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Cryo-Cell, Viacord, and Cord Blood Registry are three of the oldest and largest private cord blood banks in the United States. They’ve been storing cord blood since the early ’90s, and they’re all accredited by the AABB. Cryo-Cell is located in Oldsmar, Florida; Viacord in Cambridge, Massachusetts; and Cord Blood Registry in San Bruno, California. Each of these banks has its own private labs that test for syphilis, HIV, hepatitis, cytomegalovirus, and human T-cell lymphotrophic virus (considered a precursor to leukemia); the testing is included in their registration fee.
ViaCord collaborates with leading research and medical centers across the country to help advance medical treatments using cord blood, discover treatments using cord tissue, and connect families to relevant clinical trials.
Hard numbers are tricky to pin down, but between that first transplant in 1988 and 2015, an estimated 35,000 umbilical cord blood transplants had been performed globally. That number includes people treated for leukemia and other types of cancer, blood disorders and immune diseases. And the utility of umbilical cord cells may stretch well beyond the disorders that the cells are currently being used for. “If you read the literature, it’s pretty exciting,” says pediatrician and immunologist William Shearer of Baylor College of Medicine and Texas Children’s Hospital.
AABB accredited: Some cord blood companies have received extra accreditation from the AABB, or the American Association of Blood Banks, which means they meet a certain standard of service and accuracy of work.
Some ethical concerns over umbilical cord blood banking warrant mention. As previously stated, the AAP (2007) acknowledges that claims in advertisements for private cord blood banks are not accurate. In fact, some of the statements made by private cord blood banks are outright misleading (Fox et al., 2007), which raises questions about how informed consent for cord blood collection is obtained. Legally, the cord blood belongs to the child, but the consent of the mother alone is usually obtained for collection, and the consent of the father is rarely considered (Ballen, 2006). Because the cord blood now has a “value,” the person who obtains consent and that same person’s professional connection to the private cord blood bank may come into question (Pinch, 2001).
If the doubts of the AAP, weren’t enough to turn you off cord banking, the cost is enormous. At Viacord, (see ad on left) the price begins at $1550 at birth, plus $150 for a courier to deliver the blood, plus $95 dollars for storage a year. At these prices, that will cost you $2840 by the time your baby is 21.
With public cord blood banks, there’s a greater chance that your cord blood will be put to use because it could be given to any child or adult in need, says William T. Shearer, M.D., Ph.D., professor of Pediatrics and Immunology at Baylor College of Medicine in Houston. Cord blood is donated and is put on a national registry, to be made available for any transplant patient. So if your child should need the cord blood later in life, there’s no guarantee you would be able to get it back.
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.
Your own cord blood will always be accessible. This applies only if you pay to store your cord blood at a private bank. The blood is reserved for your own family; nobody else can access or use it, and it will never be allotted to another family or be donated to research. If you donate your cord blood to a public bank, on the other hand, anyone who needs compatible cord blood can have it; there’s no guarantee that it will be available if and when your family needs it.
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.
Research on stem cell transplants began in the 1950s, with successful bone marrow transplants occurring in the 1970s, often to treat cancer patients whose own bone marrow was destroyed by chemotherapy and radiation. The first successful umbilical cord blood stem cell transplant was reported as occurring in the late 1980s. The recipient was a 6-year-old American boy from North Carolina who was treated for Fanconi’s anemia (a genetic disorder) at Hospital St. Louis in Paris, France, using cord blood obtained from his younger sister’s birth. Interestingly, more than 20 years after the transplant, this young man is alive and well. Not only did he survive long term, but both his immune system and his blood were transformed by the transplant of his sister’s cord blood stem cells. Soon after this first documented cord blood stem cell transplant, the first public umbilical cord blood bank was established in 1991 in New York (McGuckin & Forraz, 2008).
An additional cost that is borne only by public banks is the “HLA typing” that is used to match donors and patients for transplants. This is an expensive test, running about $75 to $125 per unit. Family banks always defer this test until it is known whether a family member might use the cord blood for therapy.
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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.
Check if the cord blood bank you’re considering is accredited with the American Association of Blood Banks (AABB). AABB is an international, not-for-profit organization that has been setting standards for both public and private cord blood banking companies for over 20 years. LifebankUSA is registered with the FDA and accredited by AABB. Click here for a list of AABB-accredited cord blood banking companies in the U.S. and around the world.
Families with a history of diseases can store cord blood in a bank. These families can access it should a person get sick with an immune system or blood disease, like leukemia or sickle-cell anemia, later in life.
There are three types of umbilical cord blood banks: private, public, and direct-donation banks. The private bank is a commercial, for-profit entity that often advertises directly to expectant parents. These banks are designed for the sole use of the families who have saved the cord blood. Private banks charge an initial fee for collection and processing and, then, a yearly fee to maintain the specimen. Another fee is often charged when a sample is removed for testing or treatment (Moise, 2005).
