As UC Davis builds California’s first public umbilical cord blood collection system, its labs are helping the nation’s oldest bank harness some of its most valuable inventory

A stem cell-rich substance that was once – and unfortunately, is often still – discarded as medical waste is now recognized as the stuff of potential medical miracles.

But not quite yet recognized as widely as it should be, according to UC Davis scientists who are leading California’s recently launched effort to capture more of it and harness it for the public good.

Usually overlooked after the exciting moment of birth, the umbilical cord and placenta that nourished the fetus throughout pregnancy are normally taken to the incinerator. As they are destroyed, however, so too is a treasure trove of natural elements that can be lifesaving to others.

Cord blood offers an important alternative to bone marrow for treating a host of blood diseases, including anemia, leukemia, lymphoma, sickle cell disease and severe combined immunodeficiency. And the stem cells in cord blood are invaluable for experimental therapies focused on regenerating many types of human tissues.

UC Davis Health System is now playing a leading role in two separate efforts to extract that powerful value from otherwise-wasted cord blood:

  • To help build the inventory and diversity of publicly available cord blood units in California and beyond, UC Davis Stem Cell program staff are managing the launch and growth of the state’s first comprehensive public collection system.
  • As they do, leading-edge UC Davis research processing laboratories are also helping the nation’s oldest and largest public cord blood bank to turn some of the cream of its stock into a line of heavily versatile stem cell lines, for use in a wide range of potential therapies.

A focus on collection

UC Davis Health System’s Stem Cell Program is the founding administrator of California’s Umbilical Cord Blood Collection Program, established in 2010 by the state’s legislature to increase the amount of cord blood donated within the state and added to the national inventory.

Funded with a $2 fee on purchases of certified birth certificates, it is the first such publicly supported program nationwide. The program is not a cord blood bank itself, but collects cord blood for public banks. Mothers are now able to donate their newborns’ umbilical cord blood and have it publicly banked so it is available to anyone for lifesaving transplantations.

Such “prescriptions” have increased dramatically in recent years because cord blood is now considered a treatment for the same conditions indicated for bone marrow transplantation, but with several advantages:

  • cord blood collection involves no risk or trauma to the donor, while bone marrow must be extracted through an often-painful procedure
  • an exact match is less critical with cord blood because the newborn’s immune system is less developed, reducing the likelihood that it will react against the recipient
  • cord blood can be frozen and stored for years – even decades – so it can quickly be distributed “off the shelf” when a need arises.

To date the UC Davis-led effort has more than tripled the number of hospital sites statewide that collect cord blood. More than 1,200 units from the program are now listed on the National Marrow Donor Program’s public registry, and 21 have been selected for transplantation.

“Saving lives with California’s diverse cord blood units is the most effective way to measure our growing success,” said Suzanne Pontow, a UC Davis scientist who co-directs the state collection system. “We’re very thankful for all our donor mothers for their eagerness to participate in this program that’s free to families.”

Program team members continue to train collection specialists and certify collection sites at hospitals around the state, hoping to encourage as many donations as possible so that the range of California population groups is well represented and helps enhance the national inventory of publicly stored units.

Cord blood donations are particularly important for ethnic minorities due to a number of factors. African-Americans, Hispanics and Asians each make up a smaller portion of the U.S. population – meaning less donors are available – and they can also have a greater degree of genetic variation. Because a partial match is acceptable with cord blood, it allows more minority patients to find a suitable unit for treatment.

In addition, African-Americans are more likely than others to suffer from sickle cell disease which can now benefit from cord blood transplants. In general, minorities are more likely to find a suitable match from donors within their own ethnic groups.

“Due to our ethnic diversity, California is an ideal place to focus on enhancing cord blood collection,” said Jon Walker, a UC Davis laboratory scientist who co-directs the collection program. “A more varied pool increases the likelihood that members of minority groups and mixed heritage can find a match and have access to lifesaving treatments.”

A focus on research and clinical application

Cord blood collected through the program that can’t be used directly for clinical purposes – usually because the cell number is insufficient – is made available for research with permission from the donor’s family. The stem cells within can be invaluable for experimental therapies focused on repairing damaged tissue and developing specialized cells and organs.

A cooperative effort involving the UC Davis stem cell processing laboratories provides an example of that rich vein of potential. Last year the UC Davis Stem Cell Program established a major collaboration with the nation’s oldest and largest public cord blood bank, New York Blood Center’s (NYBC’s) National Cord Blood Program at the Howard P. Milstein Cord Blood Center, to manufacture specialized lines of highly adaptable stem cells for potential new therapies.

The NYBC’s umbilical cord bank is unique in having a rare collection of homozygous blood units, which are much more easily matched to recipients than more commonly available heterozygous units. Meanwhile, UC Davis is one of only a handful of centers in the nation that has a Good Manufacturing Practice (GMP) facility and processing capabilities that can transform these units into induced pluripotent stem cell (iPSC) lines useful for both research and clinical purposes. The 6,000-square-foot UC Davis lab complex is the largest academic GMP facility in Northern California.

The partnership presents a unique opportunity to make iPSC lines that will be capable of making any human tissue and being matched to a large number of people.

“Just 100 of the homozygous cell lines would match 85 percent of the entire U.S. population,” said Jan Nolta, director of the UC Davis stem program and the university’s Institute for Regenerative Cures. “We expect that this will be a collaboration that will allow for vast new opportunities for future clinical use.”

Under the two-year agreement with the NYBC, UC Davis plans to manufacture 20 iPSC lines, which will be made available to collaborating institutions, other researchers and for clinical products. The initial lines will provide a good pool for applying to the Food and Drug Administration for specific indications for clinical uses, Nolta said, and allow for feedback before proceeding with future work in this direction.

“This collaboration will provide a big push to the field of stem cell medicine,” Nolta said. “Using our combined resources, we will manufacture stem cell lines from cord blood that can be used as source material to develop new treatments for diseases and injuries for which there are few, if any, other options.”