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In fact, the shocking truth is that the majority of all cord blood stored in private banks may be unusable. Approximately 75 percent of the units donated to public banks are discarded or used in research because they don’t contain enough stem cells for transplants, says Mary Halet, manager of cord-blood operations for the Center for Cord Blood at the National Marrow Donor Program, a Minneapolis-based nonprofit organization that maintains the nation’s largest public supply of cord blood. Yet private banks store every unit they collect, which means that you might pay to store blood that won’t be usable if you need it years later.
Donating cord blood to a public cord blood bank involves talking with your doctor or midwife about your decision to donate and then calling a cord blood bank (if donation can be done at your hospital). Upon arriving at the hospital, tell the labor and delivery nurse that you are donating umbilical cord blood.
If you are interested in donating cord blood to a public bank and do not have access to a hospital that accepts cord blood donations, you can contact a lab that offers a mail-in program. After you’ve passed the lab’s eligibility screening process, they’ll send you a kit that you can use to package and mail in your cord blood.2
First, the cells are checked to see if they can be used for a transplant. If there are too few cells, the cord blood unit may be used for research to improve the transplant process for future patients or to investigate new therapies using cord blood, or discarded.
The therapuetic potential of cord blood continues to grow. Over the last few years cord blood use has expanded into an area known as regenerative medicine. Regenerative medicine is the science of living cells being used to potentially regenerate or facilitate the repair of cells damaged by disease, genetics, injury or simply aging. Research is underway with the hope that cord blood stem cells may prove beneficial in young patients facing life-changing medical conditions once thought untreatable – such as autism and cerebral palsy.
A major limitation of cord blood transplantation is that the blood obtained from a single umbilical cord does not contain as many haematopoeitic stem cells as a bone marrow donation. Scientists believe this is the main reason that treating adult patients with cord blood is so difficult: adults are larger and need more HSCs than children. A transplant containing too few HSCs may fail or could lead to slow formation of new blood in the body in the early days after transplantation. This serious complication has been partially overcome by transplanting blood from two umbilical cords into larger children and adults. Results of clinical trials into double cord blood transplants (in place of bone marrow transplants) have shown the technique to be very successful. Some researchers have also tried to increase the total number of HSCs obtained from each umbilical cord by collecting additional blood from the placenta.
Ironically, some private banks also hope to benefit from this new legislation. “We have the capabilities and capacity to collect and store donated as well as private units,” says Cryo-Cell’s Maass. In fact, because the bill recommends that pregnant women be informed of all of their cord-blood options, it’s likely that donations to both public and private banks will increase.
Then, the cord blood is listed on a national registry. Be The Match is the name of the U.S. registry. This organization also partners with international programs, which means your child’s stem cells could be used to treat a patient on the other side of the world.
In the rare event of a processed sample not adhering to quality standards, CBR’s certified genetic counselors will work with potential clients to help them understand their options. Under this scenario, clients will have the option to discontinue storage and receive a refund.
The Doneses were shocked, however, when doctors told them that Anthony’s cord blood couldn’t be used because the cells contained the same genetic defect that caused his condition. “The materials provided by the bank said this was Anthony’s life insurance and could save him if he needed it. They never mentioned that the cells could be diseased. We felt duped,” Tracey says. The Long Island, New York, couple has since filed a lawsuit against the bank alleging false advertising and consumer fraud.
ES cells are pluripotent, and similar to iPS cells, but come from an embryo. However, this kills the fertilized baby inside the embryo. This type of cell also has a high chance for graft-versus-host disease, when transplanted cells attack the patient’s body.
Even if a sick child has a sibling donor, there’s only a 25 percent chance that cord blood will be a perfect match — and an equal chance it won’t match at all. That’s why public donations are so important. So far, many more stem-cell transplants have been done using cord blood stored in public banks. From 2000 to 2004, more than 2,200 unrelated transplants were done nationwide.
Once donated cord blood is listed on the Be the Match registry, doctors can access it to treat patients who need stem cell transplants. Public cord blood banks keep the names of both mothers and babies confidential to protect the privacy of families.
While cord-blood companies herald the possible future treatments of many adult diseases with stem cells, they rarely mention a key issue. Researchers have greater hopes for the potential of embryonic stem cells, which are thought to have the ability to develop into many different types of cells. It is not known whether the stem cells in cord blood have that ability; until recently, it was thought that they (like those in bone marrow) could only regenerate blood and immune cells.
