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Người soạn: BS Nguyễn Thị Diễm Kiều (Khoa sanh – cấp cứu)

  Năm 1987, một bệnh nhân 5 tuổi, mắc bệnh thiếu máu Fanconi đã được ghép tế bào gốc máu cuống rốn của em gái sơ sinh. Đây là ca ghép tế bào gốc máu cuống rốn đầu tiên trên thế giới, được bác sĩ Eliane Gluckman thực hiện tại Bệnh viện Saint-Louis. Ca ghép diễn ra thành công và kể từ đó đã có hơn hàng ngàn bệnh nhân khác được cứu sống từ tế bào gốc lấy từ máu cuống rốn của chính mình, của những người thân hoặc thậm chí là từ những người không cùng huyết thống.

  Hiện nay việc lưu trữ tế bào gốc máu cuống rốn của trẻ sơ sinh đang dần nhận được sự quan tâm từ các bậc cha mẹ bởi những lợi ích thiết thực mà phương pháp này mang lại. Rất nhiều gia đình lựa chọ lưu trữ tế báo gốc máu cuống rốn cho trẻ sơ sinh như mua bảo hiểm sinh học trọn đời cho con.

1. Tế bào gốc máu cuống rốn là gì?

  Tế bào gốc là dạng tế bào đặc biệt, có khả năng tự tái tạo và biệt hóa thành những tế bào chuyên biệt. Chính những đặc điểm này mà tế bào gốc đang được nghiên cứu, ứng dụng rộng rãi trong điều trị bệnh di truyền, bệnh do cơ quan tạo máu, bệnh miễn dịch.

  Tế bào gốc có thể lấy từ 3 nguồn: máu ngoại vi, tủy xương, máu cuống rốn. Tuy nhiên việc lưu trữ tế bào gốc máu ngoại vi và tủy xương đòi hỏi kỷ thuật phức tạp và tốn kém hên nên máu cuống rốn được ưu tiên sử dụng.

  Cuống rốn là một bộ phận giúp cung cấp dinh dưỡng nuôi thai nhờ sự kết nối thai nhi với nhau thai trong tử cung người mẹ. Máu cuống rốn là máu được lấy từ cuống rốn và nhau thai ngay sau khi cắt rốn.

  Tế bào gốc máu cuống rốn là máu tồn tại trong nhau thai và trong dây rốn ngay sau khi sinh. Máu trong cuốn rốn được thu thập vì nó chứa các tế bào gốc, có thể được sử dụng để điều trị rối loạn máu và di truyền.

  Máu cuống rốn bao gồm tất cả các thành phần của máu như hồng cầu, bạch cầu, tiểu cầu và huyết tương. Máu cuống rốn khác máu toàn phần vì có chứa các tế bào gốc chủ yếu là các tế bào gốc tạo máu ( Hematopoietic stemcells (HSCs)). HSCs chịu trách nhiệm cho việc bổ sung máu và tái tạo hệ miễn dịch. Trước đây, dây rốn bánh nhau sau khi tách rời em bé thì được xem như một loại chất thải y tế. Nhưng hiện nay, khi mà sự ra đời của nhiều phương pháp điều trị mới sư dụng tế bào gốc, máu cuống rốn sẽ được thu thập, xử lý, kiểm tra chất lượng và lưu trữ lại. Mục đích của việc lưu trữ tế bào gốc là phục vụ cho điều trị cho chính người sở hữu dây rốn đó hoặc các thành viên khác trong gia đình khi có vấn đề sức khỏe.

2. Tại sao bạn nên lưu trữ tế bào gốc máu cuống rốn?

  Việc lưu trữ tế bào gốc máu cuống rốn của trẻ là một biện pháp tốt, bảo đảm sức khỏe trong tương lai cho những đứa trẻ này và các thành viên khác trong gia đình. Tế bào gốc được lấy từ máu cuống rốn nếu được lưu trữ có thể được sử dụng trong điều trị hơn 80 bệnh lý. Nếu lưu trữ tế bào gốc máu cuống rốn, sau này khi trẻ chẵng may mắc bệnh cần dùng tế bào gốc điều trị, đây sẽ là nguồn tế bào gốc phù hợp nhất, không gây ra những phản ứng thải ghép của cơ thể. Bởi đây là nguồn tế bào gốc có khả năng phù hợp miễn dịch phục vụ cho:

– Điều trị bệnh cho chính đứa trẻ đó trong cả cuộc đời

– Điều trị cho người thân nhờ khả năng phù hợp giữa người bệnh và mẫu tế bào của trẻ sẽ cao hơn so với nguồn tế bào gốc từ những người không huyết thống.

