Umbilical Cord Blood Banking

INTRODUCTION-

In mammalian species, the umbilical cord carries nutrient rich blood and gases to the fetus through the arteries and veins it encloses. After delivery, a major portion of the umbilical cord is discarded, and the smaller portion left attached to the infant is allowed to dry off. Research in recent times indicates that the blood contained in the umbilical cord or Umbilical Cord Blood is rich in “Stem Cells”.

• Stem cells are a part of the “haematopoietic system”; or the system that is responsible for the production of various mature blood cells present in the body. The production of the blood cells from immature to mature stages takes place in the red bone marrow.
• The different mature blood cells need constant replacement that is provided by the stem cell.
• Some stem cells are differentiated; that is, they are slated to produce a specific type of blood cell. Still another stem cell type is the pluripotent stem cell. Researchers have only recently found sources of it in the bone marrow, placenta and umbilical cord. These pluripotent cells acquire, through a process of differentiation under specific conditions, let us say, an identity; be it a white blood cell, red blood cell, platelet etc.

There are few active sites of blood cell production in the adult body. These are responsible for producing the blood cells through out an individual’s life span. Blood diseases can either incapacitate these centers or create imbalances in the blood cell count. Traditionally, blood diseases have been treated with chemotherapy, marrow transplants or transfusions.

Scientists are now able to manipulate the haematopoietic stem cells found in Umbilical Cord Blood externally to form a specific type of cell. Once transplanted, the stem cells have helped to treat diseases like leukemia, lymphoma and inherited diseases like sickle cell anemia.

Pluripotent cells have been manipulated externally to grow into organs and even nerve cells, where they can be used to treat conditions like Parkinsons. Although these cells are found in the placenta and Cord Blood, the richest source of these stem cells is from discarded embryos themselves. This has resulted in much controversy.

UMBILICAL CORD BLOOD BANKS-

Researchers now urge parents to store or donate the Umbilical Cord Blood to specialized “Cord Blood Banks”. These can be either public or private institutions.

• Private Cord Blood Banks

This system is run by individuals or private organizations. The organization will store the Cord Blood irrespective of medical reasons. There are charges for collection and storage. The arguments against private cord blood banking are –

1. If the child has inherited blood disease, the Cord Blood would be affected too. It would be useless to have it stored in that case.
2. Doctors also prefer, in cases of children with leukemia, to have the Cord Blood of a healthy donor.
3. Private banking does not allow for choosing from an array of donors. It can only hold an individual’s Cord Blood for their personal or immediate family’s needs.

The advantage of this system is that blood from a healthy child with no inherited diseases can be maintained as insurance, in case a family member or the child itself should need it in the future.

• Public Cord Blood Banks

This system is usually government run. There are generally no charges for collection and storage. Parents are encouraged to donate Cord Blood to Public Banks.

The reasons are -

1. The chances of needing the Cord Blood are rare for a child in a family without history of disease.
2. By donating the Cord Blood, parents contribute to an already growing reserve. This way, another person from anywhere in the world may find a match in the donated blood.
3. Often, a person may not find a match among relatives for a marrow transplant. With a stem cell transplant being a viable option, a Public Cord Blood Bank would ensure a chance for the most appropriate cord blood unit even from several unrelated donors.

The disadvantage of this system is that it is not always guaranteed that the donor will receive Cord Blood should he or she need it. It may have been donated. However, matches may be found from among many other donated samples.

The match referred to is required between the donor’s and recipient’s HLA antigens. The closer the match is, the better is the body’s chance of accepting the new stem cell.

The first ever Cord Blood Bank in the world was started in New York’s Milstein National Cord Blood Center. It is a Public Cord Blood Bank.

Today, there are over 40 Cord Blood Banks worldwide, both public and private.

CORD BLOOD COLLECTION AND STORAGE-

The Cord Blood Bank that the parents have chosen is generally responsible for collection of the blood.

There are usually lists of participating hospitals in every country. However, the related authorities (delivery doctors, nurses) must be aware of the mothers’ wish to donate or store Cord Blood after the birth.