Cord blood is currently approved by the FDA for the treatment for nearly 80 diseases, and cord blood treatments have been performed more than 35,000 times around the globe to treat cancers (including lymphoma and leukemia), anemias, inherited metabolic disorders and some solid tumors and orthopedic repair. Researchers are also exploring how cord blood has the ability to cross the blood–brain barrier and differentiate into neurons and other brain cells, which may be instrumental in treating conditions that have been untreatable up to this point. The most exciting of these are autism, cerebral palsy and Alzheimer’s.
If you received your information in the mail, you can give them the reminder post card that was sent to you. During the admission process you may be asked if you want to be a cord blood donor. In the event that you had not pre-registered, you can still donate and complete all the necessary paperwork at the hospital.
The biggest advantage for cord blood is the “immaturity” of the cells, which means transplants do not require an exact match. For bone marrow and peripheral blood transplants, donors need to match the patient’s cellular structure. However, cord blood cells can adapt to a wide variety of patients, and don’t require donor matching. Chances for graft-versus-host disease are also much lower for cord blood transplants.
Cord blood contains mesenchymal stem cells but is much more abundant in hematopoietic stem cells. Cord tissue, on the other hand, contains some hematopoietic stem cells but is much richer in mesenchymal stem cells. Cord tissue, or Wharton’s jelly, is the protective layer that covers the umbilical cord’s vein and other vessels. Its MSCs can become a host of cells including those found in the nervous system, sensory organs, circulatory tissues, skin, bone, cartilage, and more. MSCs are currently undergoing clinical trials for sports injuries, heart and kidney disease, ALS, wound healing and autoimmune disease. As with cord blood, cord tissue is easily collected at the type of birth and holds great potential in regenerative medicine. Learn more about cord tissue banking here.
One part of the Program, the Cord Blood Coordinating Center, has a network of cord blood banks, including some banks that get Federal support to build the NCBI. The Cord Blood Coordinating Center works with its network of cord blood banks to recruit expectant parents for umbilical cord blood donations and to distribute cord blood units listed on the registry of the C.W. Bill Young Cell Transplantation Program, also called the Be The Match Registry®. The registry is a listing of potential marrow donors and donated cord blood units.
Umbilical cord blood contains haematopoietic (blood) stem cells. These cells are able to make the different types of cell in the blood – red blood cells, white blood cells and platelets. Haematopoietic stem cells, purified from bone marrow or blood, have long been used in stem cell treatments for leukaemia, blood and bone marrow disorders, cancer (when chemotherapy is used) and immune deficiencies.
We will notify both your doctor and the hospital that you have registered to donate your baby’s cord blood to our program. However, we recommend that you remind the Labor and Delivery staff when you go for your delivery that you want to donate cord blood.
Mesenchymal cells have been reported to act as supporting cells that promote the expansion of other stem cell types. For example, MSCs and MSC-like cells support ex vivo expansion of hematopoietic stem cells (28,69–71). When co-grafted, MSCs and MSC-like cells support in vivo engraftment of hematopoietic stem cells, too (23,43,72). This work suggests that MSCs from a variety of sources, including umbilical cord, may facilitate engraftment of hematopoietic stem cells. This addresses two significant problems found in umbilical cord blood transplantation: (1) getting enough cells to engraft an adult and (2) increasing the speed of engraftment (12,73). Theoretically, cografting or ex vivo expansion may enable transplantation of cord blood units into larger patients and speed the engraftment in other patients.
If you’re looking to attain cord blood from a public bank, be aware that matched cord blood, as with bone marrow, can be difficult to obtain through a public cord blood bank. Once a match is ascertained, it may take valuable weeks, even months, to retrieve the match, and the cost of acquiring the cord blood from a public bank can be upwards of $40,000. When the newborn’s umbilical cord blood is banked privately, they can be retrieved quickly, and since the parents own the cord blood, banks can perform the retrieval free of charge. Learn more about public versus private cord blood banking here.
What is cord blood and why should we care? Cord blood contains stem cells that have huge potential to help your family. It can only be collected from a newborn’s umbilical cord immediately after birth. They’re unique and can be used to treat life threatening diseases such as anemia and leukemia. We’re just beginning to tap into its potential.
