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Cord blood donation doesn’t cost anything for parents. Public cord blood banks pay for everything which includes the collection, testing, and storing of umbilical cord blood. This means that cord blood donation is not possible in every hospital.
The first cord blood banks were private cord blood banks. In fact, Cryo-Cell is the world’s first private cord blood bank. It wasn’t until later that the government realized the need to preserve cord blood for research and public welfare. As a result, 31 states have adopted a law or have a piece of pending legislation that requires or encourages OBGYNs to educate expectant parents about cord blood banking and many states now have publicly held cord blood banks. As a result, parents have the option of banking their baby’s cord blood privately for the exclusive use of the child and the rest of the family or donating the cord blood to a public bank so that it can be used in research or by any patient who is a match and in need.
The second question concerns “storing” the newborn’s cord blood for the child’s future use or a family member’s future use. The American Academy of Pediatrics has issued a policy statement saying that, “Cord blood donation should be discouraged when cord blood stored in a bank is to be directed for later personal or family use.” They state: “No accurate estimates exist of the likelihood of children to need their own stored cord blood stem cells in the future. The range of available estimates is from 1 in 1000 to more than 1 in 200000.51 The potential for children needing their own cord blood stem cells for future autologous use is controversial presently.” Read the complete statement here.
Meet Dylan. Diagnosed with leukemia at just 8 weeks old, he received a life-saving cord blood transplant at 6 months old. Today, Dylan is growing up strong, going to school, travelling with his family and just having fun being a kid!
Cord blood is collected by your obstetrician or the staff at the hospital where you give birth. Not all hospitals offer this service. Some charge a separate fee that may or may not be covered by insurance.
Most public banks only work with selected hospitals in their community. They do this because they need to train the staff who will collect the cord blood, and they want the blood to be transported to their laboratory as quickly as possible. A parent who wants to donate should start by finding public banks in your country.
The baby’s cord blood will be processed and stored in a laboratory facility, often referred to as a blood bank. The cord blood should be processed and stored in a facility that is accredited by the American Association of Blood Banks (AABB) for the purpose of handling stem cells.
Private (commercial) cord banks will store the donated blood for use by the donor and family members only. They can be expensive. These banks charge a fee for processing and an annual fee for storage.
With the consent of the parents, blood can be collected from the umbilical cord of a newborn baby shortly after birth. This does not hurt the baby or the mother in any way, and it is blood that would otherwise be discarded as biological waste along with the placenta (another rich source of stem cells) after the birth.
You need to plan ahead if you decide to store cord blood. Banks need to be notified four to six weeks before your due date if you’re interested in donating blood. Once you do decide on a public bank, those affiliated with the Be the Match registry (bethematch.org/cord) will cover the costs of collecting, processing, and storing cord blood units.
One reason BMT and PBSCT are used in cancer treatment is to make it possible for patients to receive very high doses of chemotherapy and/or radiation therapy. To understand more about why BMT and PBSCT are used, it is helpful to understand how chemotherapy and radiation therapy work.
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.
So what are your options? You have three choices. One is to store the cord blood with a private company at a cost to you ranging from $1,500 to $2,500 and an annual storage fee in the ballpark of $125. Secondly, you can donate the cord blood to a public bank, if there is one working with your hospital, and your doctor is on board with the idea. There are also public banks that accept mail-in donations, if you register during your second trimester and your doctor is willing to take a short training class on-line. Zero cost to you. The third option is to do nothing and have the cord blood, umbilical cord, and placenta destroyed as medical waste.
For example, in the UK the NHS Cord Blood Bank has been collecting and banking altruistically donated umbilical cord blood since 1996. The cord blood in public banks like this is stored indefinitely for possible transplant, and is available for any patient that needs this special tissue type. There is no charge to the donor but the blood is not stored specifically for that person or their family.
When an immediate family member has a disease that requires a stem cell transplant, cord blood from a newborn baby in the family may be the best option. There is a 25% chance, for example, that cord blood will be a perfect match for a sibling, because each child shares one of its two HLA genes with each parent. Occasionally cord blood will be a good match for a parent if, by chance, both parents share some of the six HLA antigens. The baby’s cord blood is less likely to be a good match for more distant relatives. The inventories of unrelated cord blood units in public cord blood banks are more likely to provide appropriate matches for parents and distant relatives, as well as for siblings that do not match.
Georgia Regents University is conducting an FDA-regulated phase I/II clinical trial to assess whether an infusion of autologous stem cells derived from their own cord blood can improve the quality of life for children with cerebral palsy.
As noted, there are different ways to process cord blood, and although the type of processing method doesn’t always enter the conversation on cord blood banking, it is a big part of the purity of any cord blood collection. Red blood cells can have a negative impact on a cord blood transfusion. In addition, there is a certain number of stem cells that need to be present in order for the cord blood to be effective in disease treatment. Each processing method has the ability to better reduce the number of RBCs and capture more stem cells. Some processing methods like AutoXpress and Sepax are automated to ensure a level of consistency across all collections. HES is preferred by some banks because it was the original processing method used by most banks and it has a proven track record. You can read more about the different cord blood processing methods here.
