Abstract 21: Feasibility of Harnessing Umbilical Cord Tissue for Alveolar Cleft Repair: A Collaboration between a Large Academic Institution and a Private Family Cord Blood Bank

Introduction Cleft lip and/or palate (CLP) is the most common craniofacial birth defect, affecting 1 in 700 live births. Most patients with complete CLP also have an alveolar cleft, typically repaired using secondary alveolar bone grafting with autogenous iliac crest bone grafts. Umbilical cord (UC)-derived mesenchymal stem cells (h-UCMSC) show promise for bone regeneration and offer advantages due to their non-invasive collection and lack of ethical issues. Objectives To create a pool of potential candidates by harvesting their UC tissue for future research in children born with CLP to aid in clinical application in alveolar cleft repair (ACR) and improvement in outcomes. Methods We analyzed the effectiveness of UC tissue in regenerating bone in a calvarial defects mouse model. UC tissue was collected, prepared, and implanted into the mouse model to assess the regenerative capabilities of h-UCMSC. Simultaneously, we began a program for prenatal UC tissue collection from patients diagnosed with CLP via ultrasound, in collaboration with Cord Blood Registry and the Newborn Possibilities Program (NPP). The collected UC tissue was cryopreserved, and its regenerative potential was evaluated through histological and radiographic analysis. Results The mouse model studies demonstrated complete bone fill in the calvarial defects of the h-UCMSC group compared to the controls, indicating the effective regenerative capabilities of h-UCMSC. Histological and radiographic analyses confirmed significant bone regeneration and tissue integration in the h-UCMSC mice. To date, 12 patients diagnosed with CLP via ultrasound have been successfully enrolled in NPP. Parents were offered free cryopreservation of their newborn's UC tissue for anticipated use in future ACR surgeries at age 7-8. Discussion The results highlight the promising regenerative potential of h-UCMSC in bone regeneration, evidenced by complete bone fill in the calvarial defects of the UC group compared to controls. This suggests that h-UCMSC stem cells could significantly improve outcomes in ACR for CLP patients. We continue to enroll and follow patients in NPP, aiming to refine the protocols for the optimal use of these stem cells in reconstructive surgeries.