Birth Tissue Sources for Stem Cells: Overview

Birth tissues like umbilical cord blood, cord tissue, placental tissue, and amniotic fluid are rich in stem cells that can transform into various specialized cells, such as blood, muscle, or nerve cells. These cells are collected at birth and stored for potential medical treatments. Unlike adult stem cells, they are younger, unaffected by aging, and can multiply faster. Here’s what you need to know:

• Cord Blood: Contains hematopoietic stem cells (HSCs) used in over 80 FDA-approved treatments for blood and immune disorders. Collection is painless and requires less matching for transplants, reducing risks like graft-versus-host disease.
• Cord Tissue: Rich in mesenchymal stem cells (MSCs) from Wharton’s Jelly, which can develop into bone, cartilage, and nerve cells. These cells are ideal for immune-related therapies.
• Placental Tissue: Includes amnion and chorion layers with stem cells that promote tissue repair and suppress immune responses. A single placenta can yield enough cells for thousands of treatments.
• Amniotic Fluid: Contains unique stem cells that balance properties of adult and embryonic cells, offering potential for organ repair and wound healing.

Stem cells from these sources are collected safely after childbirth and stored cryogenically for decades. With over 300 clinical trials underway, these cells are being studied for conditions like autism, multiple sclerosis, and Type 1 diabetes. Families can bank these cells to ensure future access for medical use.

Umbilical Cord Blood Stem Cells

Umbilical cord blood is a rich source of hematopoietic stem cells (HSCs), which are essential for producing red blood cells, white blood cells, and platelets. Typically, 50–200 mL of this blood is collected immediately after birth and preserved for its regenerative properties. A key advantage of these stem cells is their immunological naivety, meaning they require less stringent HLA (human leukocyte antigen) matching compared to bone marrow transplants. This results in a 10-fold lower risk of graft-versus-host disease (GVHD) when compared to HLA-matched bone marrow from siblings. Additionally, less than 1% of U.S. cord blood donors carry CMV (cytomegalovirus), compared to over 50% of bone marrow donors, making cord blood a safer option in many cases.

Collection and Storage Process

The collection process is quick, non-invasive, and painless for both mother and baby. After delivery, a healthcare provider cleans the umbilical cord and uses a needle to draw the remaining blood into a sterile collection bag containing Citrate Phosphate Dextrose (CPD) anticoagulant. This takes only 5 to 10 minutes and can still accommodate delayed cord clamping (30 to 60 seconds), as recommended by the American College of Obstetricians and Gynecologists.

Once collected, the blood must be processed and cryopreserved within 48 hours to maintain its viability. In the lab, stem cells are separated from the blood, placed into cryo-bags, and gradually cooled before being stored in cryo-freezers at temperatures ranging from -150°C to -196°C (-238°F to -320°F). Successful storage typically requires a minimum volume of 40 mL and at least 100 million total nucleated cells. Advanced techniques like CryoMaxx™, used by Americord, minimize cell manipulation, preserving higher levels of growth factors and cytokines.

"Stem cells cryogenically stored for 5, 10, 15, and 23.5 years have highly effective rates of viable stem cell recovery." - Dr. Hal Broxmeyer, Indiana University School of Medicine

Thanks to this meticulous process, stored stem cells remain viable for decades, ready to be used in treatments for a variety of conditions.

Medical Applications

Cord blood stem cells have been FDA-approved to treat over 80 conditions, primarily targeting blood and immune system disorders. These include leukemias (such as Acute Myeloid Leukemia and Chronic Myeloid Leukemia), lymphomas (Hodgkin and Non-Hodgkin), anemias (like Sickle Cell Anemia, Thalassemia, and Fanconi Anemia), inherited metabolic disorders (such as Krabbe Disease and Hurler Syndrome), and immune deficiencies (including Severe Combined Immunodeficiency). Their lower risk of GVHD and easier immunological compatibility make them particularly effective for these treatments.

