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Physicians or other professionals who recruit pregnant women and their families for for-profit placental cord blood stem cell banking should disclose any financial interest or other potential conflict of interest they have in the procedure to their patients.
The main disadvantage of cord blood transplants is that they take at least a week longer to “engraft”, which means repopulate the patient’s blood supply so that cell counts reach minimum acceptable levels. The longer engraftment time is a risk because it leaves the patient vulnerable to a fatal infection for a longer time.
Cord blood can only be collected at birth, that’s why it’s important to do your research well before your baby’s due date. Watch this short video to learn exactly how cord blood is collected, processed and stored.
A courier collection service. Private banks have a person pick up your donated cord blood, which helps ensure that it arrives at your chosen bank quickly and doesn’t get lost along the way, and that the temperature will remain consistent enough to be accepted at the lab. (Public banks usually send an insulated kit for you to preserve and mail the cord blood.)
§ CBR Systems, Inc.’s activities for New York State residents are limited to collection of umbilical cord tissue and long-term storage of umbilical cord-derived stem cells. CBR Systems, Inc.’s possession of a New York State license for such collection and long-term storage does not indicate approval or endorsement of possible future uses or future suitability of these cells.
Stem cells are able to transform into other types of cells in the body to create new growth and development. They are also the building blocks of the immune system. The transformation of these cells provides doctors with a way to treat leukemia and some inherited health disorders.
A well-established history. Public banks are affiliated with nonprofit research institutions or hospitals, so they have a better chance of being managed more soundly. For families without a history of diseases treated by cord blood, such as leukemia and sickle cell anemia, the American Academy of Pediatrics (AAP) recommends that cord blood be donated to public banks. 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 choose to bank cord blood, the AAP recommends public cord blood banking (instead of private) to cut down on expenditures. Private cord blood banks are affiliated with business corporations, so, like any business, they may go under, says William T. Shearer, M.D., Ph.D., professor of Pediatrics and Immunology at Baylor College of Medicine in Houston.
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.
The collection of your baby’s cord blood happens the day your baby is born. After delivery it’s standard procedure for your doctor or midwife to clamp and cut the umbilical cord. Using ViaCord’s collection kit, they will then insert a needle into the cord to collect the remaining blood. Once the collection is complete, they will seal the bag, attach the pre-printed label with your family’s information, and place it in the collection kit. A medical courier will pick up the kit from your hospital room and transport it to ViaCord’s state-of-the-art lab and storage facility, where lab specialists will process the cord blood in preparation for long-term storage.
Cord Blood Registry® (CBR®) is the world’s largest newborn stem cell company. Founded in 1992, CBR is entrusted by parents with storing samples from more than 600,000 children. CBR is dedicated to advancing the clinical application of cord blood and cord tissue stem cells by partnering with institutions to establish FDA-regulated clinical trials for conditions that have no cure today.
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.
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.
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.
Osteopetrosis is a genetic disease, so this means that doctors could use a sibling’s cord blood cells to treat Anthony, but they cannot use his own cells because the disease is in every cell in his body. In fact, a majority of the diseases listed in private banking firms’ marketing material as treatable with stem cells are genetic diseases.
While some companies may advertise their cord tissue preservation service as “treatment-ready”, this is a misnomer. In the U.S. there are currently no treatments available that use cord tissue cells. Without knowing what the treatment protocols may look like in the future, preserving the cord tissue sample whole today means that all of the available cell types in this precious resource may be available to your family in the future.
According to the statement, “Families may be vulnerable to emotional marketing 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 cells. The range of available estimates is from 1 in 1,000 to 1 in 200,000.” For this and other reasons, it is difficult to recommend that parents store their children’s cord blood for future use. The AAP policy states:
A “clinical trial” is a study in human patients for an emerging therapy that has not been adopted as standard therapy. This website has pages that enable patients to search worldwide for currently recruiting clinical trials with ether cord blood or umbilical cord tissue MSC. The table below checks off all diagnoses that have ever been treated in clinical trials with cord blood or cord tissue, regardless of whether the trials are still open.
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).
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.
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.
To explain why cord blood banking is so expensive in the United States, we wrote an article with the CEO of a public cord blood bank that lists the steps in cord blood banking and itemizes the cost of each one.
Many expectant parents would love the opportunity to bank their baby’s cord blood and cord tissue, but with an initial fee of $1600–$1800 for a quality service and an annual fee of $150–$175, the cost of banking cord blood may seem out of reach. At Cryo-Cell, we are committed to offering a high standard of service at the best price possible, with absolutely no unexpected fees or hidden surcharges. To help keep cord blood banking in everyone’s budget, we offer in-house financing options that begin for as little as $199 down and $128 per month. In addition, we regularly offer specials and have a number of discounts for current clients, referrals, multiple birthes and medical professionals. We will even meet the price of any reputable competitor through our best-price guarantee.
Takahashi S, Iseki T, Ooi J, et al. Single-institute comparative analysis of unrelated bone marrow transplantation and cord blood transplantation for adult patients with hematologic malignancies. Blood.2004;104 :3813– 3820
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.
Ballen K., Broxmeyer H. E., McCullough J., Piaciabello W., Rebulla P., Verfaillie C. M., & Wagner J. E. (2001). Current status of cord blood banking and transplantation in the United States and Europe. Biology of Blood and Marrow Transplantation, 7(12), 635–645 [PubMed]
Cancellations prior to CBR’s storage of the samples(s) are subject to an administrative fee of $150. If you terminate your agreement with CBR after storage of the sample(s), you will not receive a refund.
Additional ethical concerns about umbilical cord blood banking involve the timing of clamping the umbilical cord after birth. Overall, the issue of when to clamp and cut the umbilical cord is controversial. There is no consensus on how early or how late in the birthing process the umbilical cord ought to be clamped and cut, although the cord obviously still provides nourishment and removes waste until it is clamped or spontaneously stops pulsing (Lothian & DeVries, 2010). However, some practitioners might clamp the umbilical cord early in an effort to maximize the amount of cord blood obtained for banking, and thus “short change” the child and allow the infant to become anemic (Drew, 2005).
The second couple listened intently to the conversation, interjecting that they hadn’t considered cord blood banking, and they looked toward me. They started asking the other couple, and me, many questions about cord blood banking. What is the cost? How is it done? What are the uses of cord blood? Is it only used to treat the baby later in life? Will cord blood treat myasthenia gravis? And finally, is it worth the time, effort, and money to invest in cord blood banking?
Options for Umbilical Cord Blood Banking and Donation—As expectant parents, learn how umbilical cord blood can help others through public donation, family (private) cord blood banking, or directed donation for a biological sibling.