^ a b Ballen, KK; Gluckman, E; Broxmeyer, HE (25 July 2013). “Umbilical cord blood transplantation: the first 25 years and beyond”. Blood. 122 (4): 491–8. doi:10.1182/blood-2013-02-453175. PMC 3952633 . PMID 23673863.
The American Pediatric Association in 2008 recommended that physicians recommend that cord blood be donated instead of saved privately for family families. One of the major proponents for this was Joanne Kurtzberg, who profited from this by getting funding for her public cord blood bank at Duke University. She has since started her own private cord blood bank after doing more research on Cerebral Palsy. Interesting.
As noted earlier, with better matching, there is a greater chance of success and less risk of graft-versus-host disease (GvHD) in any stem cell transplant. With cord blood, the baby’s own cells are always a perfect match and share little risk. When using cord blood across identical twins, there is also a very low chance of GvHD although mutations and biological changes caused by epigenetic factors can occur. Other blood-related family members have a 35%–45% chance of GvHD, and unrelated persons have a 60%–80% chance of suffering from GvHD.
There are no hard numbers on a child’s risk of needing a stem-cell transplant: It’s anywhere between one in 1,000 and one in 200,000, according to studies cited by ACOG and the AAP. But private banks’ marketing materials often place the odds at one in 2,700 and note that these numbers don’t factor in its potential future use for diabetes, Alzheimer’s, Parkinson’s disease, and spinal-cord injuries in adults. “Researchers are constantly discovering new treatments using stem cells,” says Gerald Maass, executive vice president of corporate development for Cryo-Cell, a private bank in Clearwater, Florida. Another major bank’s Web site claims incredible odds: “Should cord blood prove successful in treating heart disease, the lifetime probability of being diagnosed with a disease treatable by cord blood will increase from one in 100 to one in two.”
Collected cord blood is cryopreserved and then stored in a cord blood bank for future transplantation. Cord blood collection is typically depleted of red blood cells before cryopreservation to ensure high rates of stem cell recovery.
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.
 Ian Thornley, Mary Eapen, Lillian Sung, Stephanie J. Lee, Stella M. Davies and Steven Joffe, “Private cord blood banking: experiences and views of pediatric hematopoietic cell transplantation physicians,” Pediatrics 123 (2009): 1011-1017.
The AMA also suggests considering private cord blood banking if there is a family history of malignant or genetic conditions that might benefit from cord blood stem cells. Keep in mind, however, that to find a suitable match for any type of transplant, 70% must look outside their family.
CBR Cord Blood Education Specialists are available 7 days a week (Monday – Friday 6 AM – 9 PM PST and Saturday – Sunday 6 AM – 4 PM PST) to respond to consumer inquiries. In addition, consumers may request to schedule a call with a CBR Cord Blood Education Specialist at a specific date and time.
“This is a medical service that has to be done when your baby’s cells arrive and you certainly want them to be handled by good equipment and good technicians,” says Frances Verter, Ph.D., founder and director of Parent’s Guide to Cord Blood Foundation, a nonprofit dedicated to educating parents about cord blood donation and cord blood therapists. “It’s just not going to be cheap.” Although the American Academy of Pediatrics (AAP) states cord blood has been used to treat certain diseases successfully, there isn’t strong evidence to support cord blood banking. If a family does choose to bank cord blood, the AAP recommends public cord blood banking (instead of private) to reduce costs.
“This reanalysis supports several previously expressed opinions that autologous [to use one’s OWN cells] banking of cord blood privately as a biological insurance for the treatment of life-threatening diseases in children and young adults is not clinically justified because the chances of ever using it are remote. The absence of published peer-reviewed evidence raises the serious ethical concern of a failure to inform prospective parents about the lack of future benefit for autologous cord banking … Attempts to justify this [commercial cord blood banking] are based on the success of unrelated public domain cord banking and allogeneic [using someone ELSE’S cells] cord blood transplantation, and not on the use of autologous [the person’s OWN cells] cord transplantation, the efficacy of which remains unproven”.
Certainly, there are plenty of doctors who have high hopes for stem-cell advances and advise patients to consider cord-blood banking. When private banks first started sending him informational packets, Jordan Perlow, MD, a maternal-fetal specialist in Phoenix, assumed they were just trying to profit from parents’ anxieties. But after attending medical conferences and scrutinizing studies about developments in stem-cell therapies, Dr. Perlow now encourages his patients to privately bank if they can afford it because he’s convinced that it might save their child’s life or the life of another family member. “If private banking had been available when my children were born, I would have done it,” he says.
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.
Becoming a parent is a life-changing moment full of promise, joy and a natural share of anxiety. For parents of a sick child, those worries are more intense – especially if that child needs a stem cell transplant to survive. You have the power to Give Life to patients in Canada and around the world.
Banking your child’s cord blood really comes down your personal choice. Some people may seem the potential benefits, while others can’t justify the costs. No one debates cord blood cells being a lifesaver, and in recent years, more than 20,000 lives have been saved because of it; however, experts, such as The American Academy of Pediatrics, note that your odds of using this blood is about one in 200,000. Instead of buying into a company’s advertising scheme, be sure to do your own research and deem what’s best for your child’s future.