The first successful cord blood transplant took place in October 1988, when Dr. Hal Broxmeyer and his team treated Matthew Farrow, a young boy with Fanconi Anemia, using HLA-matched cord blood from his newborn sister. Remarkably, as of 2010, Farrow remained healthy and free from the disease’s hematological symptoms. Since then, over 20,000 cord blood transplants have been performed worldwide.

Beyond these approved uses, cord blood is being studied in hundreds of clinical trials for other conditions, such as autism, cerebral palsy, Type 1 diabetes, and Alzheimer's disease. These ongoing studies continue to expand the potential of cord blood stem cells in medicine.

Umbilical Cord Tissue Stem Cells

Cord blood is well-known for its hematopoietic stem cells, but umbilical cord tissue also holds a treasure trove of potential in the form of mesenchymal stem cells (MSCs). These multipotent cells, found in Wharton’s Jelly (the protective layer surrounding the cord vessels), have the ability to transform into various tissue types like bone, cartilage, muscle, nerve, fat, and even cardiac tissue.

One of the standout features of these MSCs is their unique ability to regulate immune responses. They lack HLA-DR markers and have low MHC class I molecule expression, making them less likely to trigger an immune reaction. This makes them promising candidates for unmatched (allogeneic) therapies. Additionally, these cells release compounds like PGE2 and IDO, which help suppress T-cell activity and adjust immune responses. Just one 20 cm (around 8-inch) segment of umbilical cord can yield approximately 1 million MSCs, which can double in number within three days.

"Perinatal tissues are a better source of cells than adult tissues because their cell senescence is delayed and cell expansion is expedited."

• J.E. Davies, Professor, University of Toronto

Compared to MSCs from bone marrow, which require invasive procedures and represent a tiny percentage (0.001%–0.01%) of nucleated cells, cord tissue MSCs offer several advantages. They are younger, have longer telomeres, and multiply faster. The frequency of colony-forming cells in cord tissue (ranging from 1:300 to 1:1,609) is much higher than in bone marrow (1:10,000 to 1:100,000). Even after numerous cell divisions (passages 14 to 17), cord tissue MSCs maintain steady growth, unlike bone marrow MSCs, which slow significantly after passage 6. Extracting and processing these cells requires specialized techniques to unlock their full therapeutic potential.

Extraction and Processing

After cord blood is collected, a 6- to 8-inch segment of the umbilical cord is cut and stored in a sterile container. To ensure the cells remain viable, the tissue must be processed within 48 hours.

Two main methods are used to extract MSCs from the cord tissue:

• Explant method: Small fragments of tissue (1–2 mm³) are cultured, allowing MSCs to migrate out naturally.
• Enzymatic digestion: Enzymes like collagenase or hyaluronidase are used to release the cells directly.

Advanced preservation techniques, such as CryoMaxx™, help maintain cell integrity with minimal handling. Once extracted, the cells are mixed with a cryoprotectant (usually 10% DMSO) to prevent ice crystal formation. They are then cooled at a controlled rate (about 1°C per minute) before being stored in liquid nitrogen for long-term use. Research has shown that stem cells stored this way for over 23.5 years still retain high viability.

Potential Uses

With these refined extraction and storage methods, cord tissue MSCs are being actively researched for a variety of medical applications. Their ability to transform into different cell types and naturally target damaged or inflamed tissues makes them a promising tool in regenerative medicine.

Researchers are investigating their potential in treating orthopedic, neurological, and cardiac issues. For example, in preclinical studies with hemi-parkinsonian rats, transplanting human Wharton’s Jelly cells increased dopaminergic neurons in the brain and improved behavioral symptoms. In another study from 2016, using UC-MSCs in a pig lung model with cold ischemic damage improved lung compliance and reduced inflammation markers like IL-8.

"UC‐MSCs have shown the ability to differentiate into three germ layers, to accumulate in damaged tissue or inflamed regions, to promote tissue repair, and to modulate immune response."

