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An accredited lab. In the United States, the FDA requires all public banks to have a Biologics License Application, but not private banks, though they are registered and inspected. Both public and private banks should have extra accreditation, which means banks are evaluated for the quality and accuracy of work. The two companies that handle accreditation are the American Association of Blood Banks (AABB) and the Foundation for the Accreditation of Cellular Therapy (FACT). Look for a bank with its own lab (some banks use labs at other banks), which means more regular quality control and testing standards.
Cord tissue use is still in early research stages, and there is no guarantee that treatments using cord tissue will be available in the future. Cord tissue is stored whole. Additional processing prior to use will be required to extract and prepare any of the multiple cell types from cryopreserved cord tissue. 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.
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
Lamaze International (2010) does not have a policy specific to umbilical cord blood banking; however, the organization has a specific policy that prohibits advertising of private cord blood banks in any Lamaze media vehicle. This policy was most recently updated and revised in July 2010. In addition, in their book, The Official Lamaze Guide: Giving Birth With Confidence, Lothian and DeVries (2010) reinforce the AAP’s position that expectant families are vulnerable to the marketing strategies of private cord blood banks. The authors go on to say that expectant parents should know that banking umbilical cord blood does not guarantee a cure. Likewise, there is no guarantee that a private umbilical cord blood bank will be able to adequately preserve the cord blood until a time when it is needed. One potential reason for being unable to preserve the cord blood is that the private cord blood bank could go out of business.
Cord blood banking is not always cheap. It’s completely free to donate blood to a public cord blood bank, but private banks charge $1,400 to $2,300 for collecting, testing, and registering, plus an annual $95 to $125 storing fee.
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.
This web page was researched by Frances Verter, PhD, Alexey Bersenev, MD PhD, and Pedro Silva Couto, MSc ©2016-2018. Sources of information about established therapies were publications in the medical literature found via PubMed and Google Scholar. Sources of clinical trials were searches of ClinicalTrials.gov, Chinese Clinical Trial Registry (ChiCTR), Japan University hospital Medical Information Network Clinical Trial Registry (UMIN-CTR), Japan Medical Association Clinical Trial Registry (JMA-CTR), Clinical Research Information Service from South Korea (CRiS), EU Clinical Trials Register (EudraCT), World Health Organization International Clinical Trials Registry Platform (ICTRP), Netherlands Trial Register (NTR), Australian New Zealand Clinical Trial Registry (ANZCTR), Clinical Trials Registry-India (CTRI), German Clinical Trials Register (DRKS), and Iranian Registry of Clinical Trials (IRCT).
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.
Cord blood transplantation has been shown to be curative in patients with a variety of serious diseases. Physicians should be familiar with the rationale for cord blood banking and with the types of cord blood–banking programs available. Physicians consulted by prospective parents about cord blood banking can provide the following information:
A typical cord blood collection only contains enough stem cells to transplant a large child or small adult. This website has a page explaining the optimum transplant dose. At one time it was believed that cell dose limitations restricted the use of cord blood transplants to children. In recent years growing numbers of adults are also receiving cord blood transplants, either by growing the cells in a lab prior to transplant or by transplanting more than one cord blood unit at a time. More information about these trials is available on the web page about Research on Cord Blood Transplants.
LifebankUSA is the only cord blood banking company to have pioneered the advanced technology to collect additional placental stem cells for today’s treatments, and unique placental stem cells for future medical advancements. We discovered unique stem cells that remained trapped in the blood vessels of the placenta, so we created an innovative retrieval method to collect those cells.
Donating your baby’s cord blood is a wonderful gift. The cells may be the perfect match for someone in desperate need of a stem cell transplant. Unfortunately, cord blood banking is still an extremely new industry; there are only a small handful of public banks in certain regions, and those banks are primarily focused on collecting cord blood stem cells from Hispanic and African American families due to the genetic diversity associated with those families. Please visit http://www.marrow.org/ for a list of public banks with their contact information. One other note: It is also a wonderful gift to be a bone marrow donor, and becoming one is much more available to the public, unlike cord blood banking. Please call your local blood bank or the American Red Cross for additional information on how to become a bone marrow donor.
Another contributor to cord blood banking costs is the quality of the collection kit. Cheaper banks typically use flimsy collection kits. To insure the survival of newborn stem cells, the shipping container should be thermally insulated to maintain kit temperature during cord blood shipments.
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.
Clinical experience with leading institutions: Many reputed hospitals have depended on the company for cord blood, including Duke University, Children’s Healthcare of Atlanta and the University of Minnesota Medical Center.
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.
Priority shipping: Cord blood companies that use priority shipping services have families ship them cord blood in a heavily insulated box, which arrives at the cord bank at a certain time, but does not guarantee that the blood remains at a certain temperature.
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.
After the baby is delivered, according to the procedures of cord blood banking, the umbilical cord is initially clamped and then cut out in the natural and usual manner. Here, the procedure for clamping and cutting remains the same for vaginal deliveries and c-section deliveries. However, while convening the procedure, make sure to get it done under the supervision of a competent and efficient professional.
The American College of Obstetricians and Gynecologists (ACOG, 2008) recommends giving pregnant women information about umbilical cord blood banking that is free from bias. According to ACOG, the chance of a child or family member needing a stem cell transplant is about 1 in 2,700. Therefore, ACOG recommends the collection and banking of cord blood only when an immediate family member has a known diagnosis for which stem cells are currently being used for treatment, and not for potential future uses.
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.
Korthof ET, Snijder PP, de Graaff AA, et al. Allogeneic bone marrow transplantation for juvenile myelomonocytic leukemia: a single center experience of 23 patients. Bone Marrow Transplant.2005;35 :455– 461
Families with a history of diseases can greatly benefit from cord blood banking, as an insurance policy against possible future diseases. However, cord blood banking is expensive, can’t be used to treat everything, and your child may not even need it—at private cord blood banks, most is eventually discarded. Lastly, you should be aware that if the child develops certain genetic diseases, the cord blood will have the same genetic flaws.
Bielorai B, Trakhtenbrot L, Amariglio N, et al. Multilineage hematopoietic engraftment after allogeneic peripheral blood stem cell transplantation without conditioning in SCID patients. Bone Marrow Transplant.2004;34 :317– 320
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Part of the reason for the dominance of these three companies in terms of the total number of units stored is that they are three of the oldest cord blood banks within the U.S., founded in 1992, 1993, and 1989, respectively. All three of these cord blood banks also support cord blood research and clinical trials.