Pregnancy

Umbilical cord donation: information and help desks

We recently talked about the function of the umbilical cord and its importance. However, that article was a premise to a topic that closely affects many future mothers: the donation of the umbilical cord. (here the ministerial directives:  http://www.trapianti.salute.gov.it/cnt/cntDettaglioMenu.jsp? id=148&area=cnt-cell )

There is a lot of confusion and misinformation on this issue and so now we will clarify thanks to the help of a non-profit organization, InformaMamma , which operates precisely by providing all the information on the subject of the donation of this important organ.

InformaMamma is a help desk based in Sardinia but operating throughout the country, it is totally free, and operates thanks to the availability of volunteers from the Osidea onlus association. It takes care of providing mothers with all the information necessary to make their choice in terms of donation.

There is a toll-free number: 800 45 45 77 operating every day from 10.00 to 20.00, to which these operators answer who initially give all the information on the types of donation and cord blood conservation, and if the mother confirms her willingness to donate, then the operators accompany her in carrying out the bureaucratic process.

As you know, the umbilical cord is a very important source of haematopoietic stem cells.

In short, these cells are able to recreate the basic building blocks of blood, red blood cells, white blood cells and platelets. They often represent the only attempt to cure serious diseases including leukemia. The bone marrow is the most important source of these cells and marrow transplantation is a very common treatment option. The problem is that compatible donors are often not found and when they are, they may not be in optimal health. Preserving cord blood stem cells instead means creating a real bank where cryopreserved cord blood units are made available at any time, for a possible transplant.

The existing forms of conservation are the following

  • heterologous donation
  • Autologous Donation
  • Dedicated Donation
  • The Autologous Donation -Solidarity

In Italy, the storage for personal use (Autologous) of umbilical cord blood is not permitted unless there is a pathology among the blood relatives of the unborn child for which it is possible to resort to stem cells from the umbilical cord. In this case we find ourselves in the form of a “dedicated donation” and the stem cells, which are stored free of charge in Italian banks, are at the exclusive disposal of the subject for the treatment of his pathology. (source:   Ministerial Decree November 18, 2009 ).

With the Heterologous formula (the most common) the mother makes the blood of the umbilical cord available to her neighbor. In this way she loses all rights to it but gives it to whoever may need it. It is an altruistic / supportive formula but only mothers residing in regions with public cryopreservation centers can take advantage of this method. Here is the list of public banks in Italy:  http://www.adoces.it/donazione-sangue-cordone/banche-pubbliche-italiane/

However, this formula remains the only one carried out today in Italy. Anyone wishing to practice autologous donation (without the conditions mentioned above, i.e. without the presence of serious pathologies in the family that can be treated with stem cells), must rely on private centers (generally very expensive). These centers are not present in the national territory and therefore who controls their work??? Often they are real marketing companies and not laboratories and research institutes, they offer 30-year conservations that have no scientific basis and many doubts arise about their conservation procedures.

Italian public banks, on the other hand, carry out their business on the basis of quality and safety protocols defined at national and international level.

Also consider these numbers:  of the more than 60,000 private collections exported from Italy since the early 2000s , none have returned to be transplanted to the donor child or to a family member. Instead, it should also be emphasized that of the 30,000 units of cord blood donated by Italian mothers for solidarity purposes, over 1,000 have been used to transplant Italian and foreign patients (Source:  www.adoces.it Associazione Donatori Cellule Steminali).

The fourth donation/conservation formula is called Autologous-Solidarity and was conceived and structured by the Osidea non-profit association which therefore guarantees the procedure.

In this way, the cells are kept for the newborn child but if necessary, and after the mother’s consent, it will be possible to donate them to another less fortunate child. However, the Autologous-Solidarity Donation is not free because it is carried out by relying on foreign cryopreservation centers which guarantee their professionalism and availability, requesting a contribution for the entire twenty-year period of cryopreservation of the unit.

The impression is that at the moment in Italy there is no common line between hospitals and that parents are somewhat abandoned in this choice which for some unfortunate children could be of vital importance…

Information remains the only means at our disposal to understand which is the best way to proceed in this choice.

I am in favor of heterologous solidarity donation, by virtue of the numbers mentioned above. With autologous we deprive other children of one more chance to recover. Furthermore, statistics show that if you donate cord blood in Italy and therefore do not keep it for yourself abroad, you have a 97% chance of returning to possession of the donated bag if a family member needs it to treat the onset of a disease treatable with a transplant  http://www.adoces.it/)

Dr Kathryn Barlow

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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