Overview
Intravenous infusion of umbilical cord blood cells is a therapeutic procedure used in patients recovering from a stroke. The umbilical cord blood is taken from the placenta via the umbilical cord.
To achieve an optimal therapeutic effect, a dose of 50 million cells per kg is required, and each infusion includes umbilical cord blood from 4 to 8 donors. The entire infusion series extends from two to three days, and after each infusion, the patient is monitored for possible adverse reactions for several hours. In the majority of patients, umbilical cord blood infusions have improved cognitive and motor functions. These functional improvements are noticeable within the first weeks after infusion. Adverse reactions to cord blood infusions are rare and generally mild.
The treatment effect
The umbilical cord blood infusion is not intended as a substitute for standard therapy in the treatment of strokes, but as an additional therapeutic approach that can lead to a further improvement in cognitive and motor functions. In patients undergoing cord blood therapy, there is no need to temporarily discontinue other types of drug or physical therapy. Intravenous cord blood infusions improve the rain fraction activity of brain cells in stroke patients. Clinical studies suggest that cord blood therapy is more effective when administered shortly after stroke.
Patients notice initial improvements just a few weeks after the infusion. The umbilical cord blood cells are excreted from the patient’s body within 6 to 8 weeks; however, patients experience functional improvements with sustained functional improvements over the next 3 to 6 months. The achieved improvement is permanent, the patients experience no deterioration of the achieved improvement.
Clinical studies have shown that the most important factor influencing the therapeutic effect of umbilical cord blood infusion is cell dosage. In a recent clinical study conducted at Duke University in pediatric cerebral palsy patients (mostly triggered by stroke), only patients receiving more than 25 million cells per kg showed a significant therapeutic effect (Kurtzberg et al; Blood 2015). For each umbilical cord blood infusion, the patient is given more than 50 million cells per kg by default. Another study suggests that repeated cord blood infusions may lead to further functional improvements.
The treatment procedure
Umbilical cord blood infusion involves intravenously infusing donated umbilical cord blood cells. The procedure differs from conventional blood transfusions in terms of the source of blood cells.
Umbilical cord blood is the blood that remains in the placenta after the umbilical cord of the newborn is pinched and severed. The removal of umbilical cord blood from the placenta is harmless and painless for both the child and mother. The remaining placental and umbilical cord blood or "umbilical cord blood" is taken from the umbilical cord vein. If the umbilical cord blood is not taken, it is discarded along with the placenta. Cord blood unit values stored in liquid nitrogen at about -200°C. To maximize the therapeutic effect, a dose of more than 50 million umbilical cord blood cells per kilogram is infused from 4 to 8 donors with each procedure, and umbilical cord blood infusions are generally administered over a period of 2 to 3 days.
Before the surgery:
In a first telephone or video call, our doctors collect a comprehensive medical history, provide detailed information about the procedure and answer open questions. Based on the initial examination, the consultant will determine whether you are eligible for the procedure and whether additional diagnostic procedures and tests are required before treatment. Based on your weight and blood type, the umbilical cord blood units are pre-selected and reserved for your treatment.
Investigation
On the first day in the clinic, a series of preliminary examinations must be carried out, the blood type must be checked. Standard biochemical tests are performed to assess kidney function and an echocardiogram (ECG/ECG) is performed to assess heart function. If the results show anomalies, additional diagnostics can be performed. After the preliminary consultation, the examination and the basic tests, the attending physician will propose a final treatment plan.
During surgery:
Each cord blood unit (CBU) is double tested to ensure compatibility with the patient. The treatment plan is different for each patient. After the nurse has placed an intravenous access, the infusion can last between 20 minutes and 2 hours, depending on how many units are infused. During and after each infusion, patients are supervised by doctors and medical staff to monitor possible adverse reactions.
After a final examination by the attending physician, you will be discharged from the clinic. A side effect of the treatment is a slightly fishy smell in your breath in the next 24 hours. The fishy odor is caused by small amounts of dimethyl sulfoxide, a cytoprotective agent used in cryopreservation, causes that diffuses from the blood into the lungs.
The next day, return to the clinic for further infusions according to the planned treatment plan.
After the surgery:
After the last infusion, a final check-up with the attending physician takes place. After completion of therapy, your doctor will keep in touch with you for the next 6 months to monitor the effectiveness of treatment and any adverse effects.