• Tokiko Nagamura-Inoue, MD, PhD, University of Tokyo

These cells are also being explored for autoimmune and inflammatory diseases, such as graft-versus-host disease (GvHD), Systemic Lupus Erythematosus (SLE), Crohn’s disease, and Type 1 Diabetes. In one 2010 study, UC-MSC transplantation in patients with severe, treatment-resistant SLE led to improvements in both symptoms and biochemical markers. By late 2014, nearly half (47%) of MSC clinical trials involved unmatched cells, with umbilical cord tissue playing a key role in advancing regenerative medicine.

Placental Tissue Stem Cells

The placenta, a temporary organ crucial during pregnancy, is a rich source of stem cells with diverse therapeutic applications. It consists of three main layers: the amnion and chorion (both fetal in origin) and the decidua (maternal in origin). Each layer holds specific stem cell populations, each with distinct properties.

The amnion contains two key cell types: Human Amniotic Epithelial Cells (hAECs) and Human Amniotic Mesenchymal Stromal Cells (hAMSCs). hAECs are particularly noteworthy because they express pluripotency markers like OCT-4, NANOG, and SOX-2, enabling them to differentiate into all three germ layers without forming teratomas. A single amniotic membrane can yield between 80 and 300 million hAECs, making it a plentiful source. The chorion houses Chorionic Mesenchymal Stromal Cells (hCMSCs) and Chorionic Plate MSCs (CP-MSCs), with CP-MSCs showing enhanced proliferation and migration abilities compared to other placental MSCs. The decidua, the maternal layer, contains Decidua-derived Mesenchymal Stromal Cells (DMSCs), which have stronger immunosuppressive properties than MSCs derived from Wharton's Jelly.

One of the standout features of placental stem cells is their immunoprivileged status. They express low levels of MHC Class II antigens and lack co-stimulatory molecules (CD40, CD80, CD86), making them less likely to trigger immune responses. They also secrete soluble factors and express HLA-G, which suppresses lymphocyte activity and prevents dendritic cell maturation. This immunomodulatory capacity positions these cells as excellent candidates for treating autoimmune and inflammatory diseases.

"Since placental tissue is typically discarded, it offers an attractive source of research and therapeutic cells." - Maddalena Caruso et al., Researchers, Centro di Ricerca E. Menni

Harvesting and Storage

Placental tissue collection is typically done immediately after delivery, often during a Cesarean section. The placenta is placed in a sterile container and can be stored at room temperature or 39°F for up to six hours without compromising cell viability. A full-term placenta weighs between 500 and 750 grams and has a membrane surface area of approximately 1,600 cm².

The tissue is processed by dissecting, washing with Hank's Balanced Salt Solution to remove blood, and cutting it into small pieces (1–5 mm³). Stem cells are extracted using either mechanical separation or enzymatic digestion. The enzymatic method uses collagenase I, DNase I, and dispase, agitated at 98.6°F for 1–2 hours to maximize yield. Cells are then separated from debris through pulse centrifugation and filtered through a 100 µm mesh strainer.

Advanced preservation methods, such as CryoMaxx™, isolate the amnion and chorion layers while retaining multipotent cells, growth factors, and cytokines. The processed tissue is cryopreserved in multiple vials, enabling future use. A single placenta can yield enough MSCs to produce up to 7,000 clinical doses. However, parents must inform their healthcare team and coordinate with a stem cell bank before delivery,  making it vital to choose the best cord blood bank for your family's needs, as most hospitals discard placental tissue as medical waste.

Clinical Applications

Once processed, placental stem cells demonstrate incredible therapeutic versatility. Their ability to promote tissue repair and suppress immune responses stems from cytokine secretion and pro-angiogenic activity. Placental tissue has been used in surgical procedures for over a century, and more than 50 active clinical trials are currently exploring its potential for various diseases.

For example, a 2015 Phase 1b trial administered placental stem cells intravenously to patients with idiopathic pulmonary fibrosis. After six months, researchers observed no worsening of fibrosis or major side effects, with lung function remaining stable. Similarly, a pilot Phase I trial by Jiang et al. used GMP-grade placental MSCs to treat Type 2 diabetes, showing therapeutic benefits and confirming the safety of the intervention.

