014 5 6. 7/29/2014 6 7. Stem cell Stem cell are essentially the building blocks of the human body . Stem cell is capable of dividing for long periods of time , are unspecialized , but can develop into specialized cells . The earliest stem cell inside an embryo will eventually give rise to every cell , tissue and organ in the fetuss body . When it divides , it can make any one of the different cells in human body . 7/29/2014 7 8. 7/29/2014 8 Stem cell 9. There are several types of stem cells Embryonic stem cells Adult stem cells Induced pluripotent stem cells (IPSC) Umbilical cord blood stem cell 7/29/2014 9 10. 7/29/2014 10 Embryonic stem cell Adult stem cell Induced pluripotent stem cells Umbilical cord stem cell 11. Purposes: o Two main purpose for cord blood storage : Donate babys cord blood to a public cord blood banking for anyone who needs its To store for babys cord blood bank for familys use . 7/29/2014 11 12. METHODS There are two types and they are ; 7/29/2014 12 13. Syringe method: a syringe is used to draw blood from the umbilical cord shortly after the umbilical cord has been cut. The process is similar to drawing blood for a regular blood test . 7/29/2014 13 14. Syringe method 7/29/2014 14 15. Bag method: The umbilical cord is elevated to drain the blood into a bag. ( Anti-coagulate already kept in the bag ) 7/29/2014 15 16. Bag method 7/29/2014 16 17. 7/29/2014 17 18. Most common method of cord blood is bag method 7/29/2014 18 19. COLLECTION Cord blood is collected right after birth. The collection process is painless and safe for both mother and baby . In fact , its so quick and painless that parents caught up in holding and bonding with their baby are often unaware it has even happened . 7/29/2014 19 20. PROCESS Clamping and cutting the cord : After the delivery of the baby whether vaginally or by C-section , the cord is clamped and then cut in usual way . 7/29/2014 20 21. Contd Extracting the cord blood : The medical provider then inserts a needle into the umbilical vein on the part of the cord thats still attached to the placenta . The needle doesnt go anywhere near the baby . The blood drains into a collection bag . Typically , entire umbilical blood are collected . The entire process takes less than 5 minutes . 7/29/2014 21 22. Contd Off to the bank : The blood is transfer to a cord blood bank , where it is tested , processed , and cryopreserved (preserved by controlled freezing) for long-term storage. Some family cord blood banks now offer to collect a segment of umbilical cord tissue contains stem cells , and researchers are studying their possible . 7/29/2014 22 23. VALUABLE OF CORD BLOOD Cord blood is a rich source of blood stem cells . Stem cells are the building blocks of the blood and immune system . They have the ability to develop into other types of cells , so they can help to repair tissue , organs , and blood vessels and can be used to treat a host of diseases . 7/29/2014 23 24. Contd Stem cells are also found in bone marrow, human embryos , fetal tissue , hair follicles , baby teeth , fat , circulating blood , and muscle . Every part of the human body contains some stem cells , but most are not a rich enough source to have be harvest for therapeutic applications. 7/29/2014 24 25. Contd In 2012 , 38 % of Haspanic (spanish people in ancient time )patient and 44% of African American patients undergoing stem cell transplants received cord blood . More and more adults are receiving cord blood transplants , too , sometimes involving two cord blood donations if a single one doesnot contains enough cells. As the end of 2012 , more than 33,900 cord blood units had been transfer for transplants worldwise . 7/29/2014 25 26. TREATED DISEASES Cord blood stem have been used successfully to treat more than 75 different diseases , inculding: Some cancers Blood disorders Immune deficiencies 7/29/2014 26 27. Contd Among theses are ; Leukemia Aplastic anemia Thalassemia Hodgkins diseases Non-Hodgkins Lymphoma 7/29/2014 27 28. 7/29/2014 28 29. Contd Cord transplants are also used to treat rare metabolic disorder that would otherwise be fatal for infants . 7/29/2014 29 30. POSSIBLE FUTURE USES Studies are under way around the world to explore new ways of using cord blood ; Cerebral palsy and autism Hydrocephalus Treatment for adults Animal studies 7/29/2014 30 31. PARENTS NEED TO KNOW The fields of medical research with stem cells is exploding . The most important thing for parents to understand about the stem cells in cord blood , by Frances Verter (founder and executive director of the nonprofit parents guide to Cord Blood Foundation ); 1. Donate the babys cord blood to help patients seeking transplants now or 7/29/2014 31 32. Contd 2. Save the babys cord blood for the family in case the need it later , most likely for a therapy thats still being studied . 