Should I Bank Cord Blood, Cord Tissue, and Placenta Tissue?

A newborn’s umbilical cord blood, cord tissue, and placental tissue have the power to do so much more than protect and care for your baby in utero. These perinatal tissues are rich in multi-potent stem cells, growth factors, cytokines, and extracellular matrix proteins which make up treatments for over eighty conditions and are being studied extensively in hundreds of clinical trials. 

When you bank your baby’s cord blood, cord tissue, and placental tissue, you are maximizing the potential to use these life-saving stem cells for clinical applications in regenerative medicine – today and in the future.

Perinatal tissues refer to the birth tissues. They include cord blood, cord tissue, placenta, placental membrane (amnion and chorion), and all of the stem cells associated with these tissues. Collectively, these perinatal tissues function as a fetal life support system. 

Placenta

The placenta is a disc-shaped organ that develops during pregnancy and is attached to the wall of the uterus. It acts as a barrier to bacteria and viruses to protect the baby. The placenta produces hormones and signaling molecules that help the baby grow. 

Umbilical Cord Blood and Tissue

The umbilical cord connects the placenta to the baby. The cord blood transports all the needed oxygen and nutrients through the vessels in the umbilical cord. The cord blood and the cord tissue contain a rich source of signaling molecules and stem cells. 

Placental Membrane 

The placental membrane is filled with amniotic fluid, which functions to protect the developing baby and allows ample room to grow. This membrane consists of the baby facing amnion layer and the maternal facing chorion layer.

Perinatal tissues consist of a rich milieu of stem cells, growth factors, cytokines, and extracellular matrix proteins. In fact, perinatal tissue contains over 65% of all the proteins, including growth factors, cytokines and extracellular matrix proteins, found in the human body.

These tissues are proven to have multiple uses in the field of regenerative medicine and new applications are being studied and approved each year.

Due to their perinatal origin, these tissues possess unique biological properties, including being angiogenic, anti-inflammatory, anti-fibrotic, anti-microbial, and immune privileged. Perinatal tissues have significant advantages over other tissues and stem cell sources. 

• Minimal to no exposure to illnesses and/or environmental factors such as pollution or radiation, which can alter stem cell efficacy.
• Easy to collect without risk to baby or mother.
• Reduced risk of graft vs host disease.
• Less stringent requirements for HLA matching.

There have been significant advances in bringing perinatal stem cells and tissues from basic science research, to clinical research, to approved treatments. Even with these advances, there is still a lot of untapped potential for the use of perinatal tissues. In fact, it is estimated that 1 in 3 individuals in the United States could benefit from regenerative medicine over their lifetime.

See a full list of clinical trials here.

While many of the currently approved treatments and clinical trials focus on a single cell / tissue type, there are numerous studies that highlight the potential of synergistic use that could yield therapeutic benefits far greater than today’s treatments. 

• Cord blood hematopoietic stem cells + cord tissue mesenchymal stem cells
• Cord blood hematopoietic stem cells + placental tissue mesenchymal stem cells
• Cord tissue + placental tissue

There have been a number of clinical studies investigating the benefits of co-transplantation of HSCs with MSCs vs the transplantation of HSCs alone. 

• Study 1: A systematic review of 19 clinical studies comparing the co-transplantation of allogeneic HSCs with MSCs vs HSCs alone. They found that the co-infusion of HSCs and MSCs improved engraftment and reduced Graft vs Host Disease in children, without increasing safety concerns.¹ 
• Study 2: A multi-center phase II trial investigating co-transplantation of HSCs and MSCs in 44 patients with severe aplastic anemia. The researchers concluded that this method could reduce the risk of graft failure and severe Graft vs Host Disease.²
• Study 3: Fourteen patients with non-malignant hematologic disease or leukemia received co-transplantation of HSCs and MSCs or transplantation of HSCs alone. The study demonstrated that patients receiving co-transplantation of stem cells had reduced time to engraftment and faster hematopoietic recovery, compared to patients receiving HSCs alone.³ 
• Study 4: Twenty patients with high-risk leukemia received co-transplantation of HSCs and MSCs or transplantation of HSCs alone. The study demonstrated that patients receiving co-transplantation of stem cells had reduced time to engraftment compared to patients receiving HSCs alone.⁴

Key Takeaway: The co-transplantation of HSCs with MSCs improves the likelihood of engraftment, the time to engraftment and reduces the risk of Graft vs Host Disease without increasing safety concerns. This promising treatment option has potential benefits such as earlier discharge from the hospital and reduced risk of post-transplant complications. 

