cord blood facts | acog umbilical cord blood gases

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).
New England Cord Blood Bank was founded in 1971 and is one of the pioneers in processing and cryopreservation of human cells and tissue. The company is continuing to expand its research and development center.
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.
Rocha V, Wagner JE Jr, Sobocinski KA, et al. Graft-versus-host disease in children who have received a cord-blood or bone marrow transplant from an HLA-identical sibling. Eurocord and International Bone Marrow Transplant Registry Working Committee on Alternative Donor and Stem Cell Sources. N Engl J Med.2000;342 :1846– 1854
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, 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.
The main purpose of a cord blood company is to store umbilical cord blood for families in case they need to access it for future use. Cord blood from a baby is stored because it has the potential to help treat blood or immune system diseases. There are both private and public cord blood companies, sometimes referred to as cord blood banks.
“Processing” refers to separating the important components of the whole cord blood before cryopreservation. There are many methods used to process cord blood that can achieve the same goal: storing the important cells for potential future use. However, it’s important to point out some differences between methods:
It depends on who you ask. Although commercial cord blood banks often bill their services as “biological insurance” against future diseases, the blood doesn’t often get used. One study says the chance that a child will use their cord blood over their lifetime is between 1 in 400 and 1 in 200,000.
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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.
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.
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.
All cord blood banks in the US are required to register with Food and Drug Administration. To ensure safety, cord blood banks must comply with FDA regulations, including current good tissue practice regulations, donor screening and testing for infectious diseases, including HIV I & II (the virus that causes AIDS), Hepatitis B & C, which can cause liver disease, Cytomegalovirus (CMV) a virus that can lead to pneumonia, Human T-cell Lymphotropic Virus (HTLV) 1 & 2, which can suppress the immune system, West Nile Virus, Zika Virus, Treponema pallidum (the bacterium that can cause syphilis) and Variant Creutzfeldt-Jakob Disease (vCJD), a rare virus that can cause brain disease. Since 2011, the FDA has required public cord blood banks to obtain a license under a Biologics License Application.
3. Heart disease. It’s the leading cause of death in the United States, and stem cells may provide some relief. Research is underway to see if injecting the cells into the heart could help regenerate heart muscle damaged by, for example, a heart attack. Again, researchers have reported success in rodents.
Despite the benefits of using umbilical cord blood stem cells for transplant, the process also has some disadvantages (see Table 3). For stem cell transplants to be successful, measurable signs of engraftment must occur. Engraftment is the opposite of rejection and indicates that the stem cell transplant is “working.” Two measurable signs of engraftment are the recovery of both neutrophil (a type of white blood cell) and platelet (a clotting factor) production. These two clinical signs of recovery take longer to occur in umbilical cord blood stem cell transplants than in bone marrow stem cell transplants. In other words, the lab values for white blood cell production and platelet production take longer to increase after umbilical cord blood stem cell transplants than after bone marrow stem cell transplants (Hess, 1997; Moise, 2005).
Preserving stem cells does not guarantee that the saved stem cells will be applicable for every situation. Ultimate use will be determined by a physician. Please note: Americord Registry’s activities are limited to collection of umbilical cord tissue from autologous donors. Americord Registry’s possession of a New York State license for such collection does not indicate approval or endorsement of possible future uses or future suitability of cells derived from umbilical cord tissue.
Right after the cord is clamped and cut, your medical practitioner uses a needle and gets it inserted into the umbilical vein of the cord. Only that part is cut which is still attached to the placenta. High quality and proper needles are used and they do not go anywhere near your baby.
5. Alzheimer’s disease. Likewise, embryonic stem cells may come in handy against Alzheimer’s disease, a progressive and deadly disorder that degrades and kills brain cells, leading to memory loss, cognitive decline, and behavioral problems. Stem cells may give rise to new treatments or even, some say, a cure; other experts have expressed skepticism.
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.
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.
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.
Not all moms can donate their cord blood. Moms who are not eligible are those who: are younger than 18 years old (in most states), have been treated for cancer or have received chemotherapy for another illness, have had malaria in the last three years, or have been treated for a blood disease such as HIV or hepatitis. It’s also not possible to donate cord blood if a mom has delivered her baby prematurely (there may not be enough blood to collect) or delivered multiples (but it’s possible to bank your cord blood of multiples privately).
In order to preserve more types and quantity of umbilical cord stem cells and to maximize possible future health options, Cryo-Cell’s umbilical cord tissue service provides expectant families with the opportunity to cryogenically store their newborn’s umbilical cord tissue cells contained within substantially intact cord tissue. Should umbilical cord tissue cells be considered for potential utilization in a future therapeutic application, further laboratory processing may be necessary. Regarding umbilical cord tissue, all private blood banks’ activities for New York State residents are limited to collection, processing, and long-term storage of umbilical cord tissue stem cells. The possession of a New York State license for such collection, processing and long-term storage does not indicate approval or endorsement of possible future uses or future suitability of these cells.

