cord blood gas reference ranges | saving umbilical cord blood controversy

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.
Whether UCM cells are MSC-like or fit into a unique niche is currently not clear. For example, when the vital stain Hoechst 33342 was used in the dye exclusion test, about 20% of UCM cells were found to exclude dye (28). About 85% of the UCM cells expressed CD 44, the hyaluronate receptor marker found on several stem cell populations, and about 85% of the cells expressed ABCG2, the receptor thought to mediate dye exclusion. Attempts to enrich the Hoechst-dim cells were partially successful, with maximal enrichment at about 32%. It is assumed that culture conditions are the limiting factor for further enrichment of what is assumed to be the most primitive populations.
“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.
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.
Private cord blood banking costs $2,000 to $3,000 for the initial fee, and around another $100 per year for storage. While that may seem like a hefty price tag, many expectant parents may see it as an investment in their child’s long-term health.
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.
In a report to the HRSA Advisory Council, scientists estimated that the chances of a pediatric patient finding a cord blood donor in the existing Be the Match registry are over 90 percent for almost all ethnic groups.
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.
Banked cord blood is most abundant in white blood cells and stem cells. While a lot of attention is paid to the stem cells, there are approximately 10 times more total nucleated cells (TNCs) than stem cells in any cord blood collection. TNCs are basically white blood cells, or leukocytes; they are the cells of the immune system that protect the body. Despite stem cells comprising one-tenth of most collections, cord blood is still considered a rich source of hematopoietic (he-mah-toe-po-ee-tic) stem cells (HSCs). HSCs are often designated by the marker CD34+. Hematopoietic stem cells can become two categories of cells: myeloid and lymphoid cells. Myeloid cells go on to form your red blood cells, platelets, and other cells of the blood. Lymphoid cells go on to become the B cells and T cells and are the basis for the immune system. Cord blood also contains mesenchymal (meh-sen-ki-mal) stem cells (MSCs), but they are much more abundant in cord tissue, which we will discuss in a minute.
The evolution of stem cell therapies has paved the way for further research being conducted through FDA-regulated clinical trials to uncover their potential in regenerative medicine applications. Cord Blood Registry is the first family newborn stem cell company to partner with leading research institutions to establish FDA-regulated clinical trials exploring the potential regenerative ability of cord blood stem cells to help treat conditions that have no cure today, including: acquired hearing loss, autism, cerebral palsy, and pediatric stroke. In fact, 73% of the stem cell units released by CBR have been used for experimental regenerative therapies – more than any other family cord blood bank in the world.
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.
^ Jump up to: 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 process used to collect cord blood is simple and painless. After the baby is born, the umbilical cord is cut and clamped. Blood is drawn from the cord with a needle that has a bag attached. The process takes about 10 minutes.
Each year, thousands of people are diagnosed with leukemia, lymphoma, or certain immune system or genetic metabolic disorder. Many of these patients need an umbilical cord blood or bone marrow transplant (also called a BMT). Because the qualities that make a suitable match for bone marrow or umbilical cord blood are inherited, a match from a sibling or other family member is often checked first. However, 70 percent of patients will not find a matching donor in their family. For these patients, a transplant of bone marrow or cord blood from an unrelated donor may be their only transplant option.
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.

Importantly, ESCs are the de facto pluripotent cells for biomedical research. Proponents state that ESCs will enable cell-based therapeutics and biopharmaceutical testing/manufacturing. In contrast, biomedical research conducted using postnatally collected tissues and stem cells has generated less controversy and enjoyed more therapeutic applications to date. This is likely owing to the fact that blood and bone marrow stem cells were found to rescue patients with bone marrow deficiencies about 40 yr ago (8,9). The result of this work produced the national bone marrow registry, which was established in the United States in 1986.
Once considered medical waste, the blood left in the umbilical cord after a baby’s delivery is now known to be a rich source of stem cells similar to those in bone marrow. It’s been used in transplants to treat more than 70 different diseases including leukemia, lymphoma, sickle-cell disease, and some metabolic disorders. Unlike with marrow, which is obtained through a painful medical procedure and replenished by the body, there’s only one chance to collect this seemingly magical elixir: immediately after a baby’s birth.
There has been considerable debate about the ethical and practical implications of commercial versus public banking. The main arguments against commercial banking have to do with questions about how likely it is that the cord blood will be used by an individual child, a sibling or a family member; the existence of several well-established alternatives to cord blood transplantation and the lack of scientific evidence that cord blood may be used to treat non-blood diseases (such as diabetes and Parkinson’s disease). In some cases patients may not be able to receive their own cord blood, as the cells may already contain the genetic changes that predispose them to disease.
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Tracey Dones of Hicksville, N.Y., paid to bank her son Anthony’s cord blood. But four months after he was born, Anthony was diagnosed with osteopetrosis, a rare disease that causes the body to produce excess bone, leads to blindness, and can be fatal if left untreated.
