Hybrid Cord Blood Banking in Switzerland

Switzerland is a mountainous country in central Europe that is about the size of the US state of New Jersey¹. The population of Switzerland is 8 million, but depending on where citizens live, their official language is either French or German or Italian¹. Switzerland has a long history of remaining neutral in military conflicts, and has become one of the world’s wealthiest countries^2,3. European companies find it attractive to establish their headquarters in Switzerland, because the country has one of the lowest VAT rates in Europe³. The birth rate of Switzerland is falling, which is typical of developed nations that do not offer incentives to encourage parents to have children⁴.

Security and Choice for Swiss Families

Traditionally, parents in Switzerland have had to choose between private and public cord blood storage. Recently, the family bank Swiss Stem Cells Biotech (SSCB), a part of the Swiss Stem Cells Solutions group, has begun to offer a form of hybrid banking which includes a crossover from private to public. The term “hybrid” banking is applied to cord blood banks that offer both private family banking and public donation. But in most hybrid banks, the two avenues of banking are completely separate. A bank is said to offer a “crossover” option when parents initially store the cord blood for their family, but the HLA type is listed on a registry and parents have the option to release their child’s cord blood if it matches a patient in need. There are very few Hybrid/Crossover cord blood banks in the world.

Hybrid cord blood banking with a Crossover to public donation offers the best of both worlds to both families and the community. Parents can store their child’s umbilical cord blood for family use and, at the same time, register it publicly. This approach enables families to access the cells if needed, while making them available for anonymous patients should a match arise. The decision to donate remains with the family. If the family opts to donate, they will receive reimbursement for their storage costs. If the family chooses not to donate, the sample is reserved exclusively for their own use.

The Pilot Project

Swiss Stem Cells Biotech successfully completed a hybrid cord blood bank pilot project from mid-2020 to mid-2022. The pilot project was conducted at the University Clinic of Gynecology and Obstetrics at the Inselspital in Bern. The project was developed in partnership between the Bern hospital, the Swiss Red Cross Transfusion Service, and Swiss Stem Cells Biotech (SSCB), and was approved by the Swiss Federal Office of Public Health. During the pilot phase, families could select among public, private, or hybrid storage.

A published survey of the decisions made by banking mothers in the pilot study found that 72% donated their cord blood, 25% opted for hybrid storage, and 3% chose completely private storage⁵. These parent choices show that the hybrid option is not significantly reducing donations, but it is encouraging participation in family banking.

The hybrid model represents a valuable advance for families and the community. It is well known that public banks struggle to balance operating costs versus having a large enough inventory to match potential patients⁶. It is more cost effective to populate a registry of HLA types with crossover units than with pure public donations. By preserving all samples, regardless of size, it helps overcome a common barrier in public banking, where only large-volume samples are stored. This inclusive approach can collect more cord blood units from ethnicities that are not well represented in the Swiss Blood Stem Cell Donor Registry. This model gives a public option to women that are not giving birth at one of the four hospitals in Switzerland where donations are collected for the two public banks. This model also requires that all cord blood units in the bank must be processed under the strict quality standards of public banking.

Next Steps

The Swisscord Commission has approved the expansion of this model to other maternity units throughout Switzerland. The model is currently operating in the Ente Ospedaliero Cantonale (EOC) in Ticino, renowned for its UNICEF-certified Baby-Friendly Hospitals.  As the project grows, it offers Swiss families a unique, dual-purpose storage solution that improves family peace of mind and enhances the community health resources.

References

1. National Geographic Kids. Countries. Switzerland. Accessed 2024-11-11
2. Andrews E. Why is Switzerland a Neutral Country? History.com. Last updated 2023-08-25
3. The Swiss Confederation. Swiss economy – Facts and figures. About Switzerland. Last update 2024-01-01
4. Turuban P. Fertility rates plummet in Switzerland – and beyond. Swissinfo.ch Published 2024-02-29
5. Laue J, Ambühl J, Surbek D. Hybrid cord blood banking in a private-public-partnership: Women's perspectives. Transfusion 2024; 64:1270-1278.
6. Verter F. RAND Corporation report on Public Cord Blood Banking Industry. Parent's Guide to Cord Blood Foundation Newsletter Published 2017-11