nbiased and factual information. The Foundation educates parents, health professionals and the general public about the need to preserve this valuable medical resource while providing information on both public cord blood donation programs and private family cord blood banks worldwide. Learn more about our global community.
What is cord blood and how is it collected? Throughout the last few years, cord blood banking has turned out to be one of the most viable and commendable medical advancements. Wondering what is cord blood? Well, this is the blood extracted from the baby’s umbilical…
Donating cord blood to a public cord blood bank involves talking with your doctor or midwife about your decision to donate and then calling a cord blood bank (if donation can be done at your hospital). Upon arriving at the hospital, tell the labor and delivery nurse that you are donating umbilical cord blood.
If cord blood can be used for parents is the very common question that many adults have. And of course, the answer is Yes”. Actually, it’s very common reason for the parents to save and store their baby’s umbilical cord blood. And it’s not…
The therapeutic potential of stem cells from the umbilical cord is vast. Cord blood is already being used in the treatment of nearly 80 life-threatening diseases2, and researchers continue to explore it’s potential. Duke University Medical Center is currently using cord blood stem cells in a Phase II clinical trial to see if it benefits kids with Autism. The number of clinical trials using cord tissue stem cells in human patients has increased to approximately 150 since the first clinical trial in 2007. Cord tissue stem cells are also being studied for the potential use in kids with Autism – a Phase I Clinical Trial is underway.
While donating cord blood is honorable, there is a lot people do not know about the public option. Most public cord blood banks have a limited number of collection sites, and they only retain a small number of collections because of volume and other criteria that must be met. Once cord blood is donated, it is highly unlikely that the donation can ever be attained by the donor or his or her family if the need arises. In addition, it may be hard to find another viable match from what is publically available. While donating is free, retreiving a cord blood sample from a public cord blood bank is not and pales in comparison to the overall cost of privately banking cord blood. These are just some of the reasons why privately banking cord blood may be a better option for some families.
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.
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If siblings are a genetic match, a cord blood transplant is a simple procedure that is FDA approved to treat over 80 diseases. However, there are a few considerations you should make before deciding to only bank one of your children’s blood:
Umbilical cord blood contains haematopoietic (blood) stem cells. These cells are able to make the different types of cell in the blood – red blood cells, white blood cells and platelets. Haematopoietic stem cells, purified from bone marrow or blood, have long been used in stem cell treatments for leukaemia, blood and bone marrow disorders, cancer (when chemotherapy is used) and immune deficiencies.
For example, in the UK the NHS Cord Blood Bank has been collecting and banking altruistically donated umbilical cord blood since 1996. The cord blood in public banks like this is stored indefinitely for possible transplant, and is available for any patient that needs this special tissue type. There is no charge to the donor but the blood is not stored specifically for that person or their family.
Current research aims to answer these questions in order to establish whether safe and effective treatments for non-blood diseases could be developed in the future using cord blood. An early clinical trial investigating cord blood treatment of childhood type 1 diabetes was unsuccessful. Other very early stage clinical trials are now exploring the use of cord blood transplants to treat children with brain disorders such as cerebral palsy or traumatic brain injury. However, such trials have not yet shown any positive effects and most scientists believe much more laboratory research is needed to understand how cord blood cells behave and whether they may be useful in these kinds of treatments
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.
Whether you’re having trouble with your account, or would like to make a suggestion, Canadian Blood Services offers you quick and convenient options to troubleshoot or get in touch. Contact us via live chat, consult our FAQ, send an email email@example.com, or give us a call at 1 888 2 DONATE (1-888-236-6283).
In fact, the AAP does encourage parents to keep their child’s cord blood if a family member has already been diagnosed with a stem-cell-treatable disease. But a family won’t have to foot the bill: The Children’s Hospital Oakland Research Institute, in California, will bank a baby’s cord blood for free if a family member needs it at the time of the baby’s birth. Some private banks, such as Cord Blood Registry, Cryo-Cell, and ViaCord, have similar programs.
While the transplantation of cord blood has its advantages, its main disadvantage is the limited amount of blood contained within a single umbilical cord. Because of this, cord blood is most often transplanted in children. Physicians are currently trying to determine ways that cord blood can be used in larger patients, such as transferring two cord blood units or increasing the number of cells in vitro before transplanting to the patient. It also takes longer for cord blood cells to engraft. This lengthier period means that the patient is at a higher risk for infection until the transplanted cells engraft. Patients also cannot get additional donations from the same donor if the cells do not engraft or if the patient relapses. If this is the case, an additional cord blood unit or an adult donor may be used. While cord blood is screened for a variety of common genetic diseases, rare genetic diseases that manifest after birth may be passed on. The National Cord Blood Program estimates that the risk of transmitting a rare genetic disorder is approximately 1 in 10,000.
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.
Cord blood in public banks is available to unrelated patients who need haematopoietic stem cell transplants. Some banks, such as the NHS bank in the UK, also collect and store umbilical cord blood from children born into families affected by or at risk of a disease for which haematopoietic stem cell transplants may be necessary – either for the child, a sibling or a family member. It is also possible to pay to store cord blood in a private bank for use by your own family only.
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.
