cord blood collection protocol | saving umbilical cord blood controversy

The first cord blood banks were private cord blood banks. In fact, Cryo-Cell is the world’s first private cord blood bank. It wasn’t until later that the government realized the need to preserve cord blood for research and public welfare. As a result, 31 states have adopted a law or have a piece of pending legislation that requires or encourages OBGYNs to educate expectant parents about cord blood banking and many states now have publicly held cord blood banks. As a result, parents have the option of banking their baby’s cord blood privately for the exclusive use of the child and the rest of the family or donating the cord blood to a public bank so that it can be used in research or by any patient who is a match and in need.
CBR was the first family bank accredited by AABB (formerly the American Association of Blood Banks) and the company’s quality standards have been recognized through ISO 9001:2008 certification—the global business standard for quality. The Federal Drug Administration (FDA) has issued cord blood regulations, and the states of California, Illinois, Maryland, New York and New Jersey have mandatory licensing for cord blood banking. The stringent laboratory processes, record keeping, quality control and quality assurance of CBR are designed to meet all federal and state guidelines and regulations.
Complicating matters further, each public bank has its own registry, so transplant centers must search many different databases to find a match for a patient. Currently, a Caucasian patient has an 88 percent chance of finding a cord-blood match through a public-bank registry, and minorities have a 58 percent chance. (Collection hospitals tend to be in areas with higher rates of Caucasian births, and parents from certain ethnic groups are wary of donating for religious or cultural reasons.)
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.
CBR Clients: Did you know that when you refer a friend, and they preserve their baby’s stem cells with us, you receive a free year of cord blood storage? After your first referral, you start earning even more rewards. (Exclusions apply):
Bone marrow and similar sources often requires an invasive, surgical procedure and one’s own stem cells may already have become diseased, which means the patient will have to find matching stem cells from another family member or unrelated donor. This will increase the risk of GvHD. In addition, finding an unrelated matched donor can be difficult, and once a match is ascertained, it may take valuable weeks, even months, to retrieve. Learn more about why cord blood is preferred to the next best source, bone marrow.
Dr. C. L. Cetrulo is thanked for critically reviewing the manuscript. Thanks to Dr. M. S. Rao and the members of the stem cell laboratory at NIA for their hospitality during my sabbatical leave and their continued assistance with this work. Thanks to my wife, Betti, and my children, Rita, Jonathan, Ellen, and James, for their patience and understanding. Dr. S. Bennet is thanked for assisting with umbilical cord collection. The anonymous donors are thanked for donating their umbilical cords. The Midwest Institute for Comparative Stem Cell Biology members who contributed to this work: M. Pyle, J. Hix, R. Rakasheklar, D. Davis, R. Carlin, D. Davis, S. Medicety, K. Seshareddy, C. Anderson, and M. Burton are thanked for their assistance. Thanks to our collaborators at ViaCell, Inc. (E. Abraham and A. Krivtsov, M. Kraus, S. Wnendt, and J. Visser) and at Athersys, Inc. (R. Deans and A. Ting) for their assistance and support. Drs. H. Klingemann (Tufts) and F. Marini (MD Anderson) are thanked for sharing the results of their ongoing work. This work was supported by National Institutes of Health (NIH) (salary support during sabbatical leave), Department of Anatomy and Physiology, College of Veterinary Medicine Dean’s office, Terry C. Johnson center for Basic Cancer Research and NIH NS034160. MLW is a paid consultant for RMI (Las Vegas, NV).
Founded in 1992, CBR has stored more than 600,000 cord blood and cord tissue collections from 3,500 hospitals in over 100 countries and partnered with institutions to establish multiple FDA-regulated clinical trials. CBR has helped more than 400 families use their cord blood stem cells for established and experimental medical treatments, more than any other family cord blood bank. CBR’s goal is to expand the potential scope of newborn stem cell therapies that may be available to patients and their families.
If you feel that the procedure is too expensive for your child, check with the hospital to see if there are any programs and/or grants available that can assist with the procedure.  Some companies do offer financial aid.
Not surprisingly, this emotional pitch is working — especially because the seemingly unlimited potential of stem cells has dominated the news in recent years. From 2003 to 2004, for example, the number of couples opting to use a private bank increased by 55 percent to 271,000. The three biggest companies — who have the majority of the approximately $250 million market — are vying for business.
Carolinas Cord Blood Bank at Duke (CCBB) is headed by Dr. Joanne Kurtzberg. Expectant parents who have a child in need of therapy with cord blood, especially the new therapies in clinical trials at Duke, may be eligible for directed donation through CCBB.
In addition to their immune-suppressive properties, MSCs appear to exhibit a tropism for damaged or rapidly growing tissues. For example, following injection into the brain, MSCs migrate along known pathways when injected into the corpus striatum (44). MSCs migrated throughout forebrain and cerebellum, integrated into central nervous system cytoarchitecture, and expressed markers typical of mature astrocytes and neurons after injection into the lateral ventricle of neonatal mice (45). MSCs injected into injured spinal cord were found to form guiding “cord,” ushering in regenerating fibers (46). MSCs may assist with regeneration in stroke (47–51) or myocardial ischemia (52–55) by release of trophic factors such as brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor, or angiogenic factors (56–61).
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.[1][2] Its efficacy is similar as well.[1]

The first cord blood transplant was performed in Paris on October 6, 1988. Since that time, over 1 million cord blood units have been collected and stored in public and family banks all over the world.
