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Upon arrival at CBR’s laboratory, the kit is immediately checked in and inspected. Next, the cord blood unit is tested for sterility, viability, and cell count. In addition, the cord tissue is tested for sterility. CBR processes cord blood using the AutoXpress® Platform* (AXP®) – a fully automated, functionally closed stem cell processing technology. The AXP platform is an integral component of CBR’s proprietary CellAdvantage® system. CBR has the industry’s highest published average cell recovery rate of 99%.
Collected cord blood is cryopreserved and then stored in a cord blood bank for future transplantation. Cord blood collection is typically depleted of red blood cells before cryopreservation to ensure high rates of stem cell recovery.
For these and other reasons, the American Academy of Pediatrics (AAP) and many physicians do not recommend private cord blood banking except as “directed donations” in cases where a family member already has a current need or a very high potential risk of needing a bone marrow transplant. In all other cases, the AAP has declared the use of cord blood as “biological insurance” to be “unwise.” [Read the AAP’s news release at http://www.aap.org/advocacy/archives/julcord.htm ]
Excitement about cord tissue’s potential to help conditions affecting cartilage, muscle and nerve cells continues to grow.19 Researchers are focusing on a wide range of potential treatment areas, including Parkinson’s disease, Alzheimer’s, liver fibrosis, lung cancer, and sports injuries. Since 2007 there have been 150 clinical trials using cord tissue stem cells.
The Leading the Way LifeSaving Ambassadors Club is a recognition program honoring sponsor groups for outstanding performance in reaching or exceeding blood drive collections goals. CBC presents a Leading the Way plaque to winning sponsors on an annual basis. The award is based on three levels of achievement:
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.
The first cord blood transplant was performed in Paris on October 6, 1988. Since that time, over 1 million cord blood units have been collected and stored in public and family banks all over the world.
CBR created the world’s only collection device designed specifically for cord blood stem cells. CBR has the highest average published cell recovery rate in the industry – 99% – resulting in the capture of 20% more of the most important cells than other common processing methods.
Umbilical cord blood is useful for research. For example, researchers are investigating ways to grow and multiply haematopoietic (blood) stem cells from cord blood so that they can be used in more types of treatments and for adult patients as well as children. Cord blood can also be donated altruistically for clinical use. Since 1989, umbilical cord blood transplants have been used to treat children who suffer from leukaemia, anaemias and other blood diseases.
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.
Current applications for newborn stem cells include treatments for certain cancers and blood, metabolic and immune disorders. Additionally, newborn stem cell preservation has a great potential to benefit the newborn’s immediate family members with stem cell samples preserved in their most pristine state.
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.
The blood that remains in the umbilical cord and the placenta after birth is called “cord blood”. Umbilical cord blood, umbilical cord tissue, and the placenta are all very rich sources of newborn stem cells. The stem cells in the after birth are not embryonic. Most of the stem cells in cord blood are blood-forming or hematopoietic stem cells. Most of the stem cells in cord tissue and the placenta are mesenchymal stem cells.
Cade Hildreth is the Founder of BioInformant.com, the world’s largest publisher of stem cell industry news. Cade is a media expert on stem cells, recently interviewed by the Wall Street Journal, Los Angeles Business Journal, Xconomy, and Vogue Magazine.
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.
The European Group on Ethics in Science and New Technologies (EGE) has also adopted a position on the ethical aspects of umbilical cord blood banking. The EGE is of the opinion that “support for public cord blood banks for allogeneic transplantations should be increased and long term functioning should be assured.” They further stated that “the legitimacy of commercial cord blood banks for autologous use should be questioned as they sell a service which has presently no real use regarding therapeutic options.”
Much research is focused on trying to increase the number of HSCs that can be obtained from one cord blood sample by growing and multiplying the cells in the laboratory. This is known as “ex vivo expansion”. Several preliminary clinical trials using this technique are underway. The results so far are mixed: some results suggest that ex vivo expansion reduces the time taken for new blood cells to appear in the body after transplantation; however, adult patients still appear to need blood from two umbilical cords. More research is needed to understand whether there is a real benefit for patients, and this approach has yet to be approved for routine clinical use.
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.
The immune system has a way to identify foreign cells; it’s what allows the body to defend itself. So although transplants were proving successful after the first in 1956, they were limited to twins because their shared genetic makeup made them 100 percent compatible. This took a turn in 1958, when scientists discovered a protein present on the surface of almost all cells that lets the body know if the cell is one of its own cells or a foreign cell. In 1973, we finally learned enough about these compatibility markers (called human leukocyte antigens or HLAs) to perform the first unrelated bone marrow transplant.
