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”.
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?
LifebankUSA seeks mothers in NEW YORK & NEW JERSEY ONLY who will donate both their cord blood and their placenta. The donations support an international registry, clinical trials and research. Donations can be taken from any hospital, but mothers must register at least 8 weeks prior to delivery and pass a health screening.
Several research teams have reported studies in animals suggesting that cord blood can repair tissues other than blood, in diseases ranging from heart attacks to strokes. These findings are controversial: scientists often cannot reproduce such results and it is not clear HOW cord blood may be having such effects. When beneficial effects are observed they may be very slight and not significant enough to be useful for developing treatments. If there are positive effects, they might be explained not by cord blood cells making nerve or heart cells, but by the cells in the cord blood releasing substances that help the body repair damage.
Sign a consent form to donate. This consent form says that the donated cord blood may be used by any patient needing a transplant. If the cord blood cannot be used for transplantation, it may be used in research studies or thrown away. These studies help future patients have a more successful transplant.
^ a b Thornley, I; et al. (March 2009). “Private cord blood banking: experiences and views of pediatric hematopoietic cell transplantation physicians”. Pediatrics. 123 (3): 1011–7. doi:10.1542/peds.2008-0436. PMC 3120215 . PMID 19255033.
Like any insurance, cord-blood banking isn’t cheap. Banks initially charge from $1,000 to $2,000 to collect and process the stem-cell units, which are stored for a family’s exclusive use. When you factor in additional costs for shipping (about $150 for a medical courier), the doctor’s collection fee (prices can range from $150 to $500), and annual storage fees averaging $100 per year for 18 years, parents can expect to pay up to $4,000 in expenses not covered by insurance.
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.
Why should you consider donating the cord blood to a public bank? Simply because, besides bringing a new life into the world, you could be saving an individual whose best chance at life is a stem cell transplant with your baby’s donated cord blood. This can only happen if you donate and if your baby is a close enough match for a patient in need. If you chose to reserve the cord blood for your family, then siblings who have the same parents have a 25% chance of being an exact match.
Becoming a parent is a life-changing moment full of promise, joy and a natural share of anxiety. For parents of a sick child, those worries are more intense – especially if that child needs a stem cell transplant to survive. You have the power to Give Life to patients in Canada and around the world.
Current applications for newborn stem cells include treatments for certain cancers and blood, metabolic and immune disorders. Additionally, newborn stem cell preservation has a great potential to benefit the newborn’s immediate family members with stem cell samples preserved in their most pristine state.
According to Cord Blood Registry, cord blood is defined as “the blood that remains in your baby’s umbilical cord after the cord has been cut, is a rich source of unique stem cells that can be used in medical treatments.” Cord blood has been shown to help treat over 80 diseases, such as leukemia, other cancers, and blood disorders. This cord blood, which can be safely removed from your newborn’s already-cut umbilical cord, can be privately stored for the purpose of possible use in the future for your child or family member. (It can also be donated to a public bank, but this is not widely available)
2 Cordblood.com, (2014). Cord Blood Stem Cell Banking | Cord Blood Registry | CBR. [online] Available at: http://www.cordblood.com/cord-blood-banking-cost/cord-blood-stem-cells [Accessed 22 March. 2017].
Sutter Neuroscience Institute has conducted a landmark FDA-regulated phase II clinical trial to assess the use of autologous stem cells derived from cord blood to improve language and behavior in certain children with autism.
Complications Side Effects As the donor’s stem cells will always be a perfect match, there will be no incidence of graft versus host disease (GVHD), which can be a chronic and even fatal condition. Graft versus host disease (GVHD) is estimated to occur in 60–80 percent of transplants where the donor and recipient are not related. Perfect match! No incidence of graft versus host disease Graft versus host disease (GVHD) occurs in 60%–80% of non-related transplants.
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.)
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.
The stored blood can’t always be used, even if the person develops a disease later on, because if the disease was caused by a genetic mutation, it would also be in the stem cells. Current research says the stored blood may only be useful for 15 years.
The American Pediatric Association in 2008 recommended that physicians recommend that cord blood be donated instead of saved privately for family families. One of the major proponents for this was Joanne Kurtzberg, who profited from this by getting funding for her public cord blood bank at Duke University. She has since started her own private cord blood bank after doing more research on Cerebral Palsy. Interesting.
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)
In the procurement of embryonic stem cells for research, the embryo from which the cells are harvested is destroyed. For those who believe that human life begins at conception this research is obviously unethical. In contrast, adult stem cells can be isolated from tissue from a consenting patient. While cord blood stem cells are classified as adult stem cells, they appear to have greater potency (ability to differentiate into other cell types) than other adult stem cells, making them a potentially valuable option for use in a variety of treatments and therapies. Cord blood stem cells offer some of the advantages of ESCs without any of the ethical drawbacks. Research into the use of cord blood stem cells for the treatment of disease and disability is a promising and ethical avenue of stem cell research.
The European Group on Ethics in Science and New Technologies (EGE) has also adopted a position on the ethical aspects of umbilical cord blood banking. The EGE is of the opinion that “support for public cord blood banks for allogeneic transplantations should be increased and long term functioning should be assured.” They further stated that “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.”