One of the key disadvantages of cord blood banking is that the average HSC collection is not enough to treat adult patients or provide more than one round of treatments. To solve this need, scientists have been researching different ways to increase the number of HSCs outside the body. 

One area of new research is the use of placental mesenchymal stem cells (MSCs) to increase the number of HSCs. 

• Study 1: Researchers compared the efficacy of MSCs obtained from cord tissue vs placental tissue to increase the number of functional HSCs. They hypothesized that MSCs in direct contact with HSCs and through the release of signaling molecules such as growth factors / cytokines would be able to maintain the stem cell characteristics of the HSCs while also increasing their numbers.
  
  The researchers conducted a number of studies and found that placental MSCs were significantly more effective in increasing the number of HSCs compared to cord tissue MSCs. They also noted that their methodology had the potential to be directly translated to the clinical setting.⁵
• Study 2: In 2021, researchers compared MSCs obtained from bone marrow vs placental tissue. They hypothesized that placental MSCs represent a valid alternative to bone marrow MSCs to increase the number of functional HSCs.
  
  The researchers found that placental MSCs were comparable in efficacy to the “gold standard” bone marrow MSCs. 

Key Takeaway: To fully leverage the potential of HSCs, placental MSCs can be used to increase the number of HSCs while maintaining their stem cell characteristics.

Cord tissue and placental tissue membranes contain multi-potent cells, growth factors, cytokines, and ECM. However, there are key differences between these tissues that strongly influence their clinical applications. 

Cord tissue is thicker, stronger and stays in the body for a longer period of time making it ideal  as a cover, wrap or barrier membrane for surgical applications under the skin. Placental tissue is thinner and has a structure that mimics skin and ocular surfaces making it ideal for wound healing applications in these tissues. Each of these perinatal tissues plays an important role throughout the tissue repair and regeneration process. 

One potential clinical application in which cord and placental tissues could play a role is the treatment of an avocado hand injury. In this type of injury, the knife cuts through the skin and causes trauma to the underlying nerve or tendon.  The cord tissue can be wrapped around the injured nerve or tendon which can often take weeks or months to heal depending on the severity of the injury. For the skin wound, the placenta tissue can be used to cover the wound especially for those patients that have hard to heal wounds such as diabetics. 

Key Takeaway: Cord tissue and placental tissue membranes have attributes that are different from one another, but which also directly influences their respective clinical applications.

References:

• Li, T., Luo, C., Zhang, J. et al. Efficacy and safety of mesenchymal stem cells co-infusion in allogeneic hematopoietic stem cell transplantation: a systematic review and meta-analysis. Stem Cell Res Ther 12, 246 (2021). 
• Liu, Z., Zhang, Y., Xiao, H. et al. Cotransplantation of bone marrow-derived mesenchymal stem cells in haploidentical hematopoietic stem cell transplantation in patients with severe aplastic anemia: an interim summary for a multicenter phase II trial results. Bone Marrow Transplant 52, 704–710 (2017). 
• Wu, Kang-Hsi1,2; Sheu, Ji-Nan3,4; Wu, Han-Ping5; Tsai, Chris6; Sieber, Martin6; Peng, Ching-Tien1,2,7; Chao, Yu-Hua3,4,8 Cotransplantation of Umbilical Cord–Derived Mesenchymal Stem Cells Promote Hematopoietic Engraftment in Cord Blood Transplantation, Transplantation Journal: March 15, 2013 – Volume 95 – Issue 5 – p 773-777 doi: 10.1097/TP.0b013e31827a93dd 
• Kadekar, D., Kale, V. & Limaye, L. Differential ability of MSCs isolated from placenta and cord as feeders for supporting ex vivo expansion of umbilical cord blood derived CD34+ cells. Stem Cell Res Ther 6, 201 (2015). 

The views, statements, and pricing expressed are deemed reliable as of the published date. Articles may not reflect current pricing, offerings, or recent innovations.