* Annual storage fees will be charged automatically to the credit/debit card on file, on or around your baby’s birthday, unless you’ve chosen a prepay option and are subject to change until they are paid.
Cord blood collection is a completely painless procedure that does not interfere with the birth or with mother-and-child bonding following the delivery. There is no risk to either the mother or baby. Cord blood collection rarely requires Blood Center staff to be present during the baby’s delivery. There is no cost to you for donating.
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)
There are over 130 public cord blood banks in 35 countries. They are regulated by Governments and adhere to internationally agreed standards regarding safety, sample quality and ethical issues. In the UK, several NHS facilities within the National Blood Service harvest and store altruistically donated umbilical cord blood. Trained staff, working separately from those providing care to the mother and newborn child, collect the cord blood. The mother may consent to donate the blood for research and/or clinical use and the cord blood bank will make the blood available for use as appropriate.
Only three to five ounces of blood is collected from each umbilical cord. This small amount is enough to treat a sick child, but not an adult, unless multiple units of matched cord blood are used, says William T. Shearer, M.D., Ph.D., professor of Pediatrics and Immunology at Baylor College of Medicine in Houston.
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.
Through these two means, we are always producing more cells. In fact, much of your body is in a state of constant renewal because many cells can live for only certain periods of time. The lifespan for a cell in the stomach lining is about two days. Red blood cells, about four months. Nerve and brain cells are supposed to live forever. This is why these cells rarely regenerate and take a long time if they do.
Prices subject to change until they are paid. Fees apply to single-birth, U.S. customers only. Cancellation fees may apply. All major credit cards accepted. Payment plans cover first-year fees only; future annual storage fees are not included. If not paying by credit/debit card, total first year fees are due at the time of enrollment.
Cord blood transplants aren’t entirely new — they’ve been in use for about 20 years. In fact, the outcome of transplants has improved in the last 10 years, says Joanne Kurtzberg, M.D., director of the pediatric bone marrow and stem cell transplant program at Duke University.
The American Academy of Pediatrics supports efforts to provide information about the potential benefits and limitations of cord blood banking and transplantation so that parents can make an informed decision. In addition, the American College of Obstetricians and Gynecologists recommends that if a patient requests information on umbilical cord blood banking, balanced information should be given. Cord blood education is also supported by legislators at the federal and state levels. In 2005, the National Academy of Sciences published an Institute of Medicine (IoM) report titled “Establishing a National Cord Blood Stem Cell Bank Program”.
As the research into umbilical cord blood and it’s therapeutic use for blood diseases has grown, so has the question as to whether people should privately store the cord blood of their offspring for future use. A recent paper on this issue by Mahendra Rao and colleagues advocates the practice of cord blood banking (for treatment of blood diseases) but in the context of public cord blood banks rather than a private cord blood banks. Any adult needing treated would need at least two cord blood samples that are immune compatible. So one sample will not be sufficient. A child might only need one cord blood sample but in the case of childhood leukaemia there is a risk that pre-leukemic cells are present in cord blood sample – and so the child could not use their own cells for therapy.
Lead image of baby’s umbilical cord from Wikimedia Commons. Possible human blood stem cell image by Rajeev Gupta and George Chennell. Remaining images of blood sample bags and red blood cells from Wellcome Images.
Donating cord blood to a public cord blood bank involves talking with your doctor or midwife about your decision to donate and then calling a cord blood bank (if donation can be done at your hospital). Upon arriving at the hospital, tell the labor and delivery nurse that you are donating umbilical cord blood.
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).
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.
The majority of programs that accept cord blood donations require the mother to sign up in advance. In the united States, the current requirement is to sign up by the 34th week of pregnancy. This cannot be over-stressed; time and time again, mothers who want to donate are turned away because they did not inquire about donation until it was too late.
The blood within your baby’s umbilical cord is called ‘cord blood’ for short. Cord blood contains the same powerful stem cells that help your baby develop organs, blood, tissue, and an immune system during pregnancy. After your baby is born, and even after delayed cord clamping, there is blood left over in the umbilical cord that can be collected and saved, or ‘banked.’
