When it comes to cord blood banking, expectant parents have three options: (1) They can privately store their cord blood for their family, (2) They can take the public option and donate their cord blood for other families, or (3) They can do nothing, at which point the medical facility must dispose of the cord blood as medical waste. At Cryo-Cell International, we believe cord blood should not be discarded. Many states agree with our basic sentiment and have passed laws or guidelines for physicians to use when discussing private and public banking options with expectant parents.
^ Li, T; Xia, M; Gao, Y; Chen, Y; Xu, Y (2015). “Human umbilical cord mesenchymal stem cells: an overview of their potential in cell-based therapy”. Expert Opinion on Biological Therapy. 15 (9): 1293–306. doi:10.1517/14712598.2015.1051528. PMID 26067213.
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.
Private storage of one’s own cord blood is unlawful in Italy and France, and it is also discouraged in some other European countries. The American Medical Association states “Private banking should be considered in the unusual circumstance when there exists a family predisposition to a condition in which umbilical cord stem cells are therapeutically indicated. However, because of its cost, limited likelihood of use, and inaccessibility to others, private banking should not be recommended to low-risk families.” The American Society for Blood and Marrow Transplantation and the American Congress of Obstetricians and Gynecologists also encourage public cord banking and discourage private cord blood banking. Nearly all cord blood transplantations come from public banks, rather than private banks, partly because most treatable conditions can’t use a person’s own cord blood. The World Marrow Donor Association and European Group on Ethics in Science and New Technologies states “The possibility of using one’s own cord blood stem cells for regenerative medicine is currently purely hypothetical….It is therefore highly hypothetical that cord blood cells kept for autologous use will be of any value in the future” and “the legitimacy of commercial cord blood banks for autologous use should be questioned as they sell a service which has presently no real use regarding therapeutic options.”
Adverse effects are similar to hematopoietic stem cell transplantation, namely graft-versus-host disease if the cord blood is from a genetically different person, and the risk of severe infection while the immune system is reconstituted. There is a lower incidence with cord blood compared with traditional HSCT, despite less stringent HLA match requirements. 
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 stem cells from your baby’s cord blood may also be effective in treating certain diseases or conditions of a parent or sibling. Cord blood stem cells have similar ability to treat disease as bone marrow but with significantly less rejection.
Part of the reason for the dominance of these three companies in terms of the total number of units stored is that they are three of the oldest cord blood banks within the U.S., founded in 1992, 1993, and 1989, respectively. All three of these cord blood banks also support cord blood research and clinical trials.
When Tracey and Victor Dones’s 4-month-old son was diagnosed with osteopetrosis, a potentially fatal disorder that affects bone formation, the panic-stricken couple was relieved to hear that a stem-cell transplant could save his life. “We’d paid to store Anthony’s umbilical-cord blood in a private bank in case he ever needed it — and I thought we were so smart for having had the foresight to do that,” says Tracey.
Cord tissue is rich in another type of stem cell. Although there are no current uses, researchers are excited about the benefits cord tissue stem cells may offer in potential future users, such as regenerative medicine. By storing both, you’ll have potential access to more possibilities
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.
As the research into umbilical cord blood and it’s therapeutic use for blood diseases has grown, so has the question as to whether people should privately store the cord blood of their offspring for future use. A recent paper on this issue by Mahendra Rao and colleagues advocates the practice of cord blood banking (for treatment of blood diseases) but in the context of public cord blood banks rather than a private cord blood banks. Any adult needing treated would need at least two cord blood samples that are immune compatible. So one sample will not be sufficient. A child might only need one cord blood sample but in the case of childhood leukaemia there is a risk that pre-leukemic cells are present in cord blood sample – and so the child could not use their own cells for therapy.
As noted, there are different ways to process cord blood, and although the type of processing method doesn’t always enter the conversation on cord blood banking, it is a big part of the purity of any cord blood collection. Red blood cells can have a negative impact on a cord blood transfusion. In addition, there is a certain number of stem cells that need to be present in order for the cord blood to be effective in disease treatment. Each processing method has the ability to better reduce the number of RBCs and capture more stem cells. Some processing methods like AutoXpress and Sepax are automated to ensure a level of consistency across all collections. HES is preferred by some banks because it was the original processing method used by most banks and it has a proven track record. You can read more about the different cord blood processing methods here.