Ongoing research is investigating these cells for conditions like autoimmune diseases, chronic wounds, knee osteoarthritis, and neurological disorders such as Parkinson's and Multiple Sclerosis. The amnion is particularly promising for eye repair and lung fibrosis, while chorion cells may aid in bone and vascular diseases. Decidual cells, with their strong immunosuppressive abilities, are being studied for autoimmune disorders and preeclampsia. Placental MSCs can be cultured for 5–10 passages, with some hAMSCs expandable for up to 15 passages, providing ample material for research and therapeutic use.

"Placental stem cell therapy will be a promising answer for many of today's untreatable diseases in the years to come." - Wang Y and Zhao S, Authors, Vascular Biology of the Placenta

Amniotic Fluid and Membrane Stem Cells

Amniotic fluid and membranes are a rich source of stem cells, offering three primary types: Human Amniotic Epithelial Stem Cells (hAESCs), Human Amniotic Mesenchymal Stem Cells (hAMSCs), and Amniotic Fluid Stem Cells (AFSCs). These cells strike a balance between adult multipotent and embryonic pluripotent stem cells, expressing markers like Oct-4, SSEA-4, and Nanog. Notably, more than 90% of AFSCs express Oct-4. Unlike embryonic stem cells, however, they don’t form teratomas upon transplantation, making them a safer option for clinical use.

A particularly interesting subset of AFSCs is the CD117-expressing (c-Kit+) population, which makes up about 1% of amniotic fluid cells. These cells exhibit remarkable growth capabilities, maintaining normal karyotypes and long telomeres while doubling in just 36 hours. Furthermore, a single discarded term amnion can yield an impressive 100 million amniotic epithelial cells, providing ample material for research and therapeutic purposes.

Another advantage of these cells is their immune-privileged status. They express low levels of MHC class II molecules (HLA-DR) and release immunosuppressive factors like IL-10 and TGF-β, which help prevent immune rejection by inhibiting B and T cell activation.

"Clinical research has indicated that the implantation of hAESCs or amniotic tissue in patients does not trigger an immune rejection, which might indicate their potential use as a solution to the graft-rejection issue common in ESCs and iPSCs." - Qiu et al.

Collection Process

AFSCs are typically collected through amniocentesis performed between the 15th and 19th weeks of pregnancy or recovered from clinical waste during scheduled C-sections in the third trimester. Amniotic membranes, on the other hand, are gathered at term after delivery. These membranes are mechanically separated from the chorion and processed through a two-step enzymatic digestion: trypsin isolates epithelial cells, while collagenase extracts mesenchymal cells. Undifferentiated AFSCs are then sorted using CD117 (c-Kit) selection via magnetic-activated cell sorting (MACS) or fluorescence-activated cell sorting (FACS).

The cells are cultured in serum-free systems under controlled conditions - 5% CO₂ and regulated temperatures. Advanced preservation techniques ensure their long-term viability by cryopreserving them at extreme temperatures of -320°F, while maintaining their growth factors, cytokines, and multipotent nature.

AFSCs are naturally equipped with telomerase, which keeps telomere length intact, allowing for extensive growth without aging or chromosomal damage. Additionally, exposing these cells to low-oxygen environments (hypoxic preconditioning) enhances their regenerative properties and paracrine activity. These refined collection and preservation methods make them highly adaptable for various therapeutic uses.

Therapeutic Potential

Research into amniotic fluid and membrane stem cells spans a wide range of applications. For instance, a 2012 study by Piccoli et al. demonstrated that injecting 25,000 freshly isolated AFSCs into a mouse model of muscular dystrophy improved muscle function and increased survival rates by 75%. In cardiac studies, AFSCs reduced infarct size in myocardial infarction models from 54% to 40% after intravascular injection.

Organ repair is another promising area. AFSCs have been used to restore cardiac function post-heart attack, treat acute kidney injuries like tubular necrosis, and protect lung cells from ischemia-reperfusion damage. In a 2010 study, Sun et al. showed that human AFSCs could differentiate into bone tissue when combined with bone morphogenetic protein-7 and nanofibrous scaffolds. Within eight weeks of implantation in mice, the cells formed mineralized bone, confirmed through von Kossa staining and X-ray imaging.