Cord blood holds promise for future medical procedures. Scientists are still studying more ways to treat more diseases with cord blood. At Duke University, for example, researchers are using patients’ own cord blood in trials for cerebral palsy and Hypoxic ischemic encephalopathy (a condition in which the brain does not receive enough oxygen). Trials are also under way for the treatment of autism at the Sutter Neuroscience Institute in Sacramento, California.
Private cord blood banks allow families to store cord blood stem cells for themselves and their loved ones. They are privately funded, and typically charge a first-year processing fee that ranges from about $1,400 to $2,300, plus annual storage costs of about $115 to $175. (Americord offers cord blood banking for a one-time fee of $3,499, which includes 20 years of storage). The pros and cons of private cord blood banking are listed below.
To save money, public banks will not even process a cord blood donation unless they know in advance that they are going to keep it. When the collection first arrives at the lab, it is passed through a cell counting machine. Only collections that have at least 900 million nucleated cells are kept. As a result, over 60%-80% of cord blood donations are discarded. The public bank must absorb the expense of the collection kit and delivery charges for discarded blood; typically $100 per unit.
The unpredictability of stem cell transportation led CBR to create a crush-resistant, temperature-protected, and electronically tracked collection kit that is designed to preserve the integrity and to help ensure the safe delivery of the blood and/or tissue. CBR’s CellAdvantage® Collection Kit contains everything the healthcare provider needs to easily and safely collect the maximum amount of a newborn’s cord blood following birth.
Most of the diseases on the proven treatment list are inherited genetic diseases. Typically, a child with a genetic disease would require cord blood unit from a sibling or an unrelated donor. Having a sibling cord blood unit can be a great advantage as 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
Because of these limitations and the uncommon occurrence of the diseases treatable with stem cell transplant, there have been just more than 400 autologous cord blood transplants in United States in the last two decades. In contrast, more than 60,000 unrelated donor cord blood transplants have been performed worldwide.
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 next step at either a public or family bank is to process the cord blood to separate the blood component holding stem cells. The final product has a volume of 25 milliliters and includes a cryoprotectant which prevents the cells from bursting when frozen. Typical cost, $250 to $300 per unit.
Cord blood is used the same way that hematopoietic stem cell transplantation is used to reconstitute bone marrow following radiation treatment for various blood cancers, and for various forms of anemia. Its efficacy is similar as well.
Similar to transplantation, the main disadvantage is the limited number of cells that can be procured from a single umbilical cord. Different ways of growing and multiplying HSCs in culture are currently being investigated. Once this barrier is overcome, HSCs could be used to create “universal donor” stem cells as well as specific types of red or white blood cells. Immunologic rejection is a possibility, as with any stem cell transplant. HSCs that are genetically modified are susceptible to cancerous formation and may not migrate (home) to the appropriate tissue and actively divide. The longevity of cord blood HSCs is also unknown.
LifebankUSA seeks mothers in NEW YORK & NEW JERSEY ONLY who will donate both their cord blood and their placenta. The donations support an international registry, clinical trials and research. Donations can be taken from any hospital, but mothers must register at least 8 weeks prior to delivery and pass a health screening.
The cord blood collection process is simple, safe, and painless. The process usually takes no longer than five minutes. Cord blood collection does not interfere with delivery and is possible with both vaginal and cesarean deliveries.
Public cord blood banking supports the health of the community. Public banks collect qualifying cord blood donations from healthy pregnancies and save them in case one of them will be the match to save the life of a patient who needs a stem cell transplant. In the United States our registry of donors is called Be The Match. Patients who have a rare genetic type are more likely to receive cord blood transplants. In order for parents to donate cord blood to a public bank, their baby must be born at a hospital that accepts donations. Public cord blood banking is highly recommended by both the American Academy of Pediatrics (AAP) and American Medical Association (AMA).
Excitement about cord tissue’s potential to help conditions affecting cartilage, muscle and nerve cells continues to grow.19 Researchers are focusing on a wide range of potential treatment areas, including Parkinson’s disease, Alzheimer’s, liver fibrosis, lung cancer, and sports injuries. Since 2007 there have been 150 clinical trials using cord tissue stem cells.
CBR collection kits have been designed to shield the samples from extreme temperatures (shielding for more than 1 hour at extreme hot and cold). Samples remain at room temperature and are shipped directly to the CBR lab for processing.
The baby’s cord blood will be processed and stored in a laboratory facility, often referred to as a blood bank. The cord blood should be processed and stored in a facility that is accredited by the American Association of Blood Banks (AABB) for the purpose of handling stem cells.
Cord blood (short for umbilical cord blood) is the blood that remains in the umbilical cord and placenta post-delivery. At or near term, there is a maternal–fetal transfer of cells to boost the immune systems of both the mother and baby in preparation for labor. This makes cord blood at the time of delivery a rich source of stem cells and other cells of the immune system. Cord blood banking is the process of collecting the cord blood and extracting and cryogenically freezing its stem cells and other cells of the immune system for potential future medical use.
^ 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.
A limitation of cord blood is that it contains fewer HSCs than a bone marrow donation does, meaning adult patients often require two volumes of cord blood for treatments. Researchers are studying ways to expand the number of HSCs from cord blood in labs so that a single cord blood donation could supply enough cells for one or more HSC transplants.