What is cord blood banking?
Cord blood banking refers to the removal of the blood from the umbilical cord and placenta after the baby and placenta had been born to freeze and store it in hope that if needed in the future, it can be used in stem cell transplants.
Cord blood is a fetal or baby’s blood that was circulating between the baby and the placenta to pick up oxygen and nutrients for the baby. Cord blood is rich in stem cells. Stem cells are pluripotent cells which under certain conditions can transform into different lines of cells needed in our body. Stem cells can be utilized for the treatment of some congenital and acquired diseases and possibly in the future, even in regenerative medicine.
At this time, there are approximately 1 million cord blood units stored in public banks and over 5 million units held in private storage facilities. It is estimated that doctors used stem cells from cord blood in at least 30000 cases by 2013. Awareness regarding the use of cord blood is spreading, so now those numbers will be much higher (Source: AAP article).
What are the benefits of cord blood banking?
Contrary to what the general public may think, the main benefits from stored cord blood are not for a baby who was a donor but for others. In transplant medicine, there are two terms that you should be familiar with: autologous transplant and allogeneic transplant.
Autologous transplant refers to a situation where the recipient is given its own cells or tissues. Allogeneic transplantation occurs when a recipient is given cells, bone marrow, or tissues from someone else; it could be a family member or person unrelated.
For the vast majority of cases reported to date, cord blood has been used for the purpose of allogeneic transplant procedures.
The current uses of cord blood:
- Blood malignancies (leukemias, lymphomas,
- Blood disorders such as sickle cell disease, thalassemias, Fanconi anemias, and others
- Solid tumors: retinoblastoma, medulloblastoma, neuroblastoma
- Primary immunodeficiencies
- Congenital metabolic diseases such as Hurler syndrome, Hunter syndrome and others
Except for solid tumors, in all other indications, cord blood can only be used as an allogeneic transplant. Since the child’s own stored blood already contains cells that are genetically affected, it would not be of any use for the child in most cases of congenital metabolic disorders, blood diseases, and cancers that involve genetic defects.
Future research may bring more uses of cord blood for the donors themselves. Scientists work on testing stem cells from the cord blood in numerous conditions.
The following diseases are examples where we may be able to use cord blood in the future:
- Alzheimer disease
- Cerebral palsy
- Autism spectrum disorders
- Parkinson’s disease
- Spinal cord injury
- Traumatic brain injury
- Autoimmune disorders
- Cardiac disorders
- And many others
Will my baby (donor) be able to benefit from stored cord blood?
As I indicated above, most uses of cord blood are in people other than the baby that was the donor of cord blood. Progress in science will likely bring many more applications from which donors themselves will be able to benefit. I expect that examples of those will be in regenerative medicine, trying to use pluripotent cells to regenerate frail and failing organs of vital importance to us during aging — the revitalization of our brain or heart will be of utmost importance. What seems to be science fiction today may become a reality just in another 40-50 years.
Types of banks storing cord blood?
Cord blood can be stored in public banks for free and in privately operated cord blood banks for a fee. Each of these entities has different characteristics and purposes. Let’s talk about each of them separately.
Public cord blood banks:
- There is no cost to you to store cord blood
- The cord blood will be available to others
- You will not be able to decide who will be the recipient of the cord blood
- The cord blood may be used for research or as a treatment
- If cord blood is given for a transplant, the bank may receive a fee from the insurance company – you will not receive any compensation
- Cord blood has a higher likelihood of being used and helping somebody than when it is stored in a private bank.
Private cord blood banks:
- There will be cost to you to initiate storage and after that a yearly fee
- You will be in control, and you will decide how to use the cord blood
- Typically, blood will be used for a parent, sibling or family member
- Cord blood has a lesser chance of being used as a treatment for anybody
- Each cord blood bank has its own rules and regulations
- They are less stringently regulated than public blood banks
- Blood banks do not receive any further income other than initiation, storage, and any testing fees that are paid by parents
Is it worth banking cord blood?
It is for you to decide if it is worth the effort and cost in case of private storage. If you choose to give your child’s cord blood to a public bank, you can feel proud that you might be helping somebody in need. It is a selfless act.
In the case of private banking, you have to take into account monetary costs. It will cost you anywhere from $1500-$2500 in initiation fee, and after that, you will be paying yearly fees for as long as you want it to be stored and available to you. Privately stored cord blood is less likely to be used as chances that you or anybody in your family will need it are very small. As our science advances, there might be more uses for it in the future, especially for the donor baby, but it is premature to count on this right now. Private banking is like paying for specialized insurance for yourself and your family that is unlikely to be used.
Professional organizations’ opinions on cord blood banking.
Most professional organizations such as the American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG), the Society of Obstetricians and Gynecologists of Canada and the World Marrow Donor Association advocate for donation to and use of cord blood in publicly owned institutions where that valuable asset is available to every patient in need.
The only exception from that guideline would be for the family in which there is already a family member with a diagnosed condition that may benefit from a properly matched cord blood transplantation.
How do I go about storing the cord blood?
If you are thinking about donating cord blood from your baby, you need to start planning for this early on during pregnancy. It is not a very frequent procedure, and physicians and hospitals may not be very familiar with it. Some hospitals may not allow collecting blood to store in private banks. Some hospitals may have already developed an affiliation with one particular public storage institution and have a strong preference to work only with it. In most cases, you, as a mother, may need to go through some screening blood tests to determine if you are carrying any genetic or infectious diseases. If you do, most likely, cord blood from your baby would not be accepted or would have to undergo additional detailed testing.
The collection kit will need to be requested from the cord blood bank. Also, they will send to you or your physician instructions regarding the collection and transportation of the collected blood to the bank. Finally, if you choose to store cord blood privately, you will have to pay initiation fees and storage fees in advance.
If you decide to collect your baby’s cord blood for future use, you need to be aware that delayed cord clamping may lead to a suboptimal amount of cord blood available for storage. You can read my whole article on delayed cord clamping here.
This article is only for general information purposes. It should not be viewed as any medical advice. There is a chance that information here may be inaccurate. It would be best if you always discussed all health-related matters with your doctor before making any decisions that may affect your health or health of your family members.