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During the harvesting procedure, doctors use a catheter to draw out blood. The blood moves through a machine, which separates stem cells and allows these cells to be put into storage. This process takes a few hours, and may be repeated over several days in order for doctors to get enough stem cells.
“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.
The American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics don’t recommend routine cord blood storage. The groups say private banks should only be used when there’s a sibling with a medical condition who could benefit from the stem cells. Families are encouraged to donate stem cells to a public bank to help others.
The members of the team at CORD:USE are credited for discovering the field of cord blood banking and transplantation. With more than 150 years of combined knowledge and experience, our team members are universally recognized as pioneers and leading experts in the field.
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.
## Payment Plan Disclosures for in-house CBR 12-Month Plan (interest free) – No credit check required. The 12-month plan requires a $15/month administrative fee. The plans may be prepaid in full at any time.
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.
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.
The blood that remains in the umbilical cord and the placenta after birth is called “cord blood”. Umbilical cord blood, umbilical cord tissue, and the placenta are all very rich sources of newborn stem cells. The stem cells in the after birth are not embryonic. Most of the stem cells in cord blood are blood-forming or hematopoietic stem cells. Most of the stem cells in cord tissue and the placenta are mesenchymal stem cells.
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.
Osteopetrosis is a genetic disease, so this means that doctors could use a sibling’s cord blood cells to treat Anthony, but they cannot use his own cells because the disease is in every cell in his body. In fact, a majority of the diseases listed in private banking firms’ marketing material as treatable with stem cells are genetic diseases.
Recently the minimal defining characteristics of MSCs was the subject of a blue ribbon panel of scientists (24). This panel ascribed three defining characteristics to MSCs. First, MSCs are plastic-adherent when maintained in standard culture conditions. Second, MSCs express the cell surface markers CD105, CD73, and CD90 and lack expression of CD45, CD34, CD14 or CD11b, CD79 or CD19, and HLA-DR. Third, MSCs differentiate to osteoblasts, adipocytes, and chondroblasts in vitro. As shown in Table 1, mesenchymal-like cells collected from the umbilical cord, placenta, and from umbilical cord blood, perivascular space, and placenta all share a relatively consistent set of surface markers, which is apparently consistent with the hypothesis that they are MSC-like.
The American Academy of Pediatrics supports efforts to provide information about the potential benefits and limitations of cord blood banking and transplantation so that parents can make an informed decision. In addition, the American College of Obstetricians and Gynecologists recommends that if a patient requests information on umbilical cord blood banking, balanced information should be given. Cord blood education is also supported by legislators at the federal and state levels. In 2005, the National Academy of Sciences published an Institute of Medicine (IoM) report titled “Establishing a National Cord Blood Stem Cell Bank Program”.
While the stem cell count is smaller during a cord blood transplant, these cells multiply quickly, and researchers are studying new methods to increase cells naturally. Compared to bone marrow, cord blood cells multiply faster and don’t require an exact match type to complete a successful transplant. Some techniques medical experts are testing to increase the amount of stem cells include:
Gift of Life is a non-profit charity that seeks to help Jewish patients find a transplant match. They recruit both bone marrow donors and cord blood donations from the Jewish community. Gift of Life operates their own accredited cord blood laboratory that participates in the national NMDP network.
If everyone donated cord blood to public registries for the ‘common good’ this would increase the chances of someone benefiting from a double cord blood transplant. This far outweights the actual probability of the person who donated the sample being able to usefully use it for themself.
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.
Generally speaking, public cord blood banks collect, process and store your donated cord blood for free. The cord blood you donate to a public bank may be used for transplants or for research purposes, so you may not be able to access your own cord blood. View a list of public cord blood banks in North America.
‡ Payment Plan Disclosures for in-house CBR 6-Month Plan (interest free) – No credit check required. The 6-month plan requires a $10/month administrative fee. The plans may be prepaid in full at any time.
The Stem Cell Therapeutic and Research Act was passed in 2005, which supports building a public reserve of 150,000 cord blood units from ethnically diverse donors in order to treat more than 90% of patients in need of HSC transplants. Donors from ethnic minority patients are particularly in need due to the greater variation of HLA-types in non-Caucasian ethnicities. Thirty-five percent of cord blood units go to patients of diverse ethnic and racial backgrounds.
To learn more about umbilical cord blood and banking please watch Banking on cord blood, Cord blood – banking and uses, Cord blood transplantation – how stem cells can assist in the treatment of cancer in our video library.