In the last 10 yr, umbilical cord blood has been shown to be therapeutically useful for rescuing patients with bone marrow-related deficits and inborn errors of metabolism. Umbilical cord blood offers advantages over bone marrow because cord blood does not require perfect human leukocyte antigen (HLA) tissue matching, has less incidence of graft vs host disease, and may be used allogenically (11,12). In addition, cord blood may be banked, and thus is available for use “off-the-shelf.” Last year, a federally supported program was established to expand the national umbilical cord blood banks to include a wide sample of HLA types. By 2004, there were more than 6000 cord blood stem cell units banked. As of January 2006, it is estimated that there are about 300,000 units in public and private banks in the United States.
^ Jump up to: a b Thornley, I; et al. (March 2009). “Private cord blood banking: experiences and views of pediatric hematopoietic cell transplantation physicians”. Pediatrics. 123 (3): 1011–7. doi:10.1542/peds.2008-0436. PMC 3120215 . PMID 19255033.
In addition, CBR offers Genetic Counselors on staff to help families make informed decisions about newborn stem cell banking. Phone 1-888-CORDBLOOD1-888-CORDBLOOD to speak with a CBR Genetic Counselor.
Medical staff at the public cord blood bank will check to see if you can donate. If you have had a disease that can be given to another person through blood-forming cells, such as hepatitis B, hepatitis C, or HIV (the AIDS virus), you will likely not be able to donate. However, other medical reasons may still allow you to donate, for example, hepatitis A or diabetes only during your pregnancy (gestational diabetes). The staff at the public cord blood bank will tell you.
Whole genome sequencing is the process of mapping out the entire DNA sequence of a person’s genome. This test can show what type of health concerns we might face and most importantly how we can improve our health and quality of life.
^ a b Walther, Mary Margaret (2009). “Chapter 39. Cord Blood Hematopoietic Cell Transplantation”. In Appelbaum, Frederick R.; Forman, Stephen J.; Negrin, Robert S.; Blume, Karl G. Thomas’ hematopoietic cell transplantation stem cell transplantation (4th ed.). Oxford: Wiley-Blackwell. ISBN 9781444303537.
Cord Blood Registry is a registered trademark of CBR® Systems, Inc. Annual grant support for Parent’s Guide to Cord Blood Foundation is made possible by CBR® through the Newborn Possibilities Fund administered by Tides Foundation.
The parents who make the decision to store their baby’s cord blood and cord tissue are thinking ahead, wanting to do right from the start (even before the start), and taking steps to do whatever they can to protect their baby down the road. Today, many conscientious parents are also considering delayed cord clamping (DCC), a practice in which the umbilical cord is not clamped immediately but rather after it continues to pulse for an average of 30 seconds to 180 seconds. Many parents don’t realize that they can delay the clamping of the cord and still bank their baby’s cord blood. As noted early, our premium processing method, PrepaCyte-CB, is able to capture more immune system cells and reduce the greatest number of red blood cell contaminants. This makes it go hand in hand with delayed cord clamping because it is not as affected by volume, effectively making up for the smaller quantity with a superior quality. You can read more about delayed cord clamping vs. cord blood banking here.
^ Jump up to: a b Walther, Mary Margaret (2009). “Chapter 39. Cord Blood Hematopoietic Cell Transplantation”. In Appelbaum, Frederick R.; Forman, Stephen J.; Negrin, Robert S.; Blume, Karl G. Thomas’ hematopoietic cell transplantation stem cell transplantation (4th ed.). Oxford: Wiley-Blackwell. ISBN 9781444303537.
Private (commercial) cord banks will store the donated blood for use by the donor and family members only. They can be expensive. These banks charge a fee for processing and an annual fee for storage.
Umbilical cord blood contains a large amount of stem cells. If parents sign up for personalized storage or donation, medical staff will remove stem cells from the umbilical cord and placenta. The blood is then cryogenically frozen, and put into long-term storage.
MSC-like cells derived from Wharton’s jelly adjacent to umbilical vessels (termed human umbilical cord perivascular cells) cultured in nonosteogenic media nevertheless contained a subpopulation that demonstrated a functional osteogenic phenotype with the elaboration of bone nodules (29); addition of osteogenic supplements further enhanced this population. These findings suggest that cord matrix stem cells, like bmMSCs, are multipotent: capable of making ectoderm- and mesoderm-derived cells.
Most of the diseases on the proven treatment list are inherited genetic diseases. Typically, these treatments require a donor transplant, as from a sibling. In fact, research shows that treatments using cord blood from a family member are about twice as successful as treatments using cord blood from a non-relative.9a, 17 To date, over 400 ViaCord families have used their cord blood 56% were for transplant.1