– Điều trị nhiều bệnh dựa trên khả năng biến đổi của tế bào gốc máu cuống rốn thành các loại tế bào máu. Chúng có thể sản sinh ra các tế bào máu như: hồng cầu, bạch cầu, tiểu cầu…

– Điều trị các loại ung thư máu, thay thế tủy xương và sửa chữa các rối loạn do di truyền. Một số bệnh lý thường được chỉ định điều trị bằng ghép tế bào gốc máu cuống rốn: bạch cầu cấp, hội chứng rối loạn sinh tủy, suy giảm miễn dịch kết hợp trầm trọng, thiếu máu Fanconi, suy tủy nặng, Thalassemia, suy tủy dòng hồng cầu, thiếu máu hồng cầu hình liềm…

– Tái tạo các tế bào máu khỏe mạnh với tốc độ nhanh hơn, việc điều trị bệnh cũng vì thế mà khả quan hơn.

– Biệt hóa hành những tế bào của những mô khác như cơ, tế bào não, tế bào gan, tế bào da, tế bào phổi, tế bào thận, tế bào ruột, tế bào tụy.

3. Tế bào gốc máu cuống rốn được thu thập và lưu trữ như thế nào?

  Việc thu thập và lưu trữ tế bào gốc cuống rốn không vi phạm đạo đức. Quá trình thu thập tương đối dễ dàng và không có rủi ro gì đối với cả mẹ và trẻ sơ sinh.

  Trước khi sinh, người mẹ cần đến các cơ sở lưu trữ tế bào máu cuống rốn xét nghiệm sức khỏe nhằm đảm bảo bản thân không mắc các bệnh truyền nhiễm, ung thư, bệnh miễn dịch, nhiễm trùng,…

  Tương tự như kỹ thuật lấy máu toàn phần, bác sĩ sản khoa sẽ sử dụng kim nối vào tĩnh mạch rốn được nối với túi thu thập, trong túi có chứa sẵn chất chống đông để ngăn hình thành cục máu đông. Thu thập máu cuống rốn có thể thực hiện trước hoặc sau khi sổ nhau.

  Sau quá trình thu thập, máu cuống rốn cần được thực hiện các xét nghiệm để, chuyển về ngân hàng tế bào gốc máu cuống rốn để tiến hành các bước xử lý tiếp theo nhằm loại bỏ những thành phần thừa, tinh lọc tế bào gốc và lưu trữ.

  Trên thực tế rất khó để xác định thời gian lưu trữ tối đa cho các tế bào gốc máu cuống rốn. Vì thực tế trên thế giới các ngân hàng máu cuống rốn mới chỉ tồn tại được khoảng 30 năm. Tuy nhiên, các nhà khoa học cho rằng các tế bào được bảo quản trong điều kiện đông lạnh không có ngày hết hạn và máu cuống rốn đông lạnh có thể lưu trữ vô thời hạn. Điều này được dựa trên 2 giả thuyết:

– Tế bào gốc máu cuống rốn được lưu trữ ở nhiệt độ < -190OC, mức ngừng hoạt động sinh học.

– Tinh trùng và các tế bào khác khi được lưu trữ trong vòng 50 năm vẫn có thể hoạt động sau khi giải đông.

   Lấy máu cuống rốn không gây bất kỳ rủi ro nào cho mẹ và bé. Ngày nay với kỹ thuật y học hiện đại, việc ứng dụng tế bào gốc trong điều trị những căn bệnh nan y đang ngày càng phổ biến. Theo thống kê cứ 217 người sẽ có 1 người cần tế bào gốc để điều trị bệnh trong cuộc đời họ. Chính vì vậy ngày càng nhiều gia đình lưu trữ máu cuống rốn cho con, không chỉ tạo nguồn tế bào gốc có sẵn trong trường hợp đứa trẻ không may mắc các bệnh trong tương lai mà còn có thể dùng để điều trị cho những người thân.

TÀI LIỆU THAM KHẢO

1.Weiss ML, Troyer DL. Stem cells in the umbilical cord. Stem Cell Rev. 2006;2(2):155–162.
2. https://en.wikipedia.org/wiki/Cord_blood
3.http://www.stemcellsaustralia.edu.au/About-Stem-Cells/FAQ/What-are-umbilical-cord-stem-cells-.aspx
4. https://www.cordblood.com/benefits-cord-blood/umbilical-cord-stem-cells

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