Cord Blood Donation
When you’re expecting, you have many decisions to make. So if you’ve heard about banking umbilical cord blood, you might be wondering what it involves — and whether it’s right for you and your family.
About Cord-Blood Banking
Cord-blood banking basically means collecting and storing the blood from within the umbilical cord (the part of the placenta that delivers nutrients to a fetus) after a baby is born. Cord blood contains blood-forming stem cells, which are potentially useful for treating diseases that require stem cell transplants (also called bone marrow transplants), such as certain kinds of leukemia or lymphoma, aplastic anemia, severe sickle cell disease, and severe combined immunodeficiency.
There are two types of banks that store cord blood:
- Public banks collect donated cord blood for research or for use by anyone who may need it. There is no charge associated with this service. After birth, blood is collected, anonymously marked, and sent to a public bank. If you choose this option and your child or a family member later develops a disease that requires a stem cell transplant for treatment, you may not be able to obtain the donation you made to the bank.
- Private banks store cord blood for personal use by the family. There is a fee associated with this service. People who have a FAMILY HISTORY of disease that can be treated with stem cell transplants sometimes consider this option. Some people choose to privately bank their newborn’s cord blood on the off chance that someday their child or a sick family member could be treated with it. This practice isn’t recommended, however, since the costs associated with it are high and the chances of a family member ever using the cord blood are slim.
Why Cord Blood Is Important
Up until the 1970s, the placenta and umbilical cord were discarded after birth without a second thought. But around this time, researchers discovered that umbilical cord blood could supply the same kinds of blood-forming stem cells as a bone marrow donor. They started collecting and storing umbilical cord blood. What are blood-forming stem cells? These are primitive (early) cells found primarily in the bone marrow that are capable of developing into the three types of mature blood cells present in our blood —red blood cells, white blood cells, and platelets. Cord-blood stem cells may also have the potential to give rise to other cell types in the body.
Some serious illnesses (such as certain childhood cancers, blood diseases, andimmune system disorders) require radiation and chemotherapy treatments to kill diseased cells in the body. Unfortunately, these treatments also kill many “good” cells along with the bad, including healthy stem cells that live in the bone marrow. When this happens, some kids can benefit from a stem cell transplant, from a donor whose cells closely match their own. Blood-forming stem cells from the donor are transplanted into the child who is ill, and those cells go on to manufacture new, healthy blood cells and enhance the child’s blood-producing and immune system capability.
How Banking Works
Collection: Cord-blood banking isn’t routine in hospital or home deliveries. It’s a procedure you have to choose and plan for beforehand. Collection of the cord blood takes place shortly after birth in both vaginal and cesarean (C-section) deliveries. It’s done using a specific kit. If you are donating to a public bank, the kits are available on Labor and Delivery. If you are donating privately you will need to order the kit ahead of time from your chosen cord-blood bank.
After birth, the umbilical cord is cut and clamped on one side. To collect blood, a small needle is passed into the umbilical vein and the blood is collected by hanging a bag below the mother and letting gravity draw the blood down through a tube and into the bag. Blood collection can occur either before or after the placenta is delivered.
Storing: After collection, private cord blood is taken by courier to the cord-blood bank. Once there, the sample is given an identifying number. Then the stem cells are separated from the rest of the blood and are stored cryogenically (frozen in liquid nitrogen). How long can blood-forming stem cells last when properly stored? In theory, stem cells should last forever, but cord-blood research only began in the 1970s, so the maximum time for storage and potential usage are still being determined. Blood-forming stem cells that have been stored for more than a decade have been used successfully in transplants.
There is no cost involved when donating cord blood to a public bank. The cost for storing cord blood privately is approximately $1,500, in addition to a yearly maintenance fee (usually around $100). You also might pay an additional fee of several hundred dollars for the cord-blood collection kit, courier service to the cord-blood bank, and initial processing. Transplantation Cryogenic blood-forming stem cells can be thawed and used in either autologous procedures (when someone receives his or her own umbilical cord blood in a transplant) or allogeneic procedures (when a person receives umbilical cord blood donated from someone else — a sibling, close relative, or anonymous donor). In most cases, these transplants are done only with children or young adults. That’s because the volume of a cord-blood donation usually isn’t enough for an adult’s transplant. The larger a person is, the more blood-forming stem cells he or she needs for a successful transplant.
Private Banking Not Widely Recommended
Most medical organizations, including the American Academy of Pediatrics (AAP), recommend public donation of cord blood whenever possible. Currently, they do not recommend privately banking your newborn’s cord blood unless you have a child or family member with a current or potential need for a stem cell transplant. The likelihood of a healthy person ever needing stem cells is rare, and research has never confirmed that self-donated cells (rather than cells from a relative or stranger) make transplantations safer or more effective. Stem cells from cord blood from both related and unrelated donors have been successful in many transplants. That’s because blood-forming stem cells taken from cord blood are naive (a medical term for early cells that are still highly adaptable and are less likely to be rejected by the recipient’s immune system). Therefore, donor cord-blood stem cells do not need to be a perfect match to create a successful stem cell transplant.
There has been little experience with transplanting self-donated cells. Some experts are concerned that an ill baby who receives his or her own stem cells during a transplant would be prone to a repeat of the same disease. Most of the stem cell transplants that use blood-forming stem cells have been performed on relatives of the donating child, not on the donating child.
Is Banking Right for You?
If you are considering banking your newborn’s cord blood, be sure to discuss your options with your obstetrician.