Umbilical cord blood has an important and growing role in treating leukemia, lymphoma, sickle cell anemia and other life-threatening diseases and as such, many parents may have questions about cord blood banks and how to donate.
What is A Cord Blood Bank?
A cord blood bank is a facility that stores umbilical cord blood for future use. Both private and public cord blood banks have developed in response to the potential for cord blood in treating diseases of the blood and immune systems.
The American Academy of Pediatrics policy statement calls for a re-emphasis and education on the benefits and necessity of cord blood banks. Though this has a US bias, many of these same principals apply to cord blood use in other countries and regions.
Stem cell transplants
A stem cell transplant can treat children with cancer and other life-threatening illnesses, such as metabolic and immune system disorders and blood diseases. As more newborns are screened for life-threatening conditions, so do stem cell transplants. The use of umbilical cord blood for stem cell transplants instead of bone marrow or peripheral blood stem cells is less invasive and increases the number of potential donors. The primary purpose of storing umbilical cord blood is to give a child who suffers from a life-threatening disease the possibility of receiving umbilical cord blood from a compatible donor with whom they are not related.
The following are other uses for umbilical cord blood:
- Direct donation: When a child with a diagnosed disease has a compatible donor sibling. At the time of delivery, the sibling’s umbilical cord blood can be stored for future use for a stem cell transplant.
- Personal use: The use of stored umbilical cord blood for the benefit of the child himself is limited. For example, if the child manifests leukemia, his umbilical cord blood stored in the bank also can develop leukemia and cannot be used. Although the future use of the umbilical cord’s stored blood for regenerative purposes for some chronic diseases is promising, more research is needed.
How Is the Cord Blood Collected?
Cord blood collection happens after the umbilical cord has been cut and is extracted from the fetal end of the cord. It is usually done within ten minutes of giving birth. Additional stem cells may be collected from the placenta.
After the health care provider draws the cord blood from the placental end of the umbilical cord, the placenta is couriered to the stem cell laboratory, where it is processed for additional stem cells. An adequate cord blood collection requires at least 75mL in order to ensure that there will be enough cells to be used for transplantation.
Before the cord blood is stored for later use, it undergoes viral testing, including tests for HIV and Hepatitis B and C, and tissue typing to determine Human Leukocyte Antigen type. It will also be examined for nucleated cell count, cell viability, blood group antigen ABO & Rh blood group system, molecule cluster (CD34), and bacterial and fungal growth.
After the collection, the cord blood unit is shipped to the lab and processed, and then cryopreserved. There are many ways to process a cord blood unit, and there are differing opinions on what the best way is. Some processing methods separate out the red blood cells and remove them, while others keep the red blood cells. However, the unit is processed, a cryopreservant is added to the cord blood to allow the cells to survive the cryogenic process.
After the unit is slowly cooled to −90 °C, it can then be added to a liquid nitrogen tank which will keep the cord blood unit frozen at −196 °C.
Comparison of public and private Cord Blood banks
There are differences between public umbilical cord blood banks and private for-profit banks.
Reasons why public banks are preferred:
- Frequency of use: Umbilical cord blood from public banks is used more frequently than from private banks. Umbilical cord blood from public banks is used thirty times more for transplants than umbilical cord blood from private banks.
- Quality: The collection, evaluation and preservation of blood stored in public banks is very well regulated by accredited institutions, such as NetCord / Foundation for the Accreditation of Cellular Therapy (in English), FACT / Joint Accreditation Committee and the American Association of Blood Banks. Private blood banks may or may not decide to abide by these strict rules.For this reason, umbilical cord blood stored in public banks is of higher quality, increasing the likelihood that stem cell transplantation will be successful. Parents who are thinking of donating cord blood are advised to inquire from these banks about their accreditation, the failure rate for successful cord blood transplants, and the auxiliary power system they have in their bank in case of equipment failure. Information on conflicts of interest and financial transparency should also be available.
- Cost: Donating cord blood to a public bank is free. Private umbilical cord blood banks ask for a processing fee of between $ 1,350 to $ 2,350 and an annual maintenance cost of between $ 100 to $ 175.
- Ethical considerations: Blood stored in a public bank is available to anyone. National and international umbilical cord blood banks have indexed data available for children with dangerous diseases from around the world seeking stem cell donors. Private banks only meet the needs of one family.
How to close the diversity gap
Ethnic minorities are encouraged to consider donating cord blood at public banks due to its high demand. Donating in public banks is free and strengthens the supply of umbilical cord blood that can meet others’ needs in these populations.
How can you donate to a public umbilical cord blood bank?
Donating cord blood is safe for the baby and does not interfere with labour or delivery itself. Because families must register in advance to receive the kit for use after delivery, parents should discuss during the first prenatal visit with the obstetrician, pediatrician, or other medical personnel about donating cord blood banks.
Do all hospitals collect umbilical cord blood for public donations?
- No. There is legislation in some locations and US States that supports funding for the storage of cord blood in public banks, which is generally recovered when the patient’s insurance companies receive the bills. Check if your hospital is part of the registry known as Be the Match List, a list of hospitals participating in the collection of umbilical cord blood. The Parent’s Guide to Cord Blood Foundation provides a list of hospitals that accept donations and includes additional information on other programs that may not be on the “Be the Match” list. “.
How can I donate if my hospital does not work with a public donation bank?
- If the hospital where you plan to have your baby does not work directly with a public cord blood bank, you can donate by signing up for the mail-in donation program. The Umbilical Cord Guide for Parents provides a list of banks that accept donations of umbilical cord blood by mail. Talk to your doctor or midwife to make sure he or she is trained to collect umbilical cord blood.
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