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.
Yes, stem cells can be used on the donor following chemo and radiation to repair the bone marrow. For a full list of treatments, please visit : http://cellsforlife.com/cord-blood-basics/diseases-treated-with-cord-blood-stem-cells/
Stem cells are defined simply as cells meeting three basic criteria (illustrated in Fig. 1. First, stem cells renew themselves throughout life, i.e., the cells divide to produce identical daughter cells and thereby maintain the stem cell population. Second, stem cells have the capacity to undergo differentiation to become specialized progeny cells (1). When stem cells differentiate, they may divide asymmetrically to yield an identical cell and a daughter cell that acquires properties of a particular cell type, for example, specific morphology, phenotype, and physiological properties that categorize it as a cell belonging to a particular tissue (2). Stem cells that may differentiate into tissues derived from all three germ layers, for example, ectoderm, endoderm, and mesoderm, are called “pluripotent.” The best example of pluripotent stem cells are the embryonic stem cells (ESCs) derived from the inner cell mass of early embryos. In contrast with ESCs, most stem cells that have been well characterized are multipotent, i.e., they may differentiate into derivatives of two of the three germ layers. The third property of stem cells is that they may renew the tissues that they populate. All tissue compartments contain cells that satisfy the definition of “stem cells” (3), and the rate at which stem cells contribute to replacement cells varies throughout the body. For example, blood-forming stem cells, gut epithelium stem cells, and skin-forming stem cells must be constantly replaced for normal health. In contrast, the stem cells in the nervous system that replace neurons are relatively quiescent and do not participate in tissue renewal or replace neurons lost to injury or disease.
The cord blood of your baby is an abundant source of stem cells that are genetically related to your baby and your family. Stem cells are dominant cells in the way they contribute to the development of all tissues, organs, and systems in the body.
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.
Each cord blood bank has different directions for returning the consent form. Some banks may ask you to mail the consent form along with the health history forms or to bring the original consent form with you to the hospital. Other banks may have you finish the form at the hospital. Follow the directions from your public cord blood bank.
There is no significant opposition in the medical community to the public banking of cord blood.  The donation of cord blood to public banks has generally been encouraged by the medical profession.  The American Academy of Pediatrics encourages the public donation of cord blood with appropriate genetic and infectious disease testing, although they caution that parents should be notified that they will receive the results of this testing.  They also recommend that parents be informed that publicly banked cord blood may not be available for future private use.
Anthony’s doctors found a match for him through the New York Blood Center’s National Cord Blood Program, a public cord blood bank. Unlike private banks, public banks do not charge to collect cord blood, they charge a patients insurance company when cells are used. And once it is entered in the public system, the blood is available to anyone who needs it.
Just like other blood donations, there is no cost to the donor of cord blood. If you do not choose to store your baby’s blood, please consider donating it. Your donation could make a difference in someone else’s life.
In order to preserve more types and quantity of umbilical cord stem cells and to maximize possible future health options, Cryo-Cell’s umbilical cord tissue service provides expectant families with the opportunity to cryogenically store their newborn’s umbilical cord tissue cells contained within substantially intact cord tissue. Should umbilical cord tissue cells be considered for potential utilization in a future therapeutic application, further laboratory processing may be necessary. Regarding umbilical cord tissue, all private blood banks’ activities for New York State residents are limited to collection, processing, and long-term storage of umbilical cord tissue stem cells. The possession of a New York State license for such collection, processing and long-term storage does not indicate approval or endorsement of possible future uses or future suitability of these cells.
Companies throughout Europe also offer commercial (private) banking of umbilical cord blood. A baby’s cord blood is stored in case they or a family member develop a condition that could be treated by a cord blood transplant. Typically, companies charge an upfront collection fee plus an annual storage fee.
As cord blood is inter-related to cord blood banking, it is often a catch-all term used for the various cells that are stored. It may be surprising for some parents to learn that stored cord blood contains little of what people think of as “blood,” as the red blood cells (RBCs) can actually be detrimental to a cord blood treatment. (As we’ll discuss later, one of the chief goals of cord blood processing is to greatly reduce the volume of red blood cells in any cord blood collection.)
Private cord blood banking (also known as family banking), is preferred for families in a situation, where they currently have a family member suffering from a genetic disorder or have a family history of this type of disorder. By using a private cord blood bank, such as CariCord, your baby’s cord blood and tissue are stored for exclusive use by your family. It will always be there and readily available if it is ever needed. If it is donated to a public bank it can be accessed by anyone who is a match to it and there are no guarantees that it would be available, should your family ever need it later.
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.[4]
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.
[3] American Academy of Pediatrics Section on Hematology/Oncology, American Academy of Pediatrics Section on Allergy/Immunology, Bertram H. Lubin, and William T. Shearer, “Cord Blood Banking for Potential Future Transplantation,” Pediatrics 119 (2007): 165-170.
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.”
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