7 Replies to “cord blood facts | acog umbilical cord blood gases”

  1. The “cell recovery rate” is often used to compare processing methods. Expressed as a percentage, the cell recovery rate tells you how many cells are retrieved from the original cord blood collection, once plasma has been removed and red blood cells have been reduced or removed. It is expected that some cells will be lost during processing, and most processing methods have published cell recovery rates between 80%—99%
    To save money, public banks will not even process a cord blood donation unless they know in advance that they are going to keep it. When the collection first arrives at the lab, it is passed through a cell counting machine. Only collections that have at least 900 million nucleated cells are kept. As a result, over 60%-80% of cord blood donations are discarded. The public bank must absorb the expense of the collection kit and delivery charges for discarded blood; typically $100 per unit.
    ## Payment Plan Disclosures for in-house CBR 12-Month Plan (interest free) – No credit check required. The 12-month plan requires a $15/month administrative fee. The plans may be prepaid in full at any time.
    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
    These are diseases for which transplants of blood-forming stem cells (Hematopoietic Stem Cell Transplants, HSCT) are a standard treatment. For some diseases they are the only therapy, and in other diseases they are only employed when front-line therapies have failed or the disease is very aggressive. The lists below include ALL therapies that use blood-forming stem cells, without distinction as to whether the stem cells were extracted from bone marrow, peripheral blood, or cord blood.
    Wagner JE, Rosenthal J, Sweetman R, et al. Successful transplantation of HLA-matched and HLA-mismatched umbilical cord blood from unrelated donors: analysis of engraftment and acute graft-versus-host disease. Blood.1996;88 :795– 802
    There are many “what if” situations that we all consider in our life. One of the most serious is “What if a child or other family member was to become seriously ill?” Cord Blood Banking clinics have been growing exponentially in response to this common fear. But should you ever find yourself in this dilemma, what are the pros and cons of using cord blood cells versus other stem cell-related treatments? This article will take a comparative look at some of the key benefits and difficulties as well as the financial costs of cord blood banking.
    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.
    Stem cells’ role is critical for regenerative medicine. A stem cell is a special type of cell because it is the basis for all the other cells in our bodies. Stem cells have the ability to develop into one of many different types of cells. This process of a stem cell becoming a specific type of cell like a skin cell, blood cell or bone cell is known as differentiation. The other unique ability of stem cells is to replicate quickly. Combined, these abilities can quickly replenish different types of cells, making stem cells a driving factor or major enhancement in the healing process.

  2. 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):
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  3. The American Academy of Pediatrics is an organization of 55,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety, and well-being of infants, children, adolescents and young adults  Read the full article on the AAP website.
    Public umbilical cord blood banks accept altruistic donations of cord blood and do not charge donation fees. Donated units are also processed, antigen typed, and frozen, ready for use. Unlike private banks, public banks do not reserve the units for the family that donated them; rather, units are available to the general public. In fact, a family that donates the blood would be no more likely to be a recipient of the blood than anyone else in the general population. Public cord blood banks function much like venous blood banks. The blood is released on an “as-needed” basis, and a processing fee may be charged to recoup some of the cost of storage (Moise, 2005; Percer, 2009).
    Carolinas Cord Blood Bank, established in 1998, is one of the largest public cord blood banks. It’s affiliated with Duke University, where trials are currently taking place to treat children with cerebral palsy with their own cord blood. Parents can mail in their cord blood donations and receive financial aid if they have a sick older child or family member who can be treated with cord blood.

  4. 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.
    There are usually two fees involved in cord blood banking. The first is the initial fee that covers enrollment, collection, and storage for at least the first year. The second is an annual storage fee. Some facilities vary the initial fee based upon the length of a predetermined period of storage.
    That may sound expensive, but the cost of processing cord blood and storing it in medical freezers for years on end is considerable. Even public cord blood banks say the initial collection, processing, and storage cost them about $1,500 per unit of cord blood.

  5. Cord blood specimens for non-clinical scientific research studies are also available through the Cord Blood Transplantation (COBLT) Study, funded by the National Heart Lung and Blood Institute (NHLBI)
    Umbilical cord blood stem cells are different from embryonic stem cells. Umbilical cord blood stem cells are collected by your ob-gyn or a nurse from the umbilical cord after you give birth (but before your placenta is delivered). Embryonic stem cells are collected when a human embryo is destroyed.
    * Cbr Systems, Inc.’s activities for New York State residents are limited to collection of umbilical cord t style=”list-style-type: initial;”issue 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.
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    Properly preserved cord blood is long-lasting. Cord blood is stored in a nitrogen freezer (the same technology used to freeze donated sperm), so it can last for a long time. “The scientist who first developed cord blood preservation methods in 1990 has confirmed that some of the first specimens he stored 23 plus years ago are just as potent as fresh cord blood,” says Mary Halet, Director, Central Region at Be The Match, which is operated by the National Bone Marrow Foundation.
    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.