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.
The main reason for this requirement is to give the cord blood bank enough time to complete the enrollment process. For the safety of any person who might receive the cord blood donation, the mother must pass a health history screening. And for ethical reasons, the mother must give informed consent.
The stem cells from your baby’s cord blood may also be effective in treating certain diseases or conditions of a parent or sibling. Cord blood stem cells have similar ability to treat disease as bone marrow but with significantly less rejection.
Since 1989, umbilical cord blood has been used successfully to treat children with leukaemia, anaemias and other blood diseases. Researchers are now looking at ways of increasing the number of haematopoietic stem cells that can be obtained from cord blood, so that they can be used to treat adults routinely too.
With allogeneic transplants, GVHD sometimes develops when white blood cells from the donor (the graft) identify cells in the patient’s body (the host) as foreign and attack them. The most commonly damaged organs are the skin, liver, and intestines. This complication can develop within a few weeks of the transplant (acute GVHD) or much later (chronic GVHD). To prevent this complication, the patient may receive medications that suppress the immune system. Additionally, the donated stem cells can be treated to remove the white blood cells that cause GVHD in a process called “T-cell depletion.” If GVHD develops, it can be very serious and is treated with steroids or other immunosuppressive agents. GVHD can be difficult to treat, but some studies suggest that patients with leukemia who develop GVHD are less likely to have the cancer come back. Clinical trials are being conducted to find ways to prevent and treat GVHD.
According to Cord Blood Registry, cord blood is defined as “the blood that remains in your baby’s umbilical cord after the cord has been cut, is a rich source of unique stem cells that can be used in medical treatments.” Cord blood has been shown to help treat over 80 diseases, such as leukemia, other cancers, and blood disorders. This cord blood, which can be safely removed from your newborn’s already-cut umbilical cord, can be privately stored for the purpose of possible use in the future for your child or family member. (It can also be donated to a public bank, but this is not widely available)
Cord Blood banking is a confusing topic. Many parents get bombarded with information when searching to see if cord blood banking is right for them. There is information that private cord blood banking companies, like Viacord and Cord Blood Registry, will not tell you, until now.
There are options for relieving the financial burden associated with BMT and PBSCT. A hospital social worker is a valuable resource in planning for these financial needs. Federal government programs and local service organizations may also be able to help.
^ a b Ballen, KK; Gluckman, E; Broxmeyer, HE (25 July 2013). “Umbilical cord blood transplantation: the first 25 years and beyond”. Blood. 122 (4): 491–8. doi:10.1182/blood-2013-02-453175. PMC 3952633 . PMID 23673863.
CBR Clients: Did you know that when you refer a friend, and they preserve their baby’s stem cells with us, you receive a free year of cord blood storage? After your first referral, you start earning even more rewards. (exclusions apply). Refer a friend now: http://bit.ly/2JAGrcu
Unlike other banks, CBR uses a seamless cryobag for storage. The seamless construction decreases the potential for breakage that can occur in traditional, seamed-plastic storage bags. Prior to storage, each cryobag is placed in a second overwrap layer of plastic, which is hermetically sealed as an extra precaution against possible cross contamination by current and yet unidentified pathogens that may be discovered in the future. CBR stores the stem cells in vaults, called dewars, specially designed for long-term cryostorage. The cord blood units are suspended above a pool of liquid nitrogen that creates a vapor-phase environment kept at minus 196 degrees Celsius. This keeps the units as cold as liquid nitrogen without immersing them in liquid, which can enable cross-contamination. Cryopreserved cord blood stem cells have proven viable after more than 20 years of storage, and research suggests they should remain viable indefinitely.
The Cord Blood Registry (CBR) is unique, because it is currently the world’s largest cord blood bank, with over a half-million cord blood and cord tissue units stored to date. This is substantially more than its nearest competitor, ViaCord, which has 350,000 units stored. It was recently acquired by pharmaceutical giant, AMAG Pharmaceuticals, for $700 million in June 2015.
An HLA match helps ensure the body accepts the new cell and the transplant is successful. It also reduces the risk of graft-versus-host disease (GVHD), which is when the transplanted cells attack the recipient’s body. GVHD occurs in 30%–40% of recipients when they aren’t a perfect match but the donor is still related. If the donor and recipient are not related, it increases to a 60%–80% risk. The better the match, the more likely any GVHD symptoms will be mild, if they suffer from GVHD at all. Unfortunately, GVHD can also be deadly.
As noted earlier, with better matching, there is a greater chance of success and less risk of graft-versus-host disease (GvHD) in any stem cell transplant. With cord blood, the baby’s own cells are always a perfect match and share little risk. When using cord blood across identical twins, there is also a very low chance of GvHD although mutations and biological changes caused by epigenetic factors can occur. Other blood-related family members have a 35%–45% chance of GvHD, and unrelated persons have a 60%–80% chance of suffering from GvHD.