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Cord blood banking pros and cons

When the baby is born, some blood remains in the section of cord that is still attached to the placenta – known as umbilical cord blood, or cord blood. People who support cord blood banking argue that the baby does not need this blood, but it is rich in haematopoietic stem cells, which are similar to those found in bone marrow; making umbilical cord blood an excellent alternative to using bone marrow in certain treatments.

Umbilical Cord Blood Banking Guide – Free download

Parent’s Guide to Umbilical cord blood banking
Call to action text in case your image doesn't load.”The Council of Europe European Committee on Organ Transplantation has elaborated this new guide, to provide clear, accurate and balanced information about the use of cord blood in medical treatment and to guide parents through their blood storage options. If you are about to become a parent, you may find this guide helpful to make an informed decision on what to do with your baby’s cord blood.”

Council of Europe
”The Council of Europe and most professional
associations and physicians do not recommend private cord blood banking and have declared the use of cord blood as ‘biological insurance’ to be ‘ill-advised’.”

American Medical Association
”Private banking should be considered in the unusual circumstance when there exists a family predisposition to a condition in which umbilical cord stem cells are therapeutically indicated. However, because of its cost, limited likelihood of use, and inaccessibility to others, private banking should not be recommended to low-risk families.”3

 

Harvesting and storing stem cells from umbilical cord blood has become a global industry worth around $4 billion. When discussing postnatal care, doctors and midwives should give parents information regarding their options for having umbilical cord blood stored privately for their own use later on; donated to a public donor bank; or discarded altogether.

 

 

Private and Public umbilical cord blood banking – Quick Overview

Cordblood private vs public banking

Public cord blood banking

More than 500,000 cord blood units are currently available through a worldwide registry, including more than 160,000 units in the National Marrow Donor Program Registry.

 

How to donate cord blood?

 

Pre Birth

Contact your cord blood bank between your 28th and 34th weeks of pregnancy. If you are still in the early stages of your pregnancy.]Click this link to find out if you meet the basic guidelines to be a cord blood donor? Find a public cord blood bank in your country and find detailed information, such as prices, certification, handling and storage about each bank.

The National Marrow Donor Program (NMDP) recognise the following:

If your family has a child with a life-threatening disease that may be treated with a cord blood transplant, you can choose to save your baby’s umbilical cord blood for a biological sibling. The saved cord blood will be stored in a public cord blood bank.” Learn more

 

Birth

When you arrive at the hospital, tell the labor and delivery team you are donating umbilical cord blood.After your baby is delivered, the umbilical cord is clamped and blood from the umbilical cord and placenta are collected into a sterile bag. You will be asked for a blood sample to be tested for infectious diseases. This blood is taken only from you, not your baby.

Keep a copy of the informed consent in case you need to contact the cord blood bank at a later date.Shortly after your baby’s birth, the cord blood unit is delivered to the public cord blood bank.

 

Post Birth

After the cord blood unit arrives at the cord blood bank, it is:

Checked to be sure it has enough blood-forming cells for a transplant. If there are too few cells, the cord blood unit may be used for research related to using cord blood for transplant.Tested to be sure it’s free from infectious diseases. Tissue typed and listed on Be The Match Registry where it will be available for patients in need of a transplant. To protect your family’s privacy, the cord blood is identified only by number and never by name.Frozen in a liquid nitrogen freezer and stored.

Doctors search Be The Match Registry for donated cord blood units and bone marrow donors to find a match when their patient needs a transplant.

 

private cord blood bankingPrivate cord blood banking

If you store the cord blood in a family (private) cord blood bank, it is reserved for your own family members. Family cord blood banks are available throughout the country for anyone. You are charged a fee for the collection and an annual fee to store the umbilical cord blood.
The harvesting and storage of stem cells from the blood of umbilical cords has surged in the past decade to a $4 billion global industry.

 

 

3 reasons for private cord blood banking

One chance to collect Banking cord blood is a way of preserving potentially life-saving cells that usually get thrown away after birth.

 

 

Higher chance of finding a match

A child’s stem cells are less likely to be rejected by the body than someone else’s cells. Researchers say chances are slim for finding a perfect match at public banks.

 

Family health insurance People can store cord blood with a private bank in the hope that, in the future, cord stem cells may be useful, should a member of their own family develop a disease treatable by stem cell therapy. Ownership of the blood retained by the family.

 

You should ask these questions when you consider cord blood banking

 
Location

Make sure your bank is licensed to accept cord blood from your state, because a bank’s headquarters and its storage lab may not  be in the same state.

 

Transport

Transplants agencies state that cord blood should be transported within 48 hours on the time between birth and processing the cord blood for cryogenic storage.

Ask about temperature stability of transport, because temperature swings speed up cell death. Which courier service is used? Do they guarantee arrival time and a steady temperature?

 

Storage and quality control

Cord blood should be tested for contaminants and diseases. A sterile workplace is essential for testing. A final check will measure if their are enough cells in the blood to be useful. The blood should be stored in freezers with a temperature of minus 320 degrees fahrenheit.

 

Clinical experience

You should ask cord blood banks how much of their customers cord blood has been used for transplants and other therapies.

A high percentage indicates that the company is successful with clinical applications of cord blood. You should be alterted when this number is very low, it could mean that doctors have rejected their cord blood

 

Financial stability

Cord blood banking is a business, and businesses do go bankrupt.

You can ask the bank what happens to your cord blood when it’s bankrupt. Will another company take over your cordblood? What procedures for transport are in place?

Look for large stable companies which are affiliated with hospitals and research institutions.

 

Pricing

Is the enrollment fee charged for each birth or once per family? Is the storage fee of the first year included in the enrollment fee? Is the annual storage fee fixed? Discounts? Is their a refund available in case the blood cannot be stored? Is their a releasement fee when a family member needs the blood?

 

Is the marketing of private cord blood banks misleading?

  • …ods are good that your child will need their stored cord blood…

Companies come up with different numbers ( 1 in 50 / 400 or 2.700) that your child will need their stored cord blood. 45 children in a million develop leukemia, so it’s a fairly low number.

  • …a childs own cored blood can be used to treat their leukemia…

If a child developes leukemia the own cord blood is not used, because the disease is likely in the cord blood too. Almost always you want somebody elses cord blood or donor cells, because they are the ones correcting that defect. Cord blood can be used to treat a sibling with leukemia and for some parents that’s reason enough.2

  • …stem cell’s could be a cure-all…
    For now this is still theoretical and science have to develop further.

  • …finding a stem cell donar is often impossible…

Chances are excellent of finding a donar with the use of unreleated umbilical cord blood. That’s because the vast majority of the time transplant doctors can find matching stem cells either from bone marrow, blood or a public cord blood bank.

 

Cord blood banking vs delayed cord clamping

The Council of Europe and the American Medical Association do not recommend private banking to low-risk families. Public banking is stimulated but current guidance on the collection of umbilical cord blood for stem cell banks does not state when the cord should be clamped and cut. It would be reasonable to advise parents of the advantages and disadvantages of delayed cord clamping when they are considering cord blood banking.3

Many prospective parents do not realize that when they opt to bank their newborn baby’s cord blood that the birth attendants are more likely to cut the umbilical cord early (within 30 seconds of birth) in order to ensure an adequate amount of cord blood is collected for the cord blood bank

”Can cord blood donation and delayed cord clamping coexist and if so are the benefits for delayed cord clamping remaining? If so, this should be best practice.”

 

References