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.
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.
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.
Until now, however, it hasn’t always been easy for couples to donate their baby’s cord blood to a public bank. The 28 public banks currently in operation work with only about 100 hospitals in the U.S. (find the list at parentsguidetocordblood.com). If you don’t deliver at one of these hospitals, you can contact either Cryobanks International or LifebankUSA, commercial organizations that store both private and public units. These banks pick up the tab for your donation (minus the physician’s collection fee).
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.
Some brochures advertising private cord blood banking show children with cerebral palsy, a neurological disorder, who were treated with their own stem cells. In the case of Cord Blood Registry, the company lists all stem cell transplants conducted at Duke University. In a list of individuals treated in their “stem cell therapy data” cerebral palsy is listed. However, transplants were part of an early research study and studies of efficacy are just now underway.
 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.
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.
There is little doubt that scientists believe umbilical cord blood stem cells hold promise for the future. Cord blood stem cells are already used to treat blood disorders such as aplastic anemia, and research is underway to determine if they can treat other more common conditions like type 1 diabetes. But many experts question whether many companies’s marketing materials confuse or even mislead parents about the usefulness of private banking.
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.
Because of the invasive procedure required to obtain the bone marrow, scientist continued to look for a better source, which eventually lead to the discovery of similar stem cells in cord blood in 1978. Cord blood was used in its first transplant in 1988, and cord blood has since been shown to be more advantageous than other means of acquiring similar stem cells and immune system cells. This is because umbilical cord blood can be considered naïve and immature compared to other sources. Cord blood has not been exposed to disease or environmental pollutants, and it is more accepting of foreign cells. In this case, inexperience makes it stronger.
After your baby is born, the umbilical cord and placenta are usually thrown away. Because you are choosing to donate, the blood left in the umbilical cord and placenta will be collected and tested. Cord blood that meets standards for transplant will be stored at the public cord blood bank until needed by a patient. (It is not saved for your family.)
Cord Blood Registry® (CBR®) is the world’s largest newborn stem cell company. Founded in 1992, CBR is entrusted by parents with storing samples from more than 600,000 children. CBR is dedicated to advancing the clinical application of cord blood and cord tissue stem cells by partnering with institutions to establish FDA-regulated clinical trials for conditions that have no cure today.
Tissue is typed and 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. When a patient needs a transplant, the registry is searched to find a matching marrow donor or cord blood unit.) It’s frozen in a liquid nitrogen freezer and stored, so if the unit is selected as a match for a patient needing a transplant, it will be available.
^ a b c d e f Juric, MK; et al. (9 November 2016). “Milestones of Hematopoietic Stem Cell Transplantation – From First Human Studies to Current Developments”. Frontiers in Immunology. 7: 470. doi:10.3389/fimmu.2016.00470. PMC 5101209 . PMID 27881982.
Tom Moore, CEO of Cord Blood Registry, the largest private cord blood banking firm, told ABC News conceded that there was no proof that the transplants worked, but added that there is strong anecdotal evidence.
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.
In an allogenic transplant, another person’s stem cells are used to treat a child’s disease. This kind of transplant is more likely to be done than an autologous transplant. In an allogenic transplant, the donor can be a relative or be unrelated to the child. For an allogenic transplant to work, there has to be a good match between donor and recipient. A donor is a good match when certain things about his or her cells and the recipient’s cells are alike. If the match is not good, the recipient’s immune system may reject the donated cells. If the cells are rejected, the transplant does not work.
iPS cells are artificially-made pluripotent stem cells. This technique allows medical staff to create additional pluripotent cells, which will increase treatment options for patients using stem cell therapy in the near future.
Participating mothers will give a sample of blood (about four teaspoons), which will be tested for certain infections, including hepatitis and HIV. This is done to reduce the chances of passing on an infectious disease through the transplantation of the cord blood unit. This blood sample can be obtained at the hospital when the nurse is starting your IV or collecting routine blood samples for your physician.
In addition to the benefits related to transplanting HSCs derived from cord blood, HSCs are relatively easy to isolate, giving them an advantage over other adult stem cell types. Cord blood HSCs are also believed to have greater plasticity than HSCs found in bone marrow or the blood stream. The limits and possibilities of using HSCs to repair tissues and treat non-blood related disorders are currently being studied.
Your baby’s cord blood could be a valuable resource for another family. From foundations to non-profit blood banks and medical facilities, there are numerous locations that will collect, process, and use the stem cells from your baby’s cord blood to treat other people.