Fondazione Zoé

The umbilical cord has an elevated therapeutic potential, how do we make the most of it?

Not too many years ago the umbilical cord, cut after birth, was considered one of the many special wastes produced by the hospitals, and as such it was disposed. Today instead it has become an important resource, useful to face a series of hematological pathologies. Exactly for it’s therapeutic potential, though, more and more often it is used as leverage to force parents in to wasting money in a way that is, in fact, illegal.

The umbilical cord contains a special kind of blood, particularly rich of hematopoietic stem cells. These are substantially identical to the ones in the bone marrow, found in long bones and flat bones of every single human being; hematopoietic stem cells have the ability to become red blood cells, white blood cells or platelets, producing in this way the entirety of the corpuscular part of blood.

 

There are many diseases that can affect bone marrow: myelomas, lymphomas and some forms of anemia; the most know surely are leukemias. These are pathologies that cause the bone marrow to stop it’s regular function, interrupting the production of some cellular lines or starting to produce ill cells that don’t carry out their normal function and damage the body.

If the “blood factory” doesn’t work well then why not try to substitute it? This was the intuition of Morrison and Samwick, two doctors from Brooklyn that were the first, in 1940, to experiment the bone marrow transplant, practice that through years of clinical tests and experiments has progressively improved, becoming the effective solution to cure many hematologic diseases.

The umbilical cord, as we mentioned before, contains hematologic stem cells of identical function of the ones of the bone marrow; that’s where the value of those few centiliters of blood lies: it is possible in fact transplant it to heal several blood diseases.

It is not such a simple matter though: hematopoietic stem cells  produce the immunity system, this means the cells are able to recognize what is “self”, meaning part of the body, and what is not, attacking and destroying it. This is possible thanks to the HLA code, a sequence of proteins present in every cell in the body, finalized to make that distinction possible. For a hematopoietic stem cell transplant it is necessary to have a compatible donor; if we don’t the new immune system might recognize as “non self” all of the transplanted patients body, attacking him and determining a severe form of rejection, the GVHD (graft versus host disease). The average chances of finding a compatible donor for a person waiting for a transplant are 1:100’000

                                                                                                   

In Italy 33.000 units of cord blood donated, crioconserved in 17 public bio-banks, are ready to be used whenever a patient will need them; the law in fact allows to donate them for solidarity (for the benefit of an unknown ill person) but it doesn’t consent you to conserve them privately, meaning for the benefit (whenever it may be needed) of the same donor, so of the original owner of that umbilical cord. Why? If the chances of finding a compatible donor are so low, negating the authorization to privately conserving it seems absurd: the cord blood is, in fact, completely compatible with the donor!
The reason (or the reasons) are simple: firstly, the hematopoietic stem cells of the cord blood are genetically identical to the ones of the donor; so it makes it impossible to use them to cure genetic diseases, because of course they would present the same identical defect. Also, to heal hematologic diseases we never look for a perfect match: in this way the slight rejection reaction obtained contributes to destroy completely the sick cells of the bone maw, acting as a sort of natural form of radio therapy.

The private conservation of cord blood, because of this, results from a medical point of view completely useless. Not only. It is an act that damages the community. Last year in Italy the public bio-banks have released for transplant purposes 69 units of donated cord blood; seeing the low chances of finding a compatible donor, if those cords would have been conserved for private use 69 people would have probably died.

Despite the scientific and moral evidence of the uselessness and harmfulness of the private conservation, in Italy many bio-banks offer it; seeing the illegality of this practice in our country, the collected cords are then sent outside of the country, particularly in Switerzland.
The consequences? Disastrous: the parents terrorized in an inopportune manner by the illusion of terrible diseases are willing to pay from 1600 up to 2500 Euros to conserve for 20 years a cord that will be useless, and at the same time taking away the hope from people that might instead be saved.

How to avoid them? Getting informed throughreliable sources: knowing things lets you understand them, understanding things allows you to choose freely, using our head and heart as guidance, not the economic interests of some private bio-bank.

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