Normal procedure includes

1. Asking the mother and father for their health related history
2. Blood tests to rule out HIV infections, other blood diseases
3. Signing of a consent form.

The blood is collected either in-utero or immediately after the birth. The Cord Blood is taken to the Cord Blood Bank. Some tests are performed; this ensures the blood is suitable for storage. The results from the donor’s doctor regarding physical findings and blood tests are all considered.

The blood is then ready for storage at around minus 180 degrees centigrade.

It is not certain for how long Cord Blood can be stored. Current literature states that it can be safely stored for at least 10 years.

Umbilical cord offers valuable stem cells

SACRAMENTO -- The umbilical cord is birth's afterthought -- clamped, cut and discarded. But its blood is a treasure trove of stem cells that can help cure diseases, including leukemia, sickle- cell anemia and other blood-related cancers.

Why then, Assemblyman Anthony Portantino asks, are so few people aware that they can donate a newborn's umbilical cord blood to help others? And why is it so labor-intensive to make public cord-blood donations?

That quandary has become something of a crusade for Portantino, D- Pasadena, who is carrying legislation, AB 34, that would create a California public cord blood collection program by July 2009.

Generally cast off after birth, cord blood is harvested painlessly after the umbilical cord is cut. It is less invasive to collect, easier to match and carries less risk of rejection than bone marrow.

Portantino's neighbor had a son whose leukemia was cured about a decade ago by a cord blood transplant. So when Portantino and his wife, Ellen, had daughter Bella five years ago, they were keen to donate. But doing so required ordering a kit to collect the blood, getting approval from the doctor and hospital to harvest it, putting it on ice and getting it to a bank.

"I thought to myself: This is really stupid," said the freshman lawmaker. "We have this wonderful, healing blood, and we discard it after birth and lose the ability to cure 70 diseases." His legislation dovetails with efforts by the federal government and at least 10 states to develop an inventory of genetically diverse cord blood.

Exactly how the registry would function and be funded would be up to an advisory committee. But this much is settled: Donation would be free and voluntary. And special attention would be devoted to collecting from ethnic minorities, who have more trouble finding matches.

So far, the idea appears to have widespread appeal. Stem cells from cord blood may have more limited curative potential than embryonic stem cells, but they are free from the ethical concerns involved in destroying an embryo.

Portantino's bill received unanimous, bipartisan support in its first outing in the Assembly Health Committee; no interest groups have registered opposition to it.

Mountain View mother Neha Choksi understands the appeal. She has lost three young friends whose cancer could have been cured by a transplant. And she knows how hard it can be for Indo-Americans like herself to find transplant matches.

So she banked cord blood after the births of her sons Chetan and Devan. When Chetan was born five years ago, Choksi paid a company about $1,000 to store his cord blood -- just in case -- for her family's personal use.

"If for some reason we could have used it," Choksi said, "I didn't want to live with that regret."

Before Devan's birth 16 months ago, Choksi was delighted to learn she could publicly bank cord blood so it's available to anyone who needs a transplant. Fortunately, her physician was willing to collect the blood for free and they sent it to a public registry, CryobanksInternational, in Florida.

"For me, it would be so exciting" if an easier-to-use, free public registry were created here, Choksi said. "Right now, it's just going into the incinerator."

Private vs. public banking is the biggest debate in cord blood harvesting.

Some families opt to privately bank cord blood, paying a company around $2,000 plus an annual storage fee, to preserve the cells.

The American Academy of Pediatrics, however, discourages private banking as a form of "biological insurance," except for families with a history of medical conditions that could be treated by cord blood transplantation.

Instead, the academy encourages public banking. It's free, and the stem cells are available to anyone in need of a transplant. In California, only two hospitals -- St. Joseph's Hospital of Orange and Citrus Valley Medical Center in West Covina -- regularly collect cord blood for the National Marrow Donor Program, which is the nation's public cord-blood clearinghouse.

