FAQ

Here you can find some answers to the most commonly asked questions

Request a brochure

Umbilical cord blood processing with the UK’s leading stem cell company

Sign up

Place an order for your stem cell collection kit with our user friendly online ordering system

01895 424430

Call now to find out more and speak to a member of our Customer Services Team

What accreditation and quality assurance do you have?

Smart Cells has  an HTA licence which covers testing, collection, import, processing, storage, release and export of cord blood cells and tissue. We have ISO9001:2015 certification. We participate in external quality assurance schemes with regard to our TNC and CD34 cell counting. As a company, we take ongoing quality assurance very seriously and have fully trained experienced staff who operate according to validated procedures : we are rigorous about validating and auditing all our critical practices, procedures and processes.

With  28 years of experience in stem cell transplantation in the NHS, our Scientific Director  is able to ensure that we work according to best practice in the field.  (Dr. Ann Smith)

Our Quality Assurance programme, regulatory compliance and state of the art laboratory procedures are supported and overseen by our Scientific Director, Laboratory Manager and Senior Quality Officer whose expertise is also available to clients directly or via the customer services team.

How long can cord blood be stored?

Cord blood transplantation is a clinically effective form of treatment for many patients with cancer and blood diseases who need a stem cell transplant and more recently, has become a relevant source of cells in regenerative medicine.

There is no definitive consensus on how long frozen cord blood can be stored but scientists and clinicians worldwide are of the opinion that if cryopreserved and stored properly, then storage can be for decades or more.  At Smart Cells we use state of the art processing, cryopreservation and 24/7 monitored storage technologies designed to optimise the viability of stem cells. In vapour phase nitrogen temperatures below -170oC, all metabolic activities in cells are suspended therefore there should be no deterioration. The majority of public and private banks worldwide use similar technologies as they are tried and tested.

Key work undertaken by Professor Hal Broxmeyer, a distinguished world leader in the field of cord blood therapeutics has demonstrated efficient cell recovery at 5 years, 10 years, 15 years, and most recently 23.5 years after cells were cryopreserved  (1). Cord blood storage has been available for around 29 years, although in the early years not many units were being stored and used.  It is therefore not possible to look at empirical data beyond that time point, however Professor Broxmeyer’s team plan perform a 30 year assessment on the oldest cord blood specimens (2). Realistically, it is in the last 18 years approximately, that transplantation using cord blood has become a fully accepted therapeutic option and experts in the field have confidence that ongoing banking and use should continue (3).

As far as Smart Cells is concerned, 6 years is the longest interval between storage and thawing of frozen cord blood cells that were given to a patient as a transplant which was satisfactory in terms of cell recovery and engraftment. So far no older units have yet been requested.

At Smart Cells, as part of our Quality Assurance programme and regulatory compliance, we regularly undertake validation studies to ensure that our processing, freezing and storage of cord blood is efficient and that total nucleated and viable CD34+ stem cell recoveries are satisfactory after thawing.

Provided that procedures to process, store and thaw stem cells are of a high standard, the main factor that can potentially affect the ultimate post thaw recovery is the original quality of the cord blood sample itself. Those with initial low viability/low cell numbers may not withstand the thawing process in the same way as a more cellular and robust product.

It may take some time before clinical studies demonstrate conclusively that cord blood stem cells are viable after long-term frozen storage beyond 30 or more years. Clinical proof will require treating of patients with cord blood units that have been in storage for decades but for now, at SCI we are aligning our advice with current worldwide expert opinion.

(1) Blood. 2011; 5; 117(18): 4773–4777
(2) https://parentsguidecordblood.org/en/news/how-long-can-cord-blood-be-stored
(3) Stem Cells Translational Medicine S2017;6:1309–1311

 

I have a concern regarding Zika Virus, what do I do next?

You can check out the Public Health Guidelines on Zika Virus here: Public Health Guidelines

Advice for mothers wishing to store cord blood at risk of Zika Virus:

Obligatory must not donate if:
a) A mother has been diagnosed with chikungunya, dengue or Zika Virus infection whilst in an endemic area or following her return to the UK during this pregnancy. OR PARTICULAR PARTNER COUNTRY
b) A mother has either had a history of symptoms suggestive of chikungunya dengue or Zika Virus infection whilst in an endemic area or following her return to the UK during this pregnancy. OR PARTICULAR PARTNER COUNTRY
c) In other cases it is less than four weeks from a mother’s return from a Tropical Virus Risk endemic area.

Source: UK National Blood Service

We recommend that you speak to your GP if you have any concerns regarding Zika Virus.

Who collects the samples?

The collection must be performed by a trained and licensed healthcare professional. This could be a private obstetrician or midwife or an assigned phlebotomist.