  6. Blood naturally starts to clot when its outside the body. An anticoagulant is used to help prevent the cord blood from clotting while it is in transit to the laboratory for processing. CBR deliberately chose to use lyophilized (dry) heparin as the anticoagulant because of some potential advantages, including:
    Contact Us | Viewers & Players | Privacy Policy | Disclaimers | Accessibility | Freedom of Information Act | No Fear Act | U.S. Department of Health and Human Services | USA.gov | WhiteHouse.gov | Healthcare.gov
    The use of cord blood is determined by the treating physician and is influenced by many factors, including the patient’s medical condition, the characteristics of the sample, and whether the cord blood should come from the patient or an appropriately matched donor. Cord blood has established uses in transplant medicine; however, its use in regenerative medicine is still being researched. There is no guarantee that treatments being studied in the laboratory, clinical trials, or other experimental treatments will be available in the future.
    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.
    Another important disadvantage that is not well understood by the general public is the limited use of an infant’s own umbilical cord blood stem cells later in life, called an autologous transplant. Commercial cord blood banks often advertise the banking of the infant’s cord blood as “biologic insurance.” However, the chance that a child would be able to use his or her own cord blood is extremely small: from a 1:400 to a 1:200,000 chance over the child’s lifetime (Sullivan, 2008). In fact, there are certain instances in which the use of one’s own umbilical cord blood is contraindicated, as in cases when the defect is of a genetic origin. For example, autologous cord blood stem cells cannot be used to treat malignant cancers such as leukemia because the genetic mutations for the cancer already exist on the DNA of the cord blood. Using one’s own stem cells would be, in effect, “contaminating” oneself with the same disease process (Percer, 2009).
    Both public and family cord blood banks must register with the US Food and Drug Administration (FDA), and since Oct. 2011 public banks also need to apply for an FDA license. All cord blood banks are required by federal law to test the blood of the mother for infectious diseases. At public banks the screening is usually more extensive, similar to the tests performed when you donate blood. The typical expense to a public bank is $150 per unit.
    Migliaccio AR, Adamson JW, Stevens CE, Dobrila NL, Carrier CM, Rubinstein P. Cell dose and speed of engraftment in placental/umbilical cord blood transplantation: graft progenitor cell content is a better predictor than nucleated cell quantity. Blood.2000;96 :2717– 2722
    Kasamon YL, Jones RJ, Piantadosi S, et al. High-dose therapy and blood or marrow transplantation for non-Hodgkin lymphoma with central nervous system involvement. Biol Blood Marrow Transplant.2005;11 :93– 100
    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.
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  7. Throughout the last few years, cord blood banking has turned out to be one of the most viable and commendable medical advancements. Wondering what is cord blood? Well, this is the blood extracted from the baby’s umbilical cord. The entire procedure, during which the blood is extracted, turns out to be painless and safe both for the child and the mother. On top of that, the baby, his family members, and many other individuals can enjoy high health benefits from the procedure of cord blood banking. So simply read along to know better about cord blood storage as well as overall cord blood banking procedures.
    Prior to freezing the cells, samples are taken for quality testing. Banks measure the number of cells that are positive for the CD34 marker, a protein that is used to estimate the number of blood-forming stem cells present. Typical cost, $150 to $200 per unit. They also measure the number of nucleated cells, another measure of stem cells, both before and after processing to determine the cell recovery rate. Typical expense, $35 per unit. A portion of the sample is submitted to check that there is no bacterial or fungal contamination. Typical expense, $75 per unit. Public banks will also check the ability of the sample to grow new cells by taking a culture called the CFU assay. Typical expense, $200 to $250 per unit.
    When it comes to raising kids, good advice and strong evidence can be hard to come by. The Growth Curve blog brings an accessible and metered approach to new studies and popular parenting topics. Growth Curve is a blog of Science News, which gives readers a concise overview of the most important science news from all fields and applications of science and technology.
    ## Payment Plan Disclosures for in-house CBR 12-Month Plan (interest free) – No credit check required. The 12-month plan requires a $15/month administrative fee. The plans may be prepaid in full at any time.
    Refer-a-friend program: The New England Cord Blood Bank gives families $100 for each friend they refer to the company, so customers have further incentive to choose the company for storage and processing.
    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
    CBR’s lab stores over 700,000 cord blood and cord tissue stem cell units. As a result of our size, we are able to continuously invest in clinical trials, product innovation, and our lab and storage facility. We own our state-of-the-art facility. And, we continually invest in quality and security. This means our families will always have access to their stem cells.
    This means that family members, and possibly even strangers, may be able to use the cord blood stem cells for certain treatments. Siblings from the same biological parents have the highest chance of full or partial genetic match, followed by the biological parents who may be a partial match.
    Prior to the cord blood being harvested you will need to complete a health history questionnaire, and provide a blood sample to check for disease. In most situations, you will also be required to sign a consent form to confirm your intention to have the cord blood harvested.

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