"In California, the northern part of the state is not represented by a cord blood bank," said Mary Halet, who manages cord blood operations for the National Marrow Donor Program.

"It is possible for women throughout the state to donate," either through the Southern California facilities or Florida's Cryobanks International, Halet said. "But it requires effort on their part."

The National Marrow Donor Program's member banks store 50,000 units of cord blood, and it has partnerships with international banks and registries that list 190,000 units in all. South San Jose mother Jennifer Mavros said she and her husband debated the costs, utility and merits of private banking, public banking or no banking before daughter Annabella's birth nearly 11 months ago.

Mavros said she did the "inordinate amount of reading that any pregnant mom in Silicon Valley does," and finally decided not to bank the cord blood. She likes the idea of creating a public registry in California in theory, but, "I'd be very interested in how this would be funded."

Umbilical Cord Blood Storage

Umbilical cord blood storage is seen as the most comprehensive technology to prevent and even cure a wide range of life threatening diseases.

The umbilical cord is a tube that connects a growing fetus to the placenta. Its major function during pregnancy is to exchange nutrients and blood between the embryo and placenta. This makes it abundant in hematopoietic stem cells that are essential in the cure of many genetic diseases. Cord blood stem cell banking ensures that the stem cells can be used as a primary source for transplantation in the future. These cells are also genetically unique the baby and its family.

Umbilical cord blood storage transplants the stem cells to treat pediatric disorders, like leukemia, sickle cell disease, and metabolic disorders. The cord blood stem cells are used as match to the person it belongs to, or it can be matched with a sibling, relative or even an unrelated person. Increasingly parents in the United States are turning to cord blood stem cell banking for their newborn baby.

Stem cells are the building blocks of every organ, tissue and cell in the human body; these can restore or replace tissue that has been severely damaged. It has the capacity to reverse the ravaging effects of many diseases. The umbilical cord is an easy source for these vital cells. It is usually thrown away, but if it is collected and reused it is one of best options.

The decision to collect the umbilical cord cells has to be taken well before birth. Everyone right from the obstetrician, to the parents and the cord blood stem cell bank has to be prepared.

The blood is collected after the cord has been cut from the mother, before the placenta is delivered or after. In both cases, the cord blood units have to be sent immediately to a cord blood bank. If it is collected before the placenta is delivered then the umbilical cord is clamped and cut as usual. The blood is preserved in a bag and sent with a sample of the mother’s blood. It is protected from coagulating, and the possibility of bacterial contamination. The procedure for collecting the umbilical cord blood is painless.

In the cord blood stem cell bank, it is checked for its tissue type and infectious diseases like AIDS, hepatitis and malaria. It is processed to remove the red blood, to be Cryopreserved in liquid nitrogen for later use.

If it is to be used later, the cryopreserved cord blood is defrosted, cleaned of the chemicals, and injected through a vein of the patient. This is termed as allogeneic treatment.

There are many benefits in umbilical blood storage. Cord blood is now used as an alternative to bone marrow transplant. Blood and immune-system related genetic diseases like cancers like leukemia, lymphoma, sickle cell disease, or even thalassemia, are treatable with cord blood transplants. If the patient can use his or her own cord blood, or if it is matched perfectly with a sibling the chances of cure are far higher. This one single reason prompts parents to turn to umbilical cord blood storage.

Also most people are able to accept umbilical cord blood because they are immunologically immature and undeveloped as compared to adult stem cells in bone marrow or peripheral blood. Besides, cord transplants have much lower life-threatening side effects.

Plus, if a child ever needs the cord blood then it saves time in searching for a donor. If anyone in the family needs the transplant then in all likelihood the cord cells will also match. Early treatment always lessens the progression of the disease helping in faster healing.

There are those who feel that umbilical blood storage has many downsides, the huge price of the procedure being one of them. Public cord blood stem cell banking has helped in reducing the average cost and has helped some underprivileged families access its benefits.

There is an increasing trend for many public hospitals to offer umbilical cord blood storage facilities. It seems this will be the trend towards treating and curing many diseases in the future.