Clinical Trials More likely to be used in clinical trials to potentially treat strokes, heart attacks, diabetes, cerebral palsy, autism and a range of other serious medical conditions Less likely to be available to the donor or family members for use in clinical trials More likely to be used in clinical trials for range of other serious medical conditions Less likely to be available for use in clinical trials  
Umbilical cord blood is the blood left over in the placenta and in the umbilical cord after the birth of the baby. The cord blood is composed of all the elements found in whole blood. It contains red blood cells, white blood cells, plasma, platelets and is also rich in hematopoietic stem cells. There are several methods for collecting cord blood. The method most commonly used in clinical practice is the “closed technique”, which is similar to standard blood collection techniques. With this method, the technician cannulates the vein of the severed umbilical cord using a needle that is connected to a blood bag, and cord blood flows through the needle into the bag. On average, the closed technique enables collection of about 75 ml of cord blood.[3]
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.
Finally, the healthy stem cells are placed into long-term cryogenic storage. Compared to other stem cell sources, cord blood units are available very quickly since a doctor can remove them from storage and send them to the transplant hospital within a few days.
The use of cord blood is determined by the treating physician and is influenced by many factors, including the patient’s medical condition, the characteristics of the sample, and whether the cord blood should come from the patient or an appropriately matched donor. Cord blood has established uses in transplant medicine; however, its use in regenerative medicine is still being researched. There is no guarantee that treatments being studied in the laboratory, clinical trials, or other experimental treatments will be available in the future.
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Once it arrives at the storage facility, the cord blood will be processed and placed in storage.  The cord blood will either be completely immersed in liquid nitrogen or it will be stored in nitrogen vapor.
Our work has focused on human umbilical cord matrix (UCM) cells. There are cells isolated in large numbers from the Wharton’s jelly of human cords (25–28). Two other research labs have published on the isolation and characterization of cells from the Wharton’s jelly: Dr. Davies’ lab at the University of Toronto (29) and Dr. Y. S. Fu at the National Yang-Ming University, Taipei (30–32). All three groups reported that UCM cells are MSC-like cells and are robust. These cells can be isolated easily, frozen/thawed, clonally expanded, engineered to express exogenous proteins, and extensively expanded in culture. Human UCM cells express a marker of neural precursors, nestin, without exposure to differentiation signals (26,28,30). In response to differentiation signals, human UCM cells can differentiate to catecholaminergic neurons, expressing tyrosine hydroxylase TH (28,30,31). Human UCM cells meet the basic criteria established for MSCs described previously (29,32). Similarly, MSC-like cells are derived from other umbilical cord tissues, e.g., umbilical vein sub-endothelium, umbilical cord blood, amnion, placenta, and amniotic fluid (Table 1).
Your baby’s newborn stem cells are transported to our banking facilities by our medical courier partner, and you can receive tracking updates. Each sample is processed and stored with great care at our laboratory in Tucson, Arizona. CBR’s Quality Standard means we test every cord blood sample for specific quality metrics.
There is now compelling evidence that MSCs, guided by chemokines and other cues emanating from areas of pathology such as tumors, will “home” specifically to those areas. The supporting connective tissue stroma of a tumor is formed in a manner similar to wound healing and scar formation (64), and tumors generate signals to recruit stromal cells from contiguous regions as well as from bone marrow to sustain themselves (65,66). Because UCM stem cells are very closely related to MSCs (28), it would not be surprising to find that they also will home to tumors, and in fact such a phenomenon has been observed in preliminary experiments in our laboratory (unpublished observations). The exact signals that recruit transplanted or endogenous cells to regions of inflammation or neoplasia remain obscure. However, stromal cell-derived factor-1α plays a crucial role in recruitment of bone marrow-derived cells to the heart after myocardial infarction (67). Matrigel invasion assays have implicated such molecules as platelet-derived growth factor-BB, epidermal growth factor, and stromal cell-derived factor-1α as chemokines for MSCs; however, neither basic FGF (bFGF) nor vascular endothelial growth factor (VEGF) had an affect (68). In any event, the directed trafficking of umbilical and other mesenchymal stem cells to tumors opens the enticing prospect that they may be a platform for targeted delivery of high local levels of protein. Often, such proteins have a short half-life and/or cause major side effects when given systematically.
Genes: Segments of DNA that contain instructions for the development of a person’s physical traits and control of the processes in the body. They are the basic units of heredity and can be passed down from parent to offspring.
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.
The procedure for obtaining the cord blood involves clamping the umbilical cord at the time of birth. The small amount of blood remaining in the umbilical cord is drained and taken to a cord blood bank. It is free to donate.
* Disclaimer: Banking cord blood does not guarantee that treatment will work and only a doctor can determine when it can be used. Cord tissue stem cells are not approved for use in treatment, but research is ongoing. 
Make sure you meet a few basic guidelines for public banking. Your doctor will give you an advanced blood test after giving birth, but there are a few basic requirements you have to meet before signing up. The requirements are different for each bank, but you can see our basic list of public banking requirements here.
The choices expectant parents make today go beyond finding out the gender of their baby. They span beyond deciding whether to find out if their child, still in the womb, may potentially have a genetic disorder. Today, many parents must decide whether to store their baby’s umbilical cord blood so it will be available to heal their child if at any point in the child’s lifetime he or she becomes sick.
You and your baby’s personal information are always kept private by the public cord blood bank. The cord blood unit is given a number at the hospital, and this is how it is listed on the registry and at the public cord blood bank.
Stem cells can be used in treatments for many different types of diseases. One of the main places young stem cells are found is in cord blood, which can be stored at birth and saved for future use if needed. Stem cells are also found in other places in the human body, including blood and bone marrow.
Cord blood is the blood that remains in the umbilical cord and placenta following birth. This blood is usually discarded. However, cord blood banking utilizes facilities to store and preserve a baby’s cord blood. If you are considering storing your baby’s cord blood, make sure to use a cord blood bank accredited by the American Association of Blood Banks (AABB), like Viacord.