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The biggest advantage for cord blood is the “immaturity” of the cells, which means transplants do not require an exact match. For bone marrow and peripheral blood transplants, donors need to match the patient’s cellular structure. However, cord blood cells can adapt to a wide variety of patients, and don’t require donor matching. Chances for graft-versus-host disease are also much lower for cord blood transplants.
Experts believe that umbilical cord blood is an important source of blood stem cells and expect that its full potential for treatment of blood disorders is yet to be revealed. Other types of stem cell such as induced pluripotent stem cells may prove to be better suited to treating non-blood-related diseases, but this question can only be answered by further research.
There is often confusion over who can use cord blood stem cells in treatment — the baby they were collected from or a sibling? The short answer is both, but it very much depends on the condition being treated. And it’s ultimately the treating physician’s decision.
In this way, cord blood offers a useful alternative to bone marrow transplants for some patients. It is easier to collect than bone marrow and can be stored frozen until it is needed. It also seems to be less likely than bone marrow to cause immune rejection or complications such as Graft versus Host Disease. This means that cord blood does not need to be as perfectly matched to the patient as bone marrow (though some matching is still necessary).
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.
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”.
The unpredictability of stem cell transportation led CBR to create a crush-resistant, temperature-protected, and electronically tracked collection kit that is designed to preserve the integrity and to help ensure the safe delivery of the blood and/or tissue. CBR’s CellAdvantage® Collection Kit contains everything the healthcare provider needs to easily and safely collect the maximum amount of a newborn’s cord blood following birth.
^ 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.
Cord Blood Registry (CBR) is a private bank that offers collection and long-term storage of both cord blood and cord tissue. With more than 700,000 stored units, CBR is one of the largest of the cord blood banks.
In Europe, Canada, and Australia use of cord blood is regulated as well. In the United Kingdom the NHS Cord Blood Bank was set up in 1996 to collect, process, store and supply cord blood; it is a public cord blood bank and part of the NHS.
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.
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.
Then, the cord blood is listed on a national registry. Be The Match is the name of the U.S. registry. This organization also partners with international programs, which means your child’s stem cells could be used to treat a patient on the other side of the world.
The therapuetic potential of cord blood continues to grow. Over the last few years cord blood use has expanded into an area known as regenerative medicine. Regenerative medicine is the science of living cells being used to potentially regenerate or facilitate the repair of cells damaged by disease, genetics, injury or simply aging. Research is underway with the hope that cord blood stem cells may prove beneficial in young patients facing life-changing medical conditions once thought untreatable – such as autism and cerebral palsy.
The body has two ways to create more cells. The first is usually taught in middle school science. Known as cell division, it’s where a cell replicates within its membrane before dividing into two identical cells. Cells do this as needed for regeneration, which we will touch on in a second.
CBR is committed to advancing the science of newborn stem cells. We’ve awarded a grant to the Cord Blood Association Foundation to help fund a multi-center clinical trial researching the use of cord blood for children with autism and cerebral palsy. blog.cordblood.com/2018/04/suppor…
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.
There are some hospitals that have dedicated collections staff who can process mothers at the last minute when they arrive to deliver the baby. However, in the United States that is the exception to the rule.
The choices expectant parents make today go beyond finding out the gender of their baby. They span beyond deciding whether to find out if their child, still in the womb, may potentially have a genetic disorder. Today, many parents must decide whether to store their baby’s umbilical cord blood so it will be available to heal their child if at any point in the child’s lifetime he or she becomes sick.
HSCs can become any type of blood cell or cellular blood component inside the body, including white blood cells and red blood cells. These cells are found in umbilical cord blood and are multipotent, which means they can develop into more than one cell type.
Cord Blood Registry is a registered trademark of CBR® Systems, Inc. Annual grant support for Parent’s Guide to Cord Blood Foundation is made possible by CBR® through the Newborn Possibilities Fund administered by Tides Foundation.
Along with cord blood, Wharton’s jelly and the cord lining have been explored as sources for mesenchymal stem cells (MSC), and as of 2015 had been studied in vitro, in animal models, and in early stage clinical trials for cardiovascular diseases, as well as neurological deficits, liver diseases, immune system diseases, diabetes, lung injury, kidney injury, and leukemia.
Parents sign a consent form, giving the public bank permission to add their child’s cord blood to a database. This database will match transplant patients with a suitable donor. No information about the donor, or their family, is displayed online. The website used in America is Be The Match. They maintain a database of donations and banks across the country, while also working with foreign banks. Your child’s cord blood could save someone living anywhere in the world.
Medical staff at the public cord blood bank will check to see if you can donate. If you have had a disease that can be given to another person through blood-forming cells, such as hepatitis B, hepatitis C, or HIV (the AIDS virus), you will likely not be able to donate. However, other medical reasons may still allow you to donate, for example, hepatitis A or diabetes only during your pregnancy (gestational diabetes). The staff at the public cord blood bank will tell you.
The range of diseases that doctors can treat with cord blood is vast. More than 80 diseases are currently known to respond to cord blood stem cells transplants and, as more are studied and tested, that number is sure to grow.
“This is a medical service that has to be done when your baby’s cells arrive and you certainly want them to be handled by good equipment and good technicians,” says Frances Verter, Ph.D., founder and director of Parent’s Guide to Cord Blood Foundation, a nonprofit dedicated to educating parents about cord blood donation and cord blood therapists. “It’s just not going to be cheap.” Although the American Academy of Pediatrics (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 choose to bank cord blood, the AAP recommends public cord blood banking (instead of private) to reduce costs.
Sign a consent form. While there is a chance of the donor family using their child’s cord blood, by signing the consent form, you’re giving the public bank rights to your child’s blood. They can use it as a treatment for any patient, unless your family needs the stem cells first.
The longest study to date, published in 2011 by Broxmeyer at al found that stem cells cyro-preserved for 22.5 years engrafted as expected. There was no significant loss of stem cell recovery or proliferation.