Umbilical Cord Blood And Cord Blood Banking

Research at present has seen stem cells being trialled on individuals with spinal cord damage, various cancers such as leukemia, and the rebuilding or regeneration of our organs. There is hope that at some stage in the future they can take our stem cells and 'grow' new organs like a liver or heart. The best stem cells to use for this new science are those taken from a new born baby through umbilical cord - hence the name umbilical cord stem cells.

How Are Umbilical Cord Stem Cells Collected?

There are several methods used to collect umbilical cord blood. First, it should be remembered that this is not an invasive process. Once a baby is born, the umbilical cord is removed and along with the placenta, disposed of as hospital waste. There are some societies that collect these and either bury or burn them, but in most western societies, they thrown out as hospital waste.

Rather than throwing the umbilical cord and the umbilical cord blood out, either the complete umbilical cord is collected, or the umbilical cord blood is removed using a syringe. The umbilical cord blood is then sent away where the cord blood stem cells are removed and stored until required.

What Is Cord Blood Banking And A Cord Blood Registry?

As a new parent, you have two options for cord blood collection. The first is to 'donate' the cord blood. The umbilical cord stem cells are sent to a central cord blood registry. The cord blood stem cells are then used where the cord blood registry feels is best suited. They often have a waiting list of patients and scientist looking for cord blood stem cells. The most common use at present is for the treatment of juvenile leukemia where it has a high success rate - your baby's cord blood stem cells may well save another youngsters life.

The second option is to have the cord blood stem cells 'banked' for possible future use by your family, and in particular, your baby. There is nothing purer than the baby's own cord blood stem cells if he or she should become sick. Collection will cost around $2000 with an annual fee of around $100. If your child should ever become sick, this will be small price to pay to save their life.

The Future of Cord Blood Stem Cells

Science have looked upon cord blood stem cells as one of the holly grails of science. The ability to repair spinal problems and restore movement to para/quadriplegics has received a huge push due to recent progress in research. There are already 70 known diseases that can be cured using cord blood stem cells - the biggest problem has been the lack of cord blood stem cells to use. It is estimated that only one in fifty umbilical cord blood collections are made. If every baby's cord blood was collected then the lives of hundreds of children to could be improved.

What Can You Do To Help The Collection Of Cord Blood Stem Cells?

The best thing you can do to help increase in the amount of cord blood collected is to use the service. If you are pregnant, ask the hospital or midwife if they collect cord blood. If not, there are many agencies that will collect it, either for for public cord blood banking, or, if you are prepared to pay the price, your own personal cord blood banking. If friends or relatives are pregnant, get them to inquire about the process.

The more people who provide cord blood stem cells, particularly for research, the more likely it is that science will find ways to cure diseases such as juvenile diabetes, brain injuries and spinal column injuries. Why waste a valuable resource by throwing it into a hospital incinerator when it could be used to save lives. The umbilical cord - who would have thought that cord blood stem cells could do so much?

How to Donate Umbilical Cord Blood

Umbilical cord blood is the blood from the placenta that passes through the umbilical cord to the newborn child. This blood carries more hematopoietic stem cells than that of an adult's blood. Donating umbilical cord blood can help those who suffer from diseases such as leukemia, lymphoma and aplastic anemia. Studies have shown that donated umbilical cord blood may help to create heart valves but more research is needed. In turn, more donations are needed. Follow these steps to learn how to donate umbilical cord blood.

1. Inform your doctor that you would like to donate umbilical cord blood. Discuss this step with your doctor at your 34th week of pregnancy.

2. Step 2

   Learn whether your hospital collects public cord blood donations. Public cord donations are rarely taken by hospitals due to the expenses associated with this process. If your hospital does not take public donations, you may be eligible to donate through Cryobanks International.

3. Step 3

   Contact Cryobanks International to get eligibility details by calling their donation line or visiting their website. A consent form and health questionnaire will be mailed to you after your eligibility has been determined.

