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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.
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.
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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.
Yes, if you have any sick children who could benefit from umbilical cord blood. Public banks such as Carolinas Cord Bank at Duke University and private banks such as FamilyCord in Los Angeles offer programs in which the bank will assist with cord blood processing and storage if your baby has a biological sibling with certain diseases. FamilyCord will provide free cord blood storage for one year. See a list of banks with these programs at parentsguidecordblood.org/help.php.
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).
The most obvious argument against is that the odds of needing cord blood for medical treatment is very, very slim. Below is a news release on a policy published in the July,1999 issue of Pediatrics, the peer-reviewed scientific journal of the American Academy of Pediatrics (AAP):
After harvesting, the umbilical cord blood is taken to a cord blood bank where it will be tested to make sure that it is clear of disease and other contaminants. Before being frozen, a cryopreservant is added to the cord blood so that the stem cells are able to be frozen without damaging them, after which they are stored in a liquid nitrogen Cord Blood storage tank at –196 Celsius.
Currently, ViaCord has released the most cord blood units for medical transplant and has the highest cord blood transplant survival rate among companies who have disclosed complete transplant data. The one-year survival rate of patients who were treated with ViaCord cord blood units is 88%, and the long-term patient survival rate is 82%.1
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.
The primary benefit to cord blood banking is that it provides a type of medical insurance. This insurance is not from a financial perspective, but rather takes the form of having the necessary medical building blocks available should they be needed in the event of certain illnesses and diseases. Those medical building blocks are the stem cells found in umbilical cord blood.
Private cord blood banking is recommended for families with a history of certain diseases. Specifically, these are families with diseases that harm the blood and immune system, such as leukemia and certain cancers, sickle-cell anemia, and some metabolic disorders. Why? The type of stem cells in cord blood can form all kinds of blood cells that can help treat these diseases.
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).
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.
Therapies with cord blood have gotten more successful. “The outcomes of cord blood transplants have improved over the past 10 years because researchers and clinicians have learned more about dosing cord blood, picking better matches, and giving the patient better supportive care as they go through the transplant,” says Joanne Kurtzberg, M.D., director of the pediatric bone marrow and stem cell transplant program at Duke University.
Currently, cord blood stem cells have been approved by the FDA in the treatment nearly 80 diseases. In addition to these approved regenerative therapies, there are close to 350 clinical trials underway investigating the use of umbilical cord blood and umbilical cord tissue for stem cell transplantation, and this number promises to steadily increase. Cord blood stem cells are approved for numerous types of malignancies, anemias, inherited metabolic disorders and deficiencies of the immune system. The majority of cord blood transplants to date have been performed in patients younger than 18 years; however, advancements in regenerative medicine show promise for all ages. See all the diseases currently being treated.
Bunin N, Aplenc R, Iannone R, et al. Unrelated donor bone marrow transplantation for children with severe aplastic anemia: minimal GVHD and durable engraftment with partial T cell depletion. Bone Marrow Transplant.2005;35 :369– 373
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.
One of the first things I learned is that the couples in my childbirth class were not unique. In fact, research indicates that most pregnant women are underinformed about the issue of cord blood banking (Fox et al., 2007). While reviewing the literature on cord blood banking, I also found that the information available for nurses and childbirth educators often comes from private cord blood banks or their employees (Cord Blood Registry, 2009; Wolf, 1998, 1999), thus introducing the chance of bias.
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Using their banked cord blood stem cells, ViaCord families participate in ongoing IND approved research including autism, cerebral palsy, & brain injury. Over 150 families have participated in ongoing research.
Recently, it was shown that umbilical cord blood contains a sufficient number of hematopoietic stem cells to be used for transplantation. More than 5500 unrelated-donor cord blood stem cell transplants for a variety of pediatric genetic,22,24–31 hematologic,22,24,25,29,32 immunologic,28 metabolic,26,27,30 and oncologic19,20,33–36 disorders have been performed to date (Table 1). The 1-year survival may be as high as 75% to 90% after sibling HLA-matched cord blood donor stem cell transplantation21,24,29 and 40% to 80% after unrelated cord blood stem cell transplantation.19,20,26,27,33,35,36 Advantages of the use of cord blood include the fact that it is readily available, carries less risk of transmission of blood-borne infectious diseases, and is transplantable across HLA barriers with diminished risk of graft-versus-host disease compared with similarly mismatched stem cells from the peripheral blood or bone marrow of related or unrelated donors.21,34,35,37 Autologous stem cells38,39 have been used for gene therapy in infants with severe combined immunodeficiency, but the appearance of T-lymphocyte leukemia in some patients has indicated the need for more basic research before additional clinical trials of gene therapy can be undertaken.