If you make a donation to a public cord blood bank, you can’t reserve it for your family, so it may not be available for your future use. Both the American Academy of Pediatrics (AAP) and American Medical Association (AMA) recommend public cord blood banking over private cord blood banking. Here’s why:
Umbilical cord blood was once discarded as waste material but is now known to be a useful source of blood stem cells. Cord blood has been used to treat children with certain blood diseases since 1989 and research on using it to treat adults is making progress. So what are the current challenges for cord blood research and how may it be used – now and in the future?
From high school friend to the love of her life. Read about the real-life adventures of CBR mama Michelle—and why she’s so grateful for her husband and family this Mother’s Day. Read more on #TheCBRBlog blog.cordblood.com/2018/04/one-cb… … pic.twitter.com/EA4E73Rnv8
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.
Yes, if you have any sick children who could benefit from umbilical cord blood. Public banks such as Carolinas Cord Bank at Duke University and private banks such as FamilyCord in Los Angeles offer programs in which the bank will assist with cord blood processing and storage if your baby has a biological sibling with certain diseases. FamilyCord will provide free cord blood storage for one year. See a list of banks with these programs at parentsguidecordblood.org/help.php.
Banking cord blood is a new type of medical protection, and there are a lot of questions that parents may want to ask. The Parent’s Guide to Cord Blood organization even has questions it believes all parents should ask their cord blood banks. We have answers to these and other frequently asked cord blood questions in our FAQs. If you can’t find the answer for which you are looking, please feel free to engage one of our cord blood educators through the website’s chat interface.
Prior to freezing the cells, samples are taken for quality testing. Banks measure the number of cells that are positive for the CD34 marker, a protein that is used to estimate the number of blood-forming stem cells present. Typical cost, $150 to $200 per unit. They also measure the number of nucleated cells, another measure of stem cells, both before and after processing to determine the cell recovery rate. Typical expense, $35 per unit. A portion of the sample is submitted to check that there is no bacterial or fungal contamination. Typical expense, $75 per unit. Public banks will also check the ability of the sample to grow new cells by taking a culture called the CFU assay. Typical expense, $200 to $250 per unit.
CBR is committed to advancing the science of newborn stem cells. We’ve awarded a grant to the Cord Blood Association Foundation to help fund a multi-center clinical trial researching the use of cord blood for children with autism and cerebral palsy. blog.cordblood.com/2018/04/suppor…
Public cord blood banks offer free cord blood banking to anyone who meets their donation requirements. They are usually supported by federal or private funding, which is why they can perform these collections at no cost to the family. The pros and cons of public cord blood banking are listed below.
A large challenge facing many areas of medical research and treatments is correcting misinformation. Some companies advertise services to parents suggesting they should pay to freeze their child’s cord blood in a blood bank in case it’s needed later in life. Studies show it is highly unlikely that the cord blood will ever be used for their child. However, clinicians strongly support donating cord blood to public blood banks. This greatly helps increase the supply of cord blood to people who need it.
The process is safe, painless, easy and FREE. Your physician or midwife collects the cord blood after your baby has delivered, so it does not interfere with the birthing process. The collection will not take place if there is an concern for your safety or that of your baby.
With public cord blood banks, there’s a greater chance that your cord blood will be put to use because it could be given to any child or adult in need, says William T. Shearer, M.D., Ph.D., professor of Pediatrics and Immunology at Baylor College of Medicine in Houston. Cord blood is donated and is put on a national registry, to be made available for any transplant patient. So if your child should need the cord blood later in life, there’s no guarantee you would be able to get it back.
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.
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.
Experts believe that umbilical cord blood is an important source of blood stem cells and expect that its full potential for treatment of blood disorders is yet to be revealed. Other types of stem cell such as induced pluripotent stem cells may prove to be better suited to treating non-blood-related diseases, but this question can only be answered by further research.
If clients need to use the cord blood stem cells stored with CBR for transplantation and the cells fail to engraft, clients receive a full refund of all fees paid to CBR for cord blood services plus an additional $50,000.