The term “cord blood” is used for the blood remaining in the umbilical cord and the placenta after the birth of a baby. Cord Blood contains stem cells that can grow into blood and immune system cells, as well as other types of cells. Today cord blood is often used as a substitute for bone marrow in stem cell transplants. There are over 80 diseases treated this way, including cancers, blood disorders, genetic and metabolic diseases.
^ Roura S, Pujal JM, Gálvez-Montón C, Bayes-Genis A (2015). “Impact of umbilical cord blood-derived mesenchymal stem cells on cardiovascular research”. BioMed Research International. 2015: 975302. doi:10.1155/2015/975302. PMC 4377460 . PMID 25861654.
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
“One of the wonderful things about cord blood is that unlike bone marrow, you don’t always need a perfect match in order for it to work,” says Dr. Kurtzberg, who performed the first unrelated cord-blood transplant in the U.S. And it was a public donation that ultimately saved Anthony Dones. Within a week of starting a search, the National Cord Blood Program, a public bank operated by the New York Blood Center, found a “close enough” match. Had the now-3-year-old been forced to rely on a bone-marrow match, he might still be waiting.
There are so many things to think about when you have a child. One of them is the blood from your baby’s umbilical cord (which connects the baby to the mother while in the womb). It used to be thrown away at birth, but now, many parents store the blood for the future health of their child. Should you do it?
Once a cord blood donation has been saved, it may be listed on a national registry that can be searched to find a match for a transplant patient. The donation could be released to any recipient who is compatible.
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.
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.
In fact, the shocking truth is that the majority of all cord blood stored in private banks may be unusable. Approximately 75 percent of the units donated to public banks are discarded or used in research because they don’t contain enough stem cells for transplants, says Mary Halet, manager of cord-blood operations for the Center for Cord Blood at the National Marrow Donor Program, a Minneapolis-based nonprofit organization that maintains the nation’s largest public supply of cord blood. Yet private banks store every unit they collect, which means that you might pay to store blood that won’t be usable if you need it years later.
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.
Upon arrival at CBR’s laboratory, the kit is immediately checked in and inspected. Next, the cord blood unit is tested for sterility, viability, and cell count. In addition, the cord tissue is tested for sterility. CBR processes cord blood using the AutoXpress® Platform* (AXP®) – a fully automated, functionally closed stem cell processing technology. The AXP platform is an integral component of CBR’s proprietary CellAdvantage® system. CBR has the industry’s highest published average cell recovery rate of 99%.
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.
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.
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.
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.
When you consider that public banks can only expect to ship 1-2% of their inventory for transplant, you can quickly understand why most public banks are struggling to make ends meet. That struggle means that fewer collection programs are staffed, and there are fewer opportunities for parents to donate to the public good. We said earlier that public banks only keep cord blood donations over a minimum of 900 million cells, but today most public banks have raised that threshold to 1.5 billion cells. The reason is that the largest units are the ones most likely to be used for transplants that bring income to the bank. Family cord blood banks do not need to impose volume thresholds because they have a profit margin on every unit banked.
Blood from the umbilical cord and placenta is put into a sterile bag. (The blood is put into the bag either before or after the placenta is delivered, depending upon the procedure of the cord blood bank.)
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.
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.
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.
Cord Blood Banking Cost and Fees Cord Blood Banks and Banking Cost in the United States of America ViaCord | Cord Blood Banking & Research®. Services Provided: Cord Blood Banking, Cord Tissue Banking, Newborn Genetic Screening Description: ViaCord, a PerkinElmer company, is an industry leading Cord…
Public cord blood banking supports the health of the community. Public banks collect qualifying cord blood donations from healthy pregnancies and save them in case one of them will be the match to save the life of a patient who needs a stem cell transplant. In the United States our registry of donors is called Be The Match. Patients who have a rare genetic type are more likely to receive cord blood transplants. In order for parents to donate cord blood to a public bank, their baby must be born at a hospital that accepts donations. Public cord blood banking is highly recommended by both the American Academy of Pediatrics (AAP) and American Medical Association (AMA).