Well, this is how the entire procedure of cord blood banking. Right after the blood is extracted, it is sent for to the bank. In the bank, the cord blood is checked, tested, processed and finally preserved. This preservation is ensured by controlled freezing under high end freezing conditions. Certain private banks collect a certain segment of the umbilical cord along with the cord blood. The umbilical cord tissue contains various stem cells that are quite different from the general cord blood cells. Research experts are studying in order to understand the possible use of the stem cells in medicine.
Umbilical cord blood transplants are now used to treat numerous types of immune- and blood-related disorders and genetic diseases. Cord blood (CB) banks play an important role in these transplants by processing and storing CB units. In addition to their therapeutic potential, these banks raise ethical and regulatory questions, especially in emerging markets in the Arab world. In this article, the authors review CB banking in five countries in the region, Jordan, Saudi Arabia, Egypt, Qatar, and the United Arab Emirates, selected for their different CB banking policies and initiatives. In assessing these case studies, the authors present regional trends and issues, including religious perspectives, policies, and demographic risk factors. This research suggests strong incentives for increasing the number of CB units that are collected from and available to Arab populations. In addition, the deficit in knowledge concerning public opinion and awareness in the region should be addressed to ensure educated decision-making.
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.
Families should seriously pursue public banking, donation for research, or private banking instead of discarding their baby’s umbilical cord blood. We aim to be nonpartisan in our dissemination of information, but we believe that discarding your baby’s cord blood is a waste of a once-in-a-lifetime valuable resource.
Cord blood is the fastest growing source of stem cells in pediatric transplants, and ongoing research indicates that we’ve only just begun to harness the healing power of these amazing cells.3, 15 By collaborating with some of the country’s leading hospitals and research centers, ViaCord is helping to advance critical research in cord blood stem cell therapy and to unlock the promise of cord tissue stem cells.
For families that choose to bank cord blood, the American Academy of Pediatrics (AAP) recommends public cord blood banking. Estimates vary, but the chances of a child having a stem cell transplant, with either bone marrow or cord blood, are 1 in 217 over a lifetime. Although the 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 decide on cord blood banking, the AAP recommends public cord blood banking (instead of private) to cut down on costs. If you donate cord blood and your child eventually needs it, you can get it back as long as it hasn’t been discarded or used.
Cord blood has been shown to contain pluripotent stem cells that have the potential to differentiate into nonhematopoietic tissue, such as cardiac, neurologic, pancreatic, and skin tissue, in vitro.53,54 Extensive laboratory research is taking place to explore the potential therapeutic benefit of cord blood under these circumstances. The results of this research will be necessary to formulate future recommendations regarding autologous cord blood banking.
Prior to transplanting any type of tissue, a “matching” process must occur to increase the success of the transplant and decrease the likelihood that the transplant will be rejected. The rejection of a transplanted tissue is called “graft versus host disease.” The matching process dates back to the late 1950s when the human leukocyte antigens were discovered. There are two classes of human leukocyte antigens. The first class is located on the surface of almost all of the cells with a nucleus within the body of the cell. The second class of human leukocyte antigens is located on the surface of immune cells. Each of the two classes of antigens has three subgroups, creating six antigens for which matching can occur. Thus, a “6 of 6” matching of the antigens represents a “perfect” match. Beyond the matching process, other factors contribute to the success or failure of a stem cell transplant. These factors include, but are not limited to, the age of both the donor and the patient, the type of disease being treated, and the number of stem cells being transplanted (Moise, 2005).
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.
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After a baby is born, the umbilical cord and placenta are no longer needed and are usually discarded. However, the blood remaining in the umbilical cord and placenta is rich with blood-forming cells. (These cells are not embryonic stem cells.) By collecting and freezing this blood, the healthy blood-forming cells can be stored and may later be used by a patient who needs them.
Donating to research is another alternative. In some areas, you may be able to donate your newborn’s cord blood stem cells to a university or biotech firm. There are also now several private banks who offer to bank your baby’s cord blood as a donation, but they will typically sell it to a research facility. Cord Blood Options will be compiling additional data for this section in the near future.
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.
RENECE WALLER-WISE is a licensed clinical nurse specialist and childbirth educator at Southeast Alabama Medical Center in Dothan, Alabama. She is also an adjunct faculty member at Troy University in Troy, Alabama.
Given the difficulty in estimating the need for using one’s own cord blood cells for transplantation, private storage of cord blood as “biological insurance” is unwise. However, banking should be considered if there is a family member with a current or potential need to undergo a stem cell transplantation.
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