4. Step 4

   Complete consent form and health questionnaire prior to the delivery of the baby. This enables the hospital to care for your cord blood properly and follow all necessary steps to preserve the umbilical cord blood.

5. Step 5

   Inform the delivery team that you are going to donate your umbilical cord blood at the time of delivery. The delivery team will clamp the umbilical cord and collect blood from the cord and the placenta. The blood is placed into a sterilized bag and is stored and referred to as a blood unit.

6. Step 6

   Supply a sample of your blood to test for infectious diseases. This prevents passing diseases to those who might receive donations in the future.

7. Step 7

   Deliver the cord blood unit to the public cord bank. The delivery team will deliver the cord blood unit to the public cord blank within one to two days after the birth of the baby.

Private Cord Blood Banking- Is it for you?

After deciding to register for cord blood banking, next question that comes to mind is- which kind of cord blood banking would be better. For those interested in preserving the cord blood cells when the new one arrives, there are many options like private, public or research specific donation etc. Selection entirely depends upon personal criteria to foresee future requirements and philanthropy. However, the trend of opting for private cord blood banking is increasing fast comparatively to other options.

Private cord blood banks collect, process and store baby's umbilical cord blood for family's future medical need. To preserve cord blood exclusively for you, they charge a fee that is disclosed at the time of registration. If someone in the family needs stem cell transplants to treat fatal diseases like leukemia, lymphomas, immune deficiencies and sickle cell anemia etc, the preserved stem cells can be utilized. Private cord blood banking is the best way if you want to preserve cord blood of your child exclusively for your family members.

Preserving cord blood of a child in a private cord blood bank is a good step towards a medically secure future but the charges seem on the higher side. Diseases like leukemia, sickle-cell anemia, lymphomas, aplastic anemia, immune deficiency diseases or thalassemia etc can be treated with stem cells of cord blood, and hence, medical experts recommend that private cord blood banking should definitely be done. Different private cord blood banks have different charges for the services. Usually they charge for enrollment, collection and preservation services. Fee for enrollment and collection varies. Cryobanks India has introduced attractive cord blood banking packages which are affordable. There is options to pay in one go or pay over time – this facility brings private cord blood banking within the reach of lakhs of Indian families.

Single cord blood unit doesn't contain enough cells to treat a patient weighing more than 100 pounds and expanding the number of stem cells in one unit is almost impossible at least as of now. However some transplants have been made successfully by mixing 2-3 unmatched cord blood units but still it is not in common practice. The probability of finding a matching preserved cord blood unit in public banks is approximately 75 percent while it is around 25% in private banks in case of the requirements of siblings. Your doctor may reject the preserved cord blood unit because of various reasons, in such a case you will have to go to public cord blood bank.

Cord Blood Collection- once in a lifetime opportunity

What is Cord Blood?

The blood that remains in the placenta and umbilical cord following the birth of a child is called cord blood. Till now, it was discarded but recent studies have established its medical importance. So, would-be parents are getting recommendations from medical professionals that they should think about cord blood collection, in India too.

Why Cord Blood Collection?

Cord blood, because of being rich in stem cells, can save the child's life from as many as 75 serious ailments, and is especially useful in case of transplants generally administered while treating diseases like haemophilia, thalassaemia, blood cancer and immunity related genetic disorders. Stem cells are transformed into other cell types within the body to make up for their loss or deficiency. Cord blood preservation provides a type of health insurance to the child. The preserved stem cells of a child may treat many diseases of the parent also, and hence become a ‘lifeline’ for the entire immediate family.

What is the Umbilical Cord Blood Collection Process? Is it Safe?

Umbilical cord blood collection process is very simple, painless and safe. The whole process takes less than five minutes and doesn’t need any specifically trained medical professional. Existing health care provider can do it easily.

Is it possible for C-Section Deliveries?

The process of umbilical cord blood collection is not related with kind of delivery so it can be done in both- normal (vaginal) delivery or cesarean. Fully sterile cord blood collection kits to be used in c-sections are also available.

Umbilical cord blood collection can be done in two ways:

-Syringe method: In this method, a syringe is used for extraction of blood from umbilical cord just after umbilical cord is cut just like we extract blood for blood test.

-Bag method: In this method, instead of using syringe to extract blood, umbilical cord is raised up to let the blood drain in a bag.

The syringe or bags are pre-labeled with a particular code representing your baby. The complete umbilical cord blood collection process takes around 5 minutes. Cord blood may be collected within first 15 minutes after the birth and the collected cells should be processed in the laboratory within 48 hours. Larger stem cell sample means better survival rate during transplant treatment process.

Is there any risk for child during collection?

Some people think that umbilical cord blood collection may affect child’s growth or resistance power. But it is purely a myth. The process doesn’t require any alteration in the delivery process and possesses no threat or problem to the mother and child. Parents with a medical history of cancer, hepatitis, malaria, diabetes and HIV/AIDS etc are not eligible.

Do we need to give prior intimation to the Drs. for collection?

The attending gynaecologist should know well in advance your intention of umbilical cord blood storage so that requisite arrangements to store baby's umbilical cord blood can be made. Anyone interested for cord blood donation should inform the Cord blood bank authorities latest by 34th week of pregnancy. If you are interested in cord blood banking for a lifetime of medical security for your child, contact Cryobanks India and complete extremely simple sign-up formalities.

Donate Cord Blood: You can save a life!

The birth of a child in the family is a joyous event. You can make sure this joy is spread far and wide by choosing to preserve the umbilical cord blood of the baby. Earlier when the baby was born, the umbilical cord blood was treated as a waste. Today you can get it collected by a public cord blood bank where it can be used to help others – cord blood is rich in stem cells which are useful in the treatment of as many as 75 life threatening diseases. Donating the umbilical cord blood is a very simple decision whereas it can make a world of difference to those receiving it. Just to remove some misconceptions, the labor and delivery is not affected in any way when the umbilical cord blood is collected during the time of birth.

The events in which a doctor may choose to go for cord blood transplant, depend on whether the doctor favors the transplant cells to come from the patient himself or from the donor. The doctors also decide which stem cells source is best suited to the patient, cord blood, peripheral blood or bone marrow.

The donated cord is especially useful for those patients who need a transplant quickly, because the stored cord blood is ready to use. Also, those patients who find it difficult to find a suitable bone marrow donor can also use the cord blood because cord blood need not match the patient's tissue type that closely. Even those patients with ethnically diverse backgrounds may also use the cord blood cells.

At the same time, donating the cord blood cells for public use or preserving it for family’s medical well-being is entirely your personal decision in the end - you can make an informed decision by talking to your doctor about it. Many a times the cord blood sample is not used for a transplant as there are too few stem cells in the cord blood. In that case, the cord blood is used for the research purposes so that the future treatment techniques may be perfected by the doctors.

Cryobanks is a leading umbilical cord blood preservation company which offers private cord blood storage program to the expecting families. Cryobanks is a pioneer in the field of cord blood stem cell storage and processing and it remains committed to serving families requiring the same for family or private use. The company intends to be the largest inventory of cord blood stem cells in India.

Umbilical Cord Blood: Donate, Bank, or Toss

Listed below are some links to various umbilical cord blood sites and educational information. I personally didn't have this choice when my own children were born in 1986 and 1996 however, in 2000, my IP's decided to bank the cord blood of their newborn twins...and in 2005, my 2nd couple decided NOT to bank the blood of their newborns...so you can see, it is a very personal decision that needs to be made individually. I read on one of these sites that the odds are that the average baby will ever use his or her own banked cord blood is considered very low. The primary reason that parents consider banking their newborn's cord blood is because they have a child or close relative with a family medical history of diseases that can be treated with bone marrow transplants. On the other hand public cord blood banking is strongly supported. Its up to you to research the facts well before the birth. It's a procedure you have to choose and plan for beforehand as it is not routine in hospitals or home births.