Wound healing applications are equally exciting. Amniotic membranes are already being used as biological dressings for severe burns, chronic ulcers, and corneal injuries. In 2022, Kunisaki et al. developed a tissue construct using mesenchymal amniocytes on a collagen scaffold. When transplanted into neonatal lambs with diaphragmatic defects, this construct showed better structural repair compared to traditional fetal myoblast grafts.

Neurological applications are also under active investigation. These cells have shown potential to differentiate into dopaminergic neurons for Parkinson's disease treatments and secrete exosomes that reduce neuroinflammation in Alzheimer’s models. Culturing these cells as 3D spheroids has been found to enhance their expression of pluripotency genes and improve their ability to generate neurons compared to traditional 2D cultures. Researchers are also exploring cell-free therapies, using the "secretome" - a collection of exosomes and extracellular vesicles - to stimulate tissue repair from within.

"Stem cells derived from amniotic fluid and membranes possess embryonic stem cell-like differentiation capabilities and, similarly to mesenchymal stem cells, they are also able to modulate the local immune response." - Tullia Maraldi, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia

Comparing Collection Methods and Storage Options

Birth tissue collection happens right after delivery, ensuring no risk to either the mother or baby.

Cord blood collection involves using a needle to draw blood from the umbilical vein after the cord is clamped and cut. The blood flows into an FDA-approved collection bag containing CPD anticoagulant.

Cord tissue collection is done by removing a segment of the umbilical cord immediately after the cord blood is collected.

Placental tissue collection requires retrieving the placenta after delivery, which is otherwise discarded as medical waste. The amnion and chorion layers are then separated mechanically for preservation.

Amniotic fluid can be collected in two ways: through amniocentesis between the 15th and 19th weeks of pregnancy or from clinical waste during planned C-sections in the third trimester.

Here’s a breakdown of how the collection process works and storage options for each type:

Comparison Table of Collection Processes

Birth Tissue	Collection Method	Timing	Average Volume/Yield	Storage Format	Processing Window
Cord Blood	Needle and gravity-fed bag	After cord clamping	98.72 mL (range: 46.6–194.3 mL)	5-compartment cryo-bags	Within 24 hours
Cord Tissue	Surgical removal of cord segment	After blood collection	Rich in MSCs from Wharton's Jelly	Intact tissue sheets in multiple vials	48–72 hours
Placental Tissue	Organ retrieval and layer separation	After placental delivery	Isolated amnion and chorion layers	Multiple vials (amnion/chorion)	48–72 hours
Amniotic Fluid	Amniocentesis or C-section recovery	15–19 weeks or at term	Contains amniotic epithelial and mesenchymal stem cells	Cryogenic vials	Immediate processing

Cord blood collections below 40 mL often lack sufficient cells for treatments. However, skilled collectors typically gather around 110 mL per placenta. To meet industry standards for storage, cord blood must contain at least 100 million total nucleated cells. Timing is also crucial - processing cord blood within 24 hours yields an average of 3.24 million CD34+ cells, compared to only 1.86 million when delayed beyond this window.

These precise collection methods ensure that cells remain viable for future therapeutic use, as discussed earlier.

Advanced Storage Solutions

Once collected, advanced storage techniques are critical to preserving these cells for the long term.

Stem cells from birth tissues are stored cryogenically at liquid nitrogen temperatures of -196°C (-320°F). Research by Dr. Hal Broxmeyer at Indiana University School of Medicine has shown that cells stored for 23.5 years still have high recovery rates. Some experts even suggest that, with proper cryogenic storage, cells could remain usable for over 200 years without losing their integrity.

Americord Registry’s CryoMaxx™ Processing method uses manual techniques to preserve tissues as intact sheets, rather than breaking them down. This specialized method, available for a $599 fee, offers families flexibility for multiple treatments in the future. Cord blood is stored in 5-compartment bags, allowing for multiple uses from a single collection. Similarly, cord and placental tissues are stored in multiple vials, enabling portions to be accessed for various therapeutic applications over time.