Because of the invasive procedure required to obtain the bone marrow, scientist continued to look for a better source, which eventually lead to the discovery of similar stem cells in cord blood in 1978. Cord blood was used in its first transplant in 1988, and cord blood has since been shown to be more advantageous than other means of acquiring similar stem cells and immune system cells. This is because umbilical cord blood can be considered naïve and immature compared to other sources. Cord blood has not been exposed to disease or environmental pollutants, and it is more accepting of foreign cells. In this case, inexperience makes it stronger.
There has been considerable debate about the ethical and practical implications of commercial versus public banking. The main arguments against commercial banking have to do with questions about how likely it is that the cord blood will be used by an individual child, a sibling or a family member; the existence of several well-established alternatives to cord blood transplantation and the lack of scientific evidence that cord blood may be used to treat non-blood diseases (such as diabetes and Parkinson’s disease). In some cases patients may not be able to receive their own cord blood, as the cells may already contain the genetic changes that predispose them to disease.
Generally not. The reason siblings are more likely to match is because they get half of their HLA markers from each parent. Based on the way parents pass on genes, there is a 25 percent chance that two siblings will be a whole match, a 50 percent chance they will be a half match, and a 25 percent chance that they will not be a match at all. It is very rare for a parent to be a match with their own child, and even more rare for a grandparent to be a match.
To recap, we have certain types of stem cells that can become a variety of different cells—they are like the renaissance men of cells—but there is one more thing that makes stem cells special. This has to do with how they replicate themselves.
While banking cord blood is a new experience for many parents, it is a simple one. After all, most mothers are worried about how the delivery will go and don’t want to also be worried about the details of collecting, processing and cryo-preserving their babies’s cord blood. Thankfully, the healthcare provider and the cord blood bank do most of the work. Here are the steps found in cord blood banking:
When considering cord blood, cord tissue, and placenta tissue banking, you want all of the facts. Americord’s® Cord Blood Comparison Chart gives you information not only on our costs and services, but also on how other companies measure up.
Frances Verter, PhD, founded the Parent’s Guide to Cord Blood in 1998 and has been a Scientific Advisor to Community Blood Services since 2007. In 2011 the NMDP presented her with their Lifeline Award in recognition of her efforts to improve public education about cord blood donation.
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.
After a baby is born, cord blood is left in the umbilical cord and placenta. It is relatively easy to collect, with no risk to the mother or baby. It contains haematopoietic (blood) stem cells: rare cells normally found in the bone marrow.
Donors to public banks must be screened for blood or immune system disorders or other problems. With a cord blood donation, the mother’s blood is tested for genetic disorders and infections, and the cord blood also is tested after it is collected. Once it arrives at the blood bank, the cord blood is “typed.” It is tracked by a computer so that it can be found quickly for any person who matches when needed.
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.
Families have the additional option of storing a section of the umbilical cord, which is rich in unique and powerful stem cells that may help repair and heal the body in different ways than stem cells derived from cord blood.
^ a b c d e f Juric, MK; et al. (9 November 2016). “Milestones of Hematopoietic Stem Cell Transplantation – From First Human Studies to Current Developments”. Frontiers in Immunology. 7: 470. doi:10.3389/fimmu.2016.00470. PMC 5101209 . PMID 27881982.
Taking time to consider helping another person when you are already busy planning for the birth of your child is greatly appreciated. A gift of cord blood may someday give someone a second chance at life.
All cord blood is screened and tested. Whether you use a public or private bank, you’ll still need to be tested for various infections (such as hepatitis and HIV). If tests come back positive for disease or infection, you will not be able to store your cord blood.
Haematopoietic stem cells (HSCs) can make every type of cell in the blood – red cells, white cells and platelets. They are responsible for maintaining blood production throughout our lives. They have been used for many years in bone marrow transplants to treat blood diseases.
You’ve just visited the doctor and the good news is that you’re going to have a baby and everything looks good. Thirty years ago, your doctor may have given you a baby book and information about products that sponsors want you to buy for your new addition. Today, along with pretty much the same materials, you’ll be asked to consider saving the blood of your newborn that’s left over in the umbilical cord and placenta after the delivery. Another big decision, and possibly a costly one.
Like most transplants, the stem cells must be a genetic match with the patients to be accepted by the body’s immune system. It goes without saying that a patient’s own cord blood will be a 100% match. The second highest chance of a genetic match comes from siblings.
^ Roura, S; Pujal, JM; Gálvez-Montón, C; Bayes-Genis, A (2 July 2015). “The role and potential of umbilical cord blood in an era of new therapies: a review”. Stem cell research & therapy. 6: 123. doi:10.1186/s13287-015-0113-2. PMC 4489204 . PMID 26133757.