Since the first successful sibling-to-sibling cord-blood stem-cell transplant was performed in 1988 to treat a genetic disorder called Fanconi’s anemia, more than 20 private banks have opened. And they seem to have the address of every expectant couple in America — whose mailboxes bulge with brochures encouraging them to take advantage of this once-in-a-lifetime opportunity. “Cord-blood banking is like insurance to protect your family against unforeseeable events,” says Stephen Grant, cofounder and senior vice president of Cord Blood Registry, a large California-based private bank. “You do it out of love and responsibility for your family. Sure, you hope you’ll never have to use the blood, but if you do, it’ll be there.”
Only 25-50% of donations to public cord blood banks end up being stored.4 Typically, public cord blood banks only store donations that meet the size threshold for transplant use. That means most public cord blood banks will only keep cord blood collections that are at least 3 ounces.2
Much research is focused on trying to increase the number of HSCs that can be obtained from one cord blood sample by growing and multiplying the cells in the laboratory. This is known as “ex vivo expansion”. Several preliminary clinical trials using this technique are underway. The results so far are mixed: some results suggest that ex vivo expansion reduces the time taken for new blood cells to appear in the body after transplantation; however, adult patients still appear to need blood from two umbilical cords. More research is needed to understand whether there is a real benefit for patients, and this approach has yet to be approved for routine clinical use.
When an immediate family member has a disease that requires a stem cell transplant, cord blood from a newborn baby in the family may be the best option. There is a 25% chance, for example, that cord blood will be a perfect match for a sibling, because each child shares one of its two HLA genes with each parent. Occasionally cord blood will be a good match for a parent if, by chance, both parents share some of the six HLA antigens. The baby’s cord blood is less likely to be a good match for more distant relatives. The inventories of unrelated cord blood units in public cord blood banks are more likely to provide appropriate matches for parents and distant relatives, as well as for siblings that do not match.
The umbilical cord blood contains haematopoietic stem cells – similar to those found in the bone marrow – and which can be used to generate red blood cells and cells of the immune system. Cord blood stem cells are currently used to treat a range of blood disorders and immune system conditions such as leukaemia, anaemia and autoimmune diseases. These stem cells are used largely in the treatment of children but have also started being used in adults following chemotherapy treatment.
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.
Taking time to consider helping another person when you are already busy planning for the birth of your child is greatly appreciated. A gift of cord blood may someday give someone a second chance at life.
Collecting The collection for family banking can occur virtually anywhere. Public banks collect cord blood at only a limited number of locations. Can occur virtually anywhere Only a limited number of locations
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.
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.
It depends on who you ask. Although commercial cord blood banks often bill their services as “biological insurance” against future diseases, the blood doesn’t often get used. One study says the chance that a child will use their cord blood over their lifetime is between 1 in 400 and 1 in 200,000.
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.
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.
Blood in the umbilical cord and placenta is rich with blood-forming stem cells that can help save the lives of patients with diseases and disorders such as leukemia, lymphoma and aplastic anemia. With your consent, Canadian Blood Services can collect cord blood when you deliver your baby for Canadian Blood Services’ Cord Blood Bank—to be used by anyone who needs stem cell treatment.
Cost to Donate Client pays a one-time processing fee and annual storage fees. There is no cost for donating, but there is a cost for retreiving from a public bank. One-time processing fee and annual storage fees No cost for donating, but high cost for public bank retrival
There was a time before the 1990s when the umbilical cord and its blood were considered medical waste. Today, parents bank or store their baby’s umbilical cord blood because the stem cells it contains are currently utilized or show promise in the treatment of life-threatening and debilitating diseases.
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.
If you’re reading this, you may likely also agree that the cord blood should be saved, leaving only a decision whether to donate your baby’s cord blood to a public bank or to preserve it for your baby’s and other family members’ potential future use. Parents should be fully informed of how each options compares prior to making a final decision.
Life Line Stem Cell asks mothers arriving for delivery to donate all perinatal tissue: cord blood, cord tissue, and the placenta. Cord blood donations that are eligible for transplant are sent to a public cord blood bank; the tissue collections go towards research programs.
Lead image of baby’s umbilical cord from Wikimedia Commons. Possible human blood stem cell image by Rajeev Gupta and George Chennell. Remaining images of blood sample bags and red blood cells from Wellcome Images.
The Doneses were shocked, however, when doctors told them that Anthony’s cord blood couldn’t be used because the cells contained the same genetic defect that caused his condition. “The materials provided by the bank said this was Anthony’s life insurance and could save him if he needed it. They never mentioned that the cells could be diseased. We felt duped,” Tracey says. The Long Island, New York, couple has since filed a lawsuit against the bank alleging false advertising and consumer fraud.
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Your child may never need it. Stem cell-rich cord blood can be used to treat a range of diseases, but Frances Verter, Ph.D., founder and director of Parent’s Guide to Cord Blood Foundation, estimates that there’s only a 1 in 217 chance that your child will ever need a stem cell transplant with cord blood (or bone marrow). This is particularly true if the child doesn’t have a family history of diseases such as leukemia, lymphoma, or sickle cell anemia. 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 cut down on expenditures.
Cord blood collection is a completely painless procedure that does not interfere with the birth or with mother-and-child bonding following the delivery. There is no risk to either the mother or baby. Cord blood collection rarely requires Blood Center staff to be present during the baby’s delivery. There is no cost to you for donating.
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.