These advanced storage protocols ensure the regenerative potential of the collected cells is maintained, offering families a wide range of future medical possibilities.

Conclusion

The guide above highlights the incredible possibilities offered by birth tissue stem cells. Sources like cord blood, cord tissue, placental tissue, and amniotic fluid provide families with the opportunity to store powerful stem cells already used in treating more than 80 FDA-approved conditions. These cells play a key role in therapies for blood disorders and are being studied in hundreds of clinical trials for a wide range of medical conditions, showcasing their importance in the present and future of regenerative medicine.

The collection process is completely painless and non-invasive, posing no risk to either the mother or the baby. These stem cells are collected in their purest form - free from environmental toxins and the effects of aging - and can remain viable for decades when stored through proper cryopreservation methods.

"You only have one chance to preserve your baby's life-saving stem cells, and that's the day they are born." - Americord

Banking these cells ensures an exact genetic match for your child and increases the likelihood of compatibility for siblings and parents. With research suggesting that 1 in 3 Americans could benefit from regenerative medicine during their lifetime, storing birth tissues acts as a form of biological insurance, safeguarding your family’s health for years to come.

To take full advantage of these benefits, families are encouraged to finalize their banking plans by the 34th week of pregnancy. This ensures that collection kits and necessary consents are ready well before delivery day. Whether you decide to store just cord blood or opt for a more comprehensive approach - including cord tissue and placental tissue - providers like Americord Registry offer services that help secure access to both current medical treatments and future advancements that could redefine healthcare.

FAQs

What medical treatments can stem cells from birth tissues be used for?

Stem cells from birth tissues - like umbilical cord blood, cord tissue, and placental tissue - hold incredible promise for medical treatments, both now and in the future. These cells are already being used in therapies such as hematopoietic stem cell transplants, which treat conditions like blood disorders, immune deficiencies, and certain genetic diseases.

Beyond these established uses, stem cells from cord and placental tissue are being studied for their potential in regenerative medicine. Researchers are investigating how these cells can help repair damaged tissues, minimize scarring, and promote healing in wounds or burns that don’t naturally heal. There’s even emerging evidence pointing to their experimental use in tackling chronic conditions like heart disease and osteoporosis.

Preserving these tissues at birth offers families a chance to access cutting-edge medical treatments while contributing to the progress of regenerative medicine.

How are stem cells safely collected from birth tissues?

Stem cells from sources like umbilical cord blood, cord tissue, and placental tissue are gathered using safe, minimally invasive methods. For cord blood, the process is straightforward: once the baby is delivered and the umbilical cord is clamped and cut, blood is drawn from the cord and placenta. This is done in a sterile setting by skilled medical professionals, ensuring no harm or discomfort to the mother or baby.

Cord tissue and placental tissue are collected immediately after birth as well, regardless of whether it's a vaginal or cesarean delivery. These tissues are carefully handled to maintain sterility and safety throughout the process. Since these materials are typically discarded after delivery, their collection is non-invasive and doesn’t interfere with labor or delivery. Every step adheres to strict medical standards, prioritizing the health and safety of both the mother and child.

What are the benefits of storing birth tissue stem cells for the future?

Storing birth tissue stem cells is an incredible way to prepare for potential future medical needs. These stem cells, found in the umbilical cord, placenta, and cord tissue, are younger and more flexible than adult stem cells. This makes them especially useful for a range of treatments and regenerative therapies.

The collection process is simple, safe, and painless. It happens right after birth and doesn’t pose any risk to either the mother or the baby. Once collected and stored, these stem cells hold the potential to treat various conditions, including certain cancers, blood disorders, and immune deficiencies. Researchers are also exploring their use in advanced regenerative medicine, such as treatments for heart disease, stroke, and diabetes.

By choosing to store these stem cells, families gain access to a valuable biological resource that could one day benefit their health or even that of a close relative. It’s a forward-thinking choice that taps into the possibilities of modern medical advancements, ensuring access to treatments that continue to evolve.