However, this does not mean more is better. Cord blood banks we reviewed are similar in terms of the quality of services they provided. Affordable services are still available, especially with the different discount options offered by many of the top cord blood banks reviewed.
Marketing materials by Viacord and Cord Blood Registry, the two largest companies, do not mention that cord blood stem cells cannot be used by the child for genetic diseases, although the fine print does state that cord blood may not be effective for all of the listed conditions.
Since 1988, cord blood transplants have been used to treat over 80 diseases in hospitals around the world. Inherited blood disorders such as sickle cell disease and thalassemia can be cured by cord blood transplant. Over the past decade, clinical trials have been developing cord blood therapies for conditions that affect brain development in early childhood, such as cerebral palsy and autism.
Allows you to bank the unique stem cells in placental blood that have shown promise in the growing field of regenerative medicine,6,7,8 placing you and your family in the best position to benefit from ongoing developments in this field.
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.
Specializing in health and medicine, Sandra Gordon has written extensively about cord blood banking for national and regional parenting magazines. She also has written about baby products, including breast pumps, for national and regional parenting magazines, blogs and books. Her work has appeared in hundreds of publications, including Parents, Prevention, Woman’s Day and Self. Gordon also appears on TV as a baby safety and money-saving expert. She is also the author of 10 books and the founder of babyproductsmom.com, a site dedicated to helping new parents gear up safely and within their budget.
The standard used to identify these cord blood banks was the number of cord blood and cord tissue units stored by each company. The purpose of this analysis is to compare pricing and services among the largest cord blood banks within the U.S., the most mature cord blood banking market in the world. These three industry giants also represent several of the largest cord blood banks worldwide.
Eapen M, Horowitz MM, Klein JP, et al. Higher mortality after allogeneic peripheral-blood transplantation compared with bone marrow in children and adolescents: the Histocompatibility and Alternate Stem Cell Source Working Committee of the International Bone Marrow Transplant Registry. J Clin Oncol.2004;22 :4872– 4780
Patients with leukemia, lymphoma, or certain inherited metabolic or immune system disorders have diseased blood-forming cells. For some patients, an umbilical cord blood or bone marrow transplant (also called a BMT) may be their best treatment option.
Donating your baby’s cord blood to a public bank is always free. The limitations of the public banking network in the United States are: they only collect donations at large birthing hospitals in ethnically diverse communities, the mother must pass a health screening, they prefer registration by 34 weeks of pregnancy, and they only save the largest cord blood collections. The potential reward of public donation is that your baby could Be The Match to save a life!
Americord offers parents the ability to collect stem cells from the placenta and umbilical cord soon after the child’s birth. These stem cells, obtained from cord blood, cord tissue and placenta tissue, can be used to help treat genetic diseases and other threats to the baby’s life. Placenta tissue stem cells can also be used to benefit the mother.
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.
One of the factors that influence engraftment time is cell dose (Gunning, 2007). Cell dose is directly related to the volume of umbilical cord blood collected. Cell dose refers to the amount of useful stem cells in the sample of blood. Because of the limited volume of cells collected from cord blood, the amount of stem cells in cord blood is approximately 10% less than the amount obtained from bone marrow (Moise, 2005). A single unit of umbilical cord blood usually contains 50 to 200 ml of blood (Gonzalez-Ryan et al., 2000). If an amount of cord blood is less than this minimum volume, the unit is discarded as being unsatisfactory because the cell dose of the sample would not be high enough. Collecting an insufficient volume of cord blood occurs in about 50% or more cases of cord blood collection (Drew, 2005). In general, fewer stem cells are needed for cord blood transplantation, and usually a volume of 50 to 100 ml of cord blood will provide enough of a cell dose for a child or small adult. However, should the recipient need additional stem cells, it is impossible to obtain more stem cells from the infant because the cord blood volume is a limited amount (Percer, 2009).
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