7/29/2014 32 33. STORAGE After the collection (entire placenta and cords blood collection should be done) , lab process start through cryopreserved. There are many ways to process a cord blood until , and there are differing opinions on what is the best ways . Some processing methods separate out the red blood cells and remove them , while others keeps the red blood cells . 7/29/2014 33 34. Cont. However the unit is processed , a cryopreservant is added to the cord blood to allow the cells to survive the cryogenic process. After the unit is slowly cooled to -90oC , it can then be added to a liquid nitrogen tank which will keep the cord blood unit frozen at -196oC . The slow freezing process is important to keep the cells alive during the freezing process. 7/29/2014 34 35. Contd More than 1 million units of cord blood are stored in family banks in the United States . And the national Be the match Registry provides nearly 1,85,000 donated cord blood units in the United States , with additional access to more than 4,25,000 cord blood units through partnerships with international registries . 7/29/2014 35 36. Contd Verter estimates that about 5% of parents now bank their banks cord blood . 90% of that cord blood goes to family and 10% goes to public banks . 7/29/2014 36 37. ADVANTAGES Cord blood stem cells are currently used o several life-threatening diseases o blood and immune system related genetic diseases , cancer and blood disorder . Cord blood stem cells can also be used for siblings and other members of the family who have a matching tissue type . Siblings (75% )chance of compatibility , and the cord blood may even be a match for parents (50%) and grandfather . 7/29/2014 37 38. PUBLIC BANKS A primary concern with public banking is how to ensure the safety of the cord blood . Because of privacy concerns , it is agreed by most ethical reviews boards that blood donated to a public bank cannot be permanently linked to the donor. 7/29/2014 38 39. PRIVATE BANKS Private banking is costly to insures and private parties , averaging . The ability to use the cord blood may also depend on long-term commerical viability of the enterprise . 7/29/2014 39 40. Contd It is important to ensure the credentials of any potential private bank . In the United States , the Food and Drugs Administration regulates cord blood under the category of Human Cells , Tissues , and Cellular and Tissue Based Products . 7/29/2014 40 41. Contd The odds that two siblings will have the 6/6 match required for a bone marrow transplant are 25% . The odds that two siblings will have the 4/6 match required for a cord blood transplant are 39 % . 7/29/2014 41 42. SAFETY AND EFFECTIVENESS oUsing ones own cord blood cells might not wise or effective , especially in cases of childhood cancers and leukemia . o Children who develop an immunological disorder often are unable to use their own cord blood for transplant because the blood also contains the same genetic defect . 7/29/2014 42 43. USABILITY OF ONES OWN SAMPLE UNKNOWN oMost cord blood samples up to 75% may be too small to be used for transplantation because they dont contain enough stem cell . o While a private bank will store a sample , the sample may be too small to be usable , even by a child . 7/29/2014 43 44. cord blood banking cost There are usually two fees involved in cord blood banking;. The first is the initial fee which covers enrollment, collection and storage for at least the first year. The second is an annual storage fee. Some facilities vary the initial fee based upon the length of a predetermined period of storage. 7/29/2014 44 45. Contd Depending on the predetermined period of storage, the initial fee can range from $900 to $2100. Annual storage fees after the initial storage fee are approximately $100 . 7/29/2014 45 46. Contd It is common for storage facilities to offer prepaid plans at a discount and payment plans to help make the initial storage a more attractive option for baby and the family . 7/29/2014 46 47. AVAILABLE SERVICE IN NEPAL Cord blood banking established in Nepal at 2008 A.D . Cord blood immediately courier at store/lab in INDIA within 48 hours . Interested parents should inform the specialist during 5-7 months of pregnancy , need to pay Rs.20,000 then at the time of delivery need to pay Rs.58,000 ( TOTAL AMOUNT IN NEPAL FOR CORD BLOOD BANKING IS Rs.78,000 ) . 7/29/2014 47 48. AVAILABLE CORD BLOOD BANKS COUNTRIES NAME ESTABHLISHED DATE FLORIDA 1983 A.D GENEVA 1989 A.D INDIA 2006 A.D BANGKOK 2008 A.D KENYA 2011 A.D SINGAPORE 2013 A.D 7/29/2014 48 49. 7/29/2014 49 50. 7/29/2014 50 BABY PARENTS GRAND PARENTS PARENTS SIBILING BABY SIBILING MATERNAL PATERNAL 51. 7/29/2014 51 52. REFERENCES http/www.wikipedia.com/cord blood banking CRYOBANKS premier cord blood bank , Cryobanks International India Pvt.Ltd. Mrs . Subedi Durga , Midwifery part I , Wanmaya Publication And Research Center , 1st 2010 March , page no 95 98 Mr. Pankaj Chawla Professor of cord blood banking ,Gyaneshwor , phone no. : 9802031233 7/29/2014 52 53. 7/29/2014 53