A Hybrid Cord Blood Bank for Africa

Erna West, CELVI Founder and CEO

CELVI, the first hybrid, private umbilical cord blood bank in South Africa, was launched on 9 September 2019. CELVI’s vision is to provide a stem cell donor for everyone. This hybrid bank is based on a Spanish model where cord blood is stored privately. If an unrelated match is found, the unit can be donated to a patient in need of a stem cell transplant (provided consent is given).

Through collaboration with established partners Next Biosciences and The Sunflower Fund, CELVI will provide the only altruistic option to preserve a newborn’s stem cells in Africa.

The global cord blood industry came into existence in 1990 with the formation of several cord blood banks in the United States of America. This was followed by the establishment of cord blood banks across the globe.

Although the umbilical cord blood is a valuable source of haematopoietic stem cells, most of it is discarded at birth. One of the most important advantages of cord blood is the less stringent requirements for HLA-matching criteria. This is particularly advantageous for patients from non-Caucasian ethnic groups. Furthermore, cord blood units are cryopreserved and provide an off-the-shelf solution to patients in urgent need of a transplant. Cord blood units also have a lower risk for graft versus host disease – a common and often fatal – complication of transplantation. Some noteworthy disadvantages of cord blood are the low number of stem cells (which may result in delayed engraftment), a higher risk of infection and graft failure rates and a subsequent increase in hospitalisation and treatment costs.

The World Marrow Donor Association estimates that about 70% of patients with blood disorders such as leukaemia, severe aplastic anaemia and congenital or other acquired disorders will not have a suitable family donor. Siblings have a one-in-four chance of being a perfect match and we have seen an increase of haplo-identical transplants worldwide due to donor shortages.

Dessels et al 2018 reported that 75% of Caucasian patients, and only 20% of non-Caucasian patients are successful in finding a HLA-match globally.

In South Africa two donor registries currently recruit healthy individuals to establish a genetically diverse donor pool, and to provide donors for patients without a sibling donor.

According to Anon et al 2006, the likelihood of finding an appropriate HLA-matched allogeneic cord blood unit is at least 40% and increases as the number of publicly stored units increase (provided that there is an adequate pool of publicly stored UCB units).

The global utilisation of privately banked cord blood units is very low. According to Dessels et al 2018, only an average of 130 cord blood units are released from private banks for treatment annually. In comparison, nearly 50 000 cord blood units had been released by public banks by the end of 2016.

Meissner-Roloff et al 2013 noted that establishing a public cord blood bank in South Africa could be a positive step towards improving the quality of healthcare by providing an important unmet need.  The article also mentions that with the advances in cellular therapy such as induced pluripotent stem cell technology, cell expansion, and tissue generation the benefits provided by hybrid banks may be worth investigating.

A feasibility study pertaining to a public cord blood bank in South Africa found that, despite barriers such as affordability, cultural differences, religious practices, educational disparities and the high prevalence of HIV and associated costs, the results favour further research and education.

The CELVI team is committed to increasing cord blood awareness and expanding access to donors. We look forward to the important role cord blood will play in transplant medicine as well as cellular therapies in the emerging field of regenerative medicine in South Africa.

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The treating doctor will determine the use of cord blood for treatment, depending on many factors, including the patient’s medical condition, the quality of the cord blood sample, if the patient’s own cord blood can be used or an adequately matched donor’s cord blood.The use of cord blood has been established in stem cell transplantation and has been used to treat more than 80 diseases. The use of cord blood in regenerative medicine is still being researched and there is no guarantee that treatments being studied in the laboratory, clinical trials, or other experimental treatments will be available in the future.The use of cord tissue stem cells is still in early research stages, and there is no guarantee that treatments using cord tissue stem cells will be available in the future. Cord tissue stem cells are found in the cord tissue which is stored whole. Additional processing will be required to isolate the stem cells from the tissue for use. CELVI (Pty) Ltd outsources all cord blood and tissue processing and storage activities to Next Biosciences in Midrand, South Africa, a licensed and AABB accredited facility.

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