^ Reddi, AS; Kuppasani, K; Ende, N (December 2010). “Human umbilical cord blood as an emerging stem cell therapy for diabetes mellitus”. Current stem cell research & therapy. 5 (4): 356–61. doi:10.2174/157488810793351668. PMID 20528762.
They aren’t the only ones questioning the business practices of private cord-blood banks. Both the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) issued statements in the late 1990s opposing the use of for-profit banks — and criticizing their marketing tactics. Instead, they recommended that parents donate cord blood to public banks, which make it available for free to anyone who needs it. Globally, other organizations have done the same. Italy and France have banned private cord-blood banking altogether.
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.
When a child develops a condition that can be treated with stem cells, they undergo transplant. A doctor infuses stem cells from cord blood or bone marrow into the patient’s bloodstream, where they will turn into cells that fight the disease and repair damaged cells—essentially, they replace and rejuvenate the existing immune system.
Students who register to donate blood three or more times during their high school career earn a Red Cord to wear during graduation events. Seniors must complete the requirement by May 15 (or by the date of their school’s final blood drive of the year, whichever is later).
Certainly, there are plenty of doctors who have high hopes for stem-cell advances and advise patients to consider cord-blood banking. When private banks first started sending him informational packets, Jordan Perlow, MD, a maternal-fetal specialist in Phoenix, assumed they were just trying to profit from parents’ anxieties. But after attending medical conferences and scrutinizing studies about developments in stem-cell therapies, Dr. Perlow now encourages his patients to privately bank if they can afford it because he’s convinced that it might save their child’s life or the life of another family member. “If private banking had been available when my children were born, I would have done it,” he says.
Generally, cord blood can only be used to treat children up to 65 lbs. This is because there simply aren’t enough stem cells on average in one unit of cord blood to treat an adult. Through our Cord Blood 2.0 technology, we have been able to collect up to twice as many stem cells as the industry average. Getting more stem cells increases the chance of being able to treat someone later in life.
The unpredictability of stem cell transportation led CBR to create a crush-resistant, temperature-protected, and electronically tracked collection kit that is designed to preserve the integrity and to help ensure the safe delivery of the blood and/or tissue. CBR’s CellAdvantage® Collection Kit contains everything the healthcare provider needs to easily and safely collect the maximum amount of a newborn’s cord blood following birth.
A limitation of cord blood is that it contains fewer HSCs than a bone marrow donation does, meaning adult patients often require two volumes of cord blood for treatments. Researchers are studying ways to expand the number of HSCs from cord blood in labs so that a single cord blood donation could supply enough cells for one or more HSC transplants.
What’s more, few cord-blood transplants have been given to adults because most units haven’t contained enough stem cells to treat anyone weighing more than 90 pounds, says Joanne Kurtzberg, MD, program director of the division of pediatric blood and marrow transplantation at Duke University Medical Center. And since the procedure is relatively new, no one knows how many years the frozen units will remain viable.
The cord blood collection process is simple, safe, and painless. The process usually takes no longer than five minutes. Cord blood collection does not interfere with delivery and is possible with both vaginal and cesarean deliveries.
Quite simply, cord blood is the remaining blood from your baby’s umbilical cord and placenta after birth. Cord blood is loaded with our “stem cells” which are origins of the body’s immune and blood system and maybe the origin of other organs and important…
When the medical courier delivers the cord blood collection kit to the cord blood bank, it is quickly processed to ensure the continued viability of the stem cells and immune system cells found in the cord blood. Firstly, a sample of the cord blood is tested for microbiological contamination, and the mother’s blood is tested for infectious diseases. As these tests are being conducted, the cord blood is processed to reduce the number of red blood cells and its total volume and isolate the stem cells and immune cells.
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.
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.
Use for Donor Clients can rest assured knowing their cord blood is available if needed. Always available if needed. Donors may never find the stem cells donated if ever needed because of the following:
For these and other reasons, the American Academy of Pediatrics (AAP) and many physicians do not recommend private cord blood banking except as “directed donations” in cases where a family member already has a current need or a very high potential risk of needing a bone marrow transplant. In all other cases, the AAP has declared the use of cord blood as “biological insurance” to be “unwise.” [Read the AAP’s news release at http://www.aap.org/advocacy/archives/julcord.htm ]
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Your free donation will be part of a program that is saving lives and supporting research to discover new uses for cord blood stem cells. Units that meet criteria for storage are made available to anyone, anywhere in the world, who needs a stem cell transplant.
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.
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.
^ Caseiro, AR; Pereira, T; Ivanova, G; Luís, AL; Maurício, AC (2016). “Neuromuscular Regeneration: Perspective on the Application of Mesenchymal Stem Cells and Their Secretion Products”. Stem Cells International. 2016: 9756973. doi:10.1155/2016/9756973. PMC 4736584 . PMID 26880998.
^ 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.
Exciting news reported by US News & World Report: Results from a cerebral palsy clinical trial at Duke University have been published. Read all the details on our blog now! bit.ly/2AsXSY4 pic.twitter.com/e6vxcXxTuO
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.