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Parents who wish to donate cord blood are limited by whether there is a public bank that collects donations from the hospital or clinic where their baby will be born. Search our list of public banks in your country. Parents who wish to store cord blood and/or cord tissue for their family can find and compare private banks in your country. Family banks usually offer payment plans or insurance policies to lower the cost of cord blood banking.
Cord blood, which is harvested from the umbilical cord right after a baby is born, is marketed as a treatment for diseases such as leukemia and sickle cell disease, and as a potential source of cells for regenerative medicine – a cutting-edge field of medicine studying how to repair tissues damaged by everything from heart disease to cerebral palsy.
For transplants, the primary advantage of cord blood stem cells over stem cells from adults is that they cause much less graft versus host disease (GvHD). In order to safely transplant adult stem cells, the patient and donor must match over at least 10 of 12 tissue types called Human Leukocyte Antigens (HLA), or 83% HLA match. By comparison, medical outcomes are just as good with cord blood that has a 4 out of 6 or 67% HLA match.
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.
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.
In 1988, a 5-year-old named Matthew with a rare type of anemia received umbilical cord blood cells from his newborn sister, who didn’t have the disease. That transfer, called an umbilical cord blood transplant, worked, and the boy was soon free of the disease.
Cord blood donation should be encouraged when the cord blood is stored in a bank for public use. Parents should recognize that genetic (eg, chromosomal abnormalities) and infectious disease testing is performed on the cord blood and that if abnormalities are identified, they will be notified. Parents should also be informed that the cord blood banked in a public program may not be accessible for future private use.
Finally, there is a significant lack of regulation for umbilical cord blood banking. The lack of quality control, in turn, affects the quality of the specimen available for transplant. Some cord blood banks have submitted to voluntary accreditation, but the process of accreditation varies from bank to bank, whether public or private (McGuckin & Forraz, 2008; Moise, 2005).
The policy also points out that if cord clamping is done too soon after birth, the infant may be deprived of a placental blood transfusion, resulting in lower blood volume and increased risk for anemia later in life.
The FDA regulates cord blood bank operations with strict guidelines. However, additional licenses maybe required in some states. Laboratories should also be AABB accredited. The AABB promotes the highest standards of care for both patients and donors in all aspects of blood banking, transfusion medicine, relationship testing, hematopoietic, cord blood and other cellular therapies.
That fetal blood holds all sorts of interesting — and potentially therapeutic — cells and molecules. This realization has, in some cases, changed the way the umbilical cord and placenta are handled during birth. Instead of tossing it aside, some doctors, scientists and parents are choosing to bank this fetal blood — harvesting it from the baby’s umbilical cord and placenta, freezing it and storing it away for later.
If you do decide to bank your baby’s cord blood, there’s one more thing to keep in mind: It’s best not to make it a last-minute decision. You should coordinate with the bank before your baby is born so nothing is left to chance.
Some parents-to-be are sold on the advertising that banking their child’s cord blood could potentially treat an array of diseases the child, or his siblings, could encounter in their lives. Other parents-to-be may find all the promises too good to be true.
Because there are no scientific data at the present time to support autologous cord blood banking and given the difficulty of making an accurate estimate of the need for autologous transplantation and the ready availability of allogeneic transplantation, private storage of cord blood as “biological insurance” should be discouraged. Cord blood banks should comply with national accreditation standards developed by the Foundation for the Accreditation of Cellular Therapy (FACT), the US Food and Drug Administration (FDA), the Federal Trade Commission, and similar state agencies. At a minimum, physicians involved in procurement of cord blood should be aware of cord blood collection, processing, and storage procedures as shown in Table 2.
Accreditation agencies and registries have recognized StemCyte™ for its dedication to higher standards and patient care. StemCyte™ is the only private cord blood bank that is both FACT- and AABB-accredited.
A number of private for-profit companies have been established that encourage parents to bank their children’s cord blood for their own autologous use or for directed donor allogeneic use for a family member should the need arise. Parents have been encouraged to bank their infants’ cord blood as a form of “biological insurance.” Physicians, employees, and/or consultants of such companies may have potential conflicts of interest in recruiting patients because of their own financial gain. Annual disclosure of the financial interest and potential conflicts of interest must be made to institutional review boards that are charged with the responsibility of mitigation of these disclosures and risks. Families may be vulnerable to the emotional effects of marketing for cord blood banking at the time of birth of a child and may look to their physicians for advice. No accurate estimates exist of the likelihood of children to need their own stored cord blood stem cells in the future. The range of available estimates is from 1 in 1000 to more than 1 in 200000.51 The potential for children needing their own cord blood stem cells for future autologous use is controversial presently.51 There also is no evidence of the safety or effectiveness of autologous cord blood stem cell transplantation for the treatment of malignant neoplasms.51 Indeed, there is evidence demonstrating the presence of DNA mutations in cord blood obtained from children who subsequently develop leukemia.52 Thus, an autologous cord blood transplantation might even be contraindicated in the treatment of a child who develops leukemia.
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].
A history of releasing cord blood units for therapy. “This shows they’re not just selling contracts to parents — there are doctors who are actually accepting units of cord blood that have been stored there for therapy,” 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.
Private (commercial) cord banks will store the donated blood for use by the donor and family members only. They can be expensive. These banks charge a fee for processing and an annual fee for storage.
Wall DA, Carter SL, Kernan NA, et al. Busulfan/melphalan/antithymocyte globulin followed by unrelated donor cord blood transplantation for treatment of infant leukemia and leukemia in young children: the Cord Blood Transplantation study (COBLT) experience. Biol Blood Marrow Transplant.2005;11 :637– 646
2. Diabetes. For the many Americans with type 1 diabetes, whose insulin-making pancreatic cells have been killed off by their immune system, stem cells may be the answer. Last year, scientists reported that they had coaxed human embryonic stem cells into becoming insulin-producing, blood sugar-regulating cells in diabetic mice. The aim: to someday do the same for people.
Frances Verter, PhD, founded the Parent’s Guide to Cord Blood in 1998 and has been a Scientific Advisor to Community Blood Services since 2007. In 2011 the NMDP presented her with their Lifeline Award in recognition of her efforts to improve public education about cord blood donation.
An alternative to a related donor involves seeking unrelated HLA-matched adult allogeneic donors outside of the family.2,6,11 There are more than 7 million potential unrelated volunteer adult donors registered in the National Marrow Donor Program registry.17 Although the number of patients who receive unrelated adult allogeneic donor stem cell transplants continues to increase each year, many patients are unable to find a fully matched donor, which diminishes access to transplantation therapy. Nonwhite patients have a lower chance of identifying a fully matched unrelated adult donor because of genetic heterogeneity and lack of nonwhite donors. Over the past decade, unrelated-donor, banked umbilical cord blood has been shown to contain sufficient numbers of stem cells for successful transplantation between unrelated, partially HLA-mismatched individuals.19–23 With advances in the clinical practice of cord blood transplantation, most patients unable to find a fully matched adult donor can identify a partially matched cord blood donor.
Cord blood banking takes blood from the umbilical cord at the time of birth, and donates it to a public blood bank, or stores it in a private one. Since this blood is so rich in stem cells, which have the potential to become any human cell, it could someday be used as a treatment for the child or their family members.
Direct-donation umbilical cord blood banks function as an amalgamation of public and private banks. Direct-donation banks collect cord blood without charging fees. In addition, they accept autogenous donations and reserve them only for the family, especially for a family whose infant has a sibling with a disorder that may be treated with umbilical cord blood stem cells (Moise, 2005).
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.