Are public banks and family banks the same, except for who may use the cord blood and the cost to the parents? No. Public banks are subject to much higher regulatory requirements, and compliance with regulations carries costs. At a family bank you pay the bank enough to cover the cost of storing your baby’s cord blood, plus they make a profit. When you donate to a public bank, it costs you nothing, but the bank pays more on processing each blood collection than at a family bank. Let’s look at the steps that take place in the laboratory.
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.
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.
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.
Cord blood can’t be used to treat everything. If your child is born with a genetic condition such as muscular dystrophy or spina bifida, then the stem cells would have that condition, says Dr. Kurtzberg. But if the cord blood donor is healthy and there is a sibling or another immediate family member who has a genetic condition, the cord blood could be a good match for them.
There are around 20 companies in the United States offering public cord blood banking and 34 companies offering private (or family) cord blood banking. Public cord blood banking is completely free (collecting, testing, processing, and storing), but private cord blood banking costs between $1,400 and $2,300 for collecting, testing, and registering, plus between $95 and $125 per year for storing. Both public and private cord blood banks require moms to be tested for various infections (like hepatitis and HIV).
There is often confusion over who can use cord blood stem cells in treatment — the baby they were collected from or a sibling? The short answer is both, but it very much depends on the condition being treated. And it’s ultimately the treating physician’s decision.
Stem cell transplants from a related family member are less likely to be rejected, therefore having your baby’s stem cells available makes it less likely you would have to search for an unrelated donor who is a match
Some public banks offer sibling-directed donation programs where you can donate cord blood and designate it for use by your baby’s full sibling if that sibling has been diagnosed with a disease for which a cord blood transplant is considered standard treatment.
Checked to make sure it has enough blood-forming cells for a transplant. (If there are too few cells, the cord blood unit may be used for research to improve the transplant process for future patients or to investigate new therapies using cord blood, or discarded.)
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The next step at either a public or family bank is to process the cord blood to separate the blood component holding stem cells. The final product has a volume of 25 milliliters and includes a cryoprotectant which prevents the cells from bursting when frozen. Typical cost, $250 to $300 per unit.
Private cord blood banks allow families to store cord blood stem cells for themselves and their loved ones. They are privately funded, and typically charge a first-year processing fee that ranges from about $1,400 to $2,300, plus annual storage costs of about $115 to $175. (Americord offers cord blood banking for a one-time fee of $3,499, which includes 20 years of storage). The pros and cons of private cord blood banking are listed below.
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.
There are some diseases on the list (like neuroblastoma cancer) where a child could use his or her own cord blood. However, most of the diseases on the proven treatment list are inherited genetic diseases. Typically, a child with a genetic disease would require a cord blood unit from a sibling or an unrelated donor.
There have been several reports suggesting that cord blood may contain other types of stem cells which can produce specialised cells that do not belong to the blood, such as nerve cells. These findings are highly controversial among scientists and are not widely accepted.
And as Victor and Tracey Dones learned, a child’s own cord blood can’t always be used to treat him, even when he’s young. “Childhood leukemia is one of the diseases private banks like to play up, but most kids with leukemia are cured with chemotherapy alone. If a transplant is needed, we wouldn’t use a child’s tainted cord blood,” Dr. Kurtzberg says.
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
You’ve just visited the doctor and the good news is that you’re going to have a baby and everything looks good. Thirty years ago, your doctor may have given you a baby book and information about products that sponsors want you to buy for your new addition. Today, along with pretty much the same materials, you’ll be asked to consider saving the blood of your newborn that’s left over in the umbilical cord and placenta after the delivery. Another big decision, and possibly a costly one.
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The syringe or bag should be pre-labeled with a unique number that identifies your baby. Cord blood may only be collected during the first 15 minutes following the birth and should be processed by the laboratory within 48 hours of collection.
Cord blood holds promise for future medical procedures. Scientists are still studying more ways to treat more diseases with cord blood. At Duke University, for example, researchers are using patients’ own cord blood in trials for cerebral palsy and Hypoxic ischemic encephalopathy (a condition in which the brain does not receive enough oxygen). Trials are also under way for the treatment of autism at the Sutter Neuroscience Institute in Sacramento, California.