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Cord Blood Banking

What Is Cord Blood Banking?

Cord blood banking is the collection and storage of the blood inside the umbilical cord after a baby is born. The cord is the part of the placenta that carries nutrients to a fetus during pregnancy.

Why Is Cord Blood Saved?

Cord blood contains stem cells. Doctors use stem cell transplants to treat diseases such as aplastic anemia, severe sickle cell disease, some kinds of leukemia or lymphoma, and severe combined immunodeficiency.

How Is Cord Blood Saved?

There are two types of banks that store cord blood:

  1. Public banks: These collect donated cord blood for research or for anyone who may need it. There's usually no cost to donate. Cord blood is collected, anonymously marked, and stored in a public bank.

    With this option, if your child or a family member later needs a stem cell transplant, you can't get the donation you made to the bank.
  2. Private banks: These store cord blood for personal use by the family. There are costs for this. People with a family history of a disease treated with stem cell transplants sometimes choose this option.

    Less often, people without such a family history store their newborn's cord blood in case their child or a relative needs it later. This isn't recommended because the costs are high and a family member is unlikely to ever need the cord blood.

The U.S. Food and Drug Administration (FDA) regulates cord blood banks, just as they do community and hospital blood banks.

Why Is Cord Blood Important?

Umbilical cord blood can supply the same kinds of stem cells as a bone marrow donor. Stem cells can develop into the three types of mature blood cells — red blood cells, white blood cells, and platelets. Cord blood stem cells also can turn into other cell types, such as skin cells, liver cells, or brain cells.

Serious illnesses — such as some childhood cancers, blood diseases, and immune system disorders) — need radiation and chemotherapy treatments to kill diseased cells. But 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 are a close match for their own. These cells are transplanted into the child to make healthy new blood cells, boost the immune system, and help the body make more blood.

How Does Cord Blood Banking Work?

Collection

Cord blood banking isn't routine in hospital or home births. It's a procedure you have to choose and plan for beforehand.

An obstetrician, nurse, or technician collects the cord blood shortly after birth. They use a kit that parents usually order ahead of time from their chosen cord blood bank.

To collect the blood:

  • After birth, either vaginal or cesarean (C-section), the umbilical cord is cut and clamped on one side. It's no longer attached to the baby.
  • A small needle goes into the umbilical vein and a syringe draws the blood.

Blood also can be collected by hanging a bag below the mother and letting gravity draw the blood from the cord down through a tube and into the bag. Blood collection can happen either before or after the placenta is delivered.

Storage

A courier takes the cord blood to the cord blood bank, where the sample gets an identifying number. Then, the stem cells are separated from the rest of the blood and stored cryogenically (frozen in liquid nitrogen).

Cord blood research only began in the 1970s, so experts aren't sure how long stem cells last in storage. But successful transplants have been done with stem cells stored for more than a decade.

There is no cost to donate cord blood to a public bank, though some doctors or midwives may charge a small fee to collect the blood. Storing cord blood privately costs about $1,000–$2,000, plus a yearly maintenance fee (usually $100 or more). You also might pay another fee for the blood collection kit, courier service to the blood bank, and processing.

Transplantation

Frozen stem cells are thawed and used in either:

  • autologous procedures — when someone gets his or her own umbilical cord blood in a transplant
  • allogeneic procedures — when someone gets umbilical cord blood donated from someone else (a sibling, close relative, or anonymous donor)

Before, only children or young adults had these transplants. That's because the volume of a cord blood donation wasn't enough for an adult's transplant. But thanks to new techniques and ongoing research, they're now successful in older people as well.

Why Is Private Cord Blood Banking Not Recommended?

Most medical organizations recommend public donation of cord blood rather than private banking. They recommend private banking only when a child or family member needs a stem cell transplant or is likely to. Most healthy people will never need banked stem cells. And research does not show that self-donated cells make transplants safer or more effective.

Stem cells from cord blood from both related and unrelated donors have been successful in many transplants. That's because cord blood stem cells are naive (this means that they're adaptable, and the recipient's immune system is less likely to reject them). So donor cord blood stem cells do not need to be a perfect match for a successful transplant.

There's been little experience with transplanting self-donated cells. Some experts are concerned that an ill child who gets his or her own stem cells would be at risk for getting the same disease again. Most stem cell transplants are done on relatives of the donating child, not on the donating child.

Finally, some experts worry that private cord blood banks may play on the fears of new parents with misleading information. Parents of children of ethnic or racial minorities, who adopt children, or whose children were conceived through in vitro fertilization in particular might be encouraged to bank cord blood because it's harder to find a match in these cases.

Is Cord Blood Banking Right for Me?

If you're thinking about banking your newborn's cord blood, talk about your options with your health care provider.

Here some things to consider:

  1. What are the pros and cons of public versus private banking?
  2. Public banking:
    • Does the hospital where I will deliver work with a public cord blood bank? If not, how can I get information about public banks that have a mail-in donation program?
  3. Private banking:
    • Is the cord blood bank financially stable? What happens to my sample if it goes out of business?
    • How many samples does the facility process? (Many samples usually means that more collection and handling procedures are in place.)
    • Can I switch to another facility if I choose?
    • What are the yearly fees and maintenance costs? Will these increase or are they fixed?

Answers to all your questions might not be available. Cord blood banking is still somewhat new. Many hospitals don't yet offer it (or don't work with a public or private bank that does), and some health care providers aren't familiar with how it works.

But other resources can help you decide, including:

You also can contact your local chapter of the American Red Cross or a local university hospital.

If You Decide to Donate

Many doctors and researchers support saving umbilical cord blood. Most of us would have little use for stem cells now, but research into using them to treat diseases is ongoing — and the future looks promising.

If you want to donate your child's umbilical cord blood, talk to your health care provider or contact the hospital or birthing center where your baby will be born. It's best to start the process early in your second trimester to give yourself time to register for this service.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date Reviewed: 20-07-2018

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