The Human Tissue Authority (HTA) requires the person who performs the collection to be appropriately trained in the Smart Cells collection process and hold a valid Third Party Agreement to do so. Smart Cells can arrange for a fully trained and qualified medical professional to carry out the collection at your birth.

What are TNC and CD34+?

TNC stands for Total Nucleated Cells which are the white blood cells within a cord blood sample. We count these cells as this is an important measurement of the success of the collection in terms of cell numbers. Within the TNC cell fraction, we look at numbers of CD34 positive cells. This is a critical measurement as CD34 is a marker of stem cells.  Both TNC and CD34 levels in a cord blood sample are taken into account by clinical teams when deciding if there are sufficient  stem cells for treatment.

What is an HLA test and how is it used?

The term “HLA” is short for Human Leukocyte Antigens, which are proteins in the immune system that determine whether a patient will react against a donor transplant or if the donor transplant cells will react against the donor. A very good basic tutorial about HLA types is on the Stanford Website, and the national Be The Match program (aka NMDP) has more info on the role of HLA type in transplants of stem cells from bone marrow or cord blood.

The HLA type of cord blood is always assessed by public banks at the time of storing cells, and then the type is listed on a registry that can be searched  for patients worldwide who need  a transplant. Family/private banks typically do not measure the HLA type at the time of banking, as the actual test specification varies depending on the proposed clinical use and the testing can always be checked later using a testing segment of the stored cells.

In the case of sibling transplantation, individuals have 25% of having a sibling who is be HLA matched.

Why do Smart Cells volume reduce process cord blood before storage?

Most UK and worldwide cord blood banks, both public and private, process cord blood to reduce levels of  the plasma and the red cells, and cryo-preserve the remaining buffy coat portion which contains mononuclear cells. This mononuclear cell fraction contains the critical CD34 positive stem cells. It is valid for cord blood storage banks to use volume reduction techniques as such units are clinically preferable to whole blood, red cell replete products. This based on large cohorts of international data from respected and accredited transplant centres who use cord blood regularly as a therapeutic  tool. The plasma and red cells in cord blood are not deemed to be useful clinically.  By reducing the volume of the sample, while retaining the critical stem cells, it is possible to minimise the volume of cryoprotectant solution required in the freezing process. The cryoprotectant contains a substance called DMSO that can cause reactions in patients so it is sensible to reduce the volume as much as possible.

Reduction of red blood cell content is very important as it is well recognised that red blood cells burst or lyse during the freezing process. This results in release of free haemoglobin and red cell debris which can cause complications to patients at the time of infusion.

There are whole cord blood units in store which were mostly banked before preference for volume reduction became a factor and some of these are used for transplantation if there is no better match available in the volume reduced format. Under these circumstances, key worldwide organisations which issue standards of practice, recommend washing the units to remove lysed red blood cell material to avoid clinical complications but the downside of this can be some loss of stem cells..

Information taken from the following sources:

The Joint Accreditation Committee-ISCT (Europe) & EBMT (JACIE) : The Hematopoietic Cellular Therapy Accreditation Manual 6th Edition which accompanies the FACT-JACIE International Standards for Hematopoietic Cellular Therapy Product Collection, Processing, and Administration.

The National Marrow Donor Program® (NMDP), ( USA)

Transfusion. 2012 Jan; 52(1): 207–208

The Circular of Information for the use of cellular therapy products (AABB publication) http://www.aabb.org/aabbcct/coi/Pages/default.aspx

Ballen et al.  . Biol Blood Marrow Transplant. 2015 Apr; 21(4): 688–695.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4359657/#!po=0.617284

If I have banked for one child, do I need to do it for additional children/siblings?

All the reasons that you banked for the first child are still valid for additional children.
1. If you want the baby to have the option of using his/her own cells, then you need to bank them.
2. If you are banking to cover siblings, then the ability to use cord blood from one child for another depends on whether they have matching HLA type. Two full siblings have a 25% chance of being a perfect match, a 50% chance of being a half match, and a 25% chance of not matching at all. For a cord blood transplant, donor and patient must match at least 4 out of 6 HLA types. The more siblings with banked cord blood, the more chance that they cover each other for possible transplants or other therapies for which sibling stem cells are accepted.

References: Odds of sibling match are based on haplotype inheritence: that the child will receive 3 HLA types as a group from each parent.
Source: Parent’s Guide to Cord Blood

How much blood and stem cells does a typical umbilical cord contain?

The median size of cord blood collections in family banks is 60mL or 2 ounces. The number of Total Nucleated Cells (TNCs)  and CD34 positive stem cells can vary from cord to cord regardless of volume but generally larger volumes contain more TNCs and CD34 positive cells.  Smart Cells will always inform you about the volume of your sample and the cell counts.

Do I need to store the cord blood and tissue stem cells in the country I intend to use it?

No. After cord blood and or tissue is collected at birth, the samples are delivered, processed and stored in our UK laboratory. If you ever need the cord blood or tissue for therapy, the product will be shipped in in a constant temperature monitored frozen state a special container designed for the purpose of international cell shipment When cord blood is released for therapy from our laboratory, it can travel anywhere in the world with no loss of viability, because it travels frozen. It is only thawed at the clinic where it will be used.immediately prior to infusion. We have successfully shipped samples within the UK, Europe, USA, India and the Far East so far.

Can I donate my cord blood and tissue stem cells?

Smart Cells offer a fully private storage option for the long term storage of cord blood and tissue. . This service is a paid service and the samples are  solely stored for your own private use. If you wish to inquire more about cord blood and tissue donation then please visit the NHS Blood Bank or the Anthony Nolan Trust:

http://www.nhsbt.nhs.uk/cord-blood-bank/

https://www.anthonynolan.org/8-ways-you-could-save-life/donate-your-umbilical-cord-blood

How can the stem cells be used on the future?

Stem cells may be used in mainstream transplantation to help treat blood and bone marrow cancers or diseases such as Thalassaemia or sickle cell disease. If the cells being used are autologouse (from the individual for their own use), they are able to restore the blood and immune systems following chemotherapy used to treat the disese. If the transplant is allogeneic (from one sibling to another), not only can the cells restore the blood and immune systems, but they may play a role in cancer destruction too.

Stem cells may also be used in regenerative medicine to rhelp repair or replace damaged or diseased tissues or cells.  These  evolving regenerative applications are fairly recent and are typically being undertaken as part of research or clinical trials.  . View more information on the rest of our website.

Does my hospital allow me to have stem cells collected?

We are pleased to inform you that the majority of maternity hospitals allow us to perform this service for you. If you would like to discuss your individual hospital with us then please contact us by phone or via our ‘contact us’ page.

Can I still have my stem cells collected if I have a home birth?

Yes, we have a fully trained team of phlebotomists* who are able to visit your home to collect the sample during a home birth. They will discuss all of your options with you and make sure that they have a safe and sterile area to collect your samples.

*Specific to the United Kingdom only.

Can I still delay the clamping of the cord?

Yes, you can still delay the clamping of the cord. To optimise the chance of a good collection, it is recommended however that the cord blood is collected before pulsating stops. A prolonged delay will affect the volume of blood available for the collection. If clamping is delayed, it should be between 1-3 minutes, as advised by the World Health Organisation. A timed delay will mean that your baby will benefit from the delayed clamping as well as having their cord blood stem cells stored for future use but this is a matter for you to decide in dialogue with your healthcare professionals..

You can read more here: Delayed cord clamping & umbilical cord blood banking

References:
http://parentsguidecordblood.org/faqs/what-is-delayed-cord-clamping
http://apps.who.int/rhl/pregnancy_childbirth/childbirth/3rd_stage/cd004074_abalose_com/en/index.html

Can I wait for the placenta to deliver naturally?

You may either wait for the placenta to delivery naturally or this may be induced the delivery via an injection. Either method does not prevent us from collecting samples for you.

Does it matter if the birth is caesarean section or natural delivery?

No. If you have a Caesarean the collection can take place after the delivery of the placenta, as it would with a natural birth. Either birthing scenario is fine for the collection of cord blood and cord tissue stem cells.

Does cord blood and tissue collection hurt?

No. Cord blood and tissue collection is painless, convenient and safe for both mother and newborn. The cord blood and tissue is collected after your baby is born and the umbilical cord has been clamped and cut. The samples collected are normally discarded after birth as medical waste.

Do you have payment plans?

We offer all customers the opportunity to spread the final balance on a payment plan. We offer 3, 6 and 12 month options. To spread the cost over 3, 6 or 12 months there are no additional fees.

Do I have to pay to release or transport the sample if it is required for use in a transplant?

No additional costs will be incurred for the transportationof the sample at any time for therapeutic use.

If an HLA test is required, a low resolution test is covered but if clinical teams require high resolution testing, there may be an extra cost.

What happens if we go out of business?

Establishments licensed by the HTA are legally required to ensure that in the event of activities ceasing, any tissues/cells and records are transferred to another HTA licensed establishment and we are compliant with this requirement.

How long have we been operating?

Smart Cells was founded in 2000 and we have been collecting samples ever since.

No helpful answer?

Send us a message

If you only have a few minutes to spare and would prefer to send us a message then you can get in touch via our contact form. We aim to respond to all messages within 48 hours.

Contact us
Contact Us

Call us on +44(0)1895 424430 or you can send us a quick message and we'll aim to get back to you within 48 hours.

Start typing and press Enter to search