Many patients ask whether they should consider umbilical cord blood banking…
Umbilical cord blood is now known to contain potentially lifesaving blood cells for treatment of certain diseases. Umbilical cord blood cells are stored in both public and private banks.
Cord blood is collected at the time of cesarean section or vaginal delivery by your obstetrician. There are no clinical risks to obtaining cord blood. Patients who make a public donation must undergo screening for genetic and infectious diseases. Additionally, cord blood is not collected in the following cases: birth less than 34 weeks of gestation, multiple gestations, evidence of intrauterine infection (chorioamnionitis) at birth and from infants with major structural or chromosomal abnormalities. Other exclusion criteria include foreign travel to specific countries, use of illicit substances or high risk sexual behaviors.
A national network of public banks, the Center for Cord Blood, was established by the National Bone Marrow Donor Program in 2005. Public banks provide umbilical cord cells for both related and unrelated patients that are appropriate matches. Donated umbilical cord cells are rigorously screened for infectious diseases and donors must meet certain eligibility guidelines. Donation is free of charge. It is especially important for donations to come from patients with different ethnic backgrounds.
Private banks collect and store stem cells from the umbilical cord for future use by that individual or a closely related relative in the event that a treatable disease develops. Private banks are for profit companies and usually charge an initial specimen processing fee and an annual storage fee. Currently, private banking is not endorsed by the American College of Obstetrics and Gynecology and the American Academy of Pediatrics. This is because the cost is expensive and the odds of using the stem cells are low.
It is hard to obtain an accurate estimate of an individual’s likelihood of using a donated unit of umbilical stem cells. It has been estimated to be approximately a 1 in 2,700 chance or 0.04% of using donated umbilical cord cells in the future. Cord cells cannot be currently used to treat inborn errors of metabolism, genetic diseases, or childhood leukemia from the individuals in which the umbilical cord blood was obtained. Of note, a sibling or close relative has a 25% chance of providing cord blood that would be a suitable match.
The National Marrow Donor Program reported in 2005 that over 6000 transplants with cord blood cells had been performed worldwide and that “nearly all (more than 95%) patients are able to find at least one potential … matched cord blood unit.”
In summary, collection of your baby’s umbilical cord cells is a personal decision. Public banking involves donation of a valuable human resource so that all patients could potentially benefit. Private donation involves banking cord cells for solely personal or family use for a fee. It is impossible to predict whether cord blood will have other therapeutic uses in the future.
Additionally, it is important to consider what would happen to your baby’s cord blood if the company becomes insolvent. Also, it is currently unknown how stem cells that have been frozen for > 15 years would survive thawing. Private cord blood banking is currently not endorsed by either the American College of Ob/Gyn or the American Academy of Pediatrics.
Please ask any question that you may have at your prenatal appointments. Your OB/GYN is glad to collect cord blood cells at delivery.
Links to additional online resources:
- National Marrow Donor Program
- Parent's Guide to Cord Blood
- National Cord Blood Program (go to cord blood donation)
- American Academy of Pediatrics
ACOG Committee Cord Blood Banking, February 2008
Umbilical Cord Stem Cells. Dr. Kenneth Moise. December 2005
Ethical Considerations in Umbilical Cord Blood Banking, January 2008