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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, such as certain kinds of leukemia or lymphoma, aplastic anemia, severesickle cell disease, and severe combined immunodeficiency.

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 (hematopoietic) 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 that are capable of developing into the three types of mature blood cells found in blood — red blood cells, white blood cells, and platelets. Cord-blood stem cells also may have the potential to give rise to other cell types in the body.

Some serious illnesses (such as certain childhood cancers, blooddiseases, and immune system disorders) require radiation andchemotherapy 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 make new, healthy blood cells and boost 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 that parents usually order ahead of time from their chosen cord-blood bank.

Blood is collected immediately after delivery by an obstetrician, nurse, or technician. 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 a syringe is used to draw 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.

Storing

After collection, the 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 is 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, though some doctors or midwives may charge a small fee to collect the blood. The cost for storing cord blood privately is approximately $1,000-$2,000, 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.

What are the benefits of cord blood banking?

Cord blood is a rich source of blood stem cells. Stem cells are the building blocks of the blood and immune system. They have the ability to develop into other types of cells, so they can help repair tissues, organs, and blood vessels and can be used to treat a host of diseases.

Stem cells are also found in bone marrow, human embryos, fetal tissue, hair follicles, baby teeth, fat, circulating blood, and muscle. Every part of the human body contains some stem cells, but most are not a rich enough source to be harvested for therapeutic applications.

In patients with conditions like leukemia, for instance, chemotherapy is often used to rid their body of diseased cells so that normal blood cell production can be restored. Once that happens, the disease goes into remission.

If the treatment fails or disease recurs, however, doctors often do a stem cell transplant. A transfusion of stem cells from the bone marrow, peripheral blood (blood in the bloodstream), or cord blood from a healthy donor can help create a new blood and immune system, giving the patient a better chance of making a full recovery.

Unlike the stem cells in bone marrow or peripheral blood, stem cells in cord blood are immature and haven’t yet learned how to attack foreign substances. It’s easier to match transplant patients with cord blood than with other sources of stem cells because the cord blood stem cells are less likely to reject the transfusion. This makes cord blood an even more valuable resource for ethnic minorities, who have a harder time finding stem cell matches.

Cord blood will soon be the dominant transplant source for United States’ patients of minority or mixed racial heritage. In 2012, 38 percent of Hispanic patients and 44 percent of African American patients undergoing stem cell transplants received cord blood.

More and more adults are receiving cord blood transplants, too, sometimes involving two cord blood donations if a single one doesn’t contain enough cells.

As of the end of 2012, more than 33,900 cord blood units had been shipped for transplants worldwide.

What parents need to know

The field of medical research with stem cells is exploding, and the topic can be confusing.

The most important thing for parents to understand about the stem cells in cord blood, says Frances Verter, founder and executive director of the nonprofit Parent’s Guide to Cord Blood Foundation, is that you can either 1) donate your baby’s cord blood to help patients seeking transplants now or 2) save your baby’s cord blood for your family in case you need it later, most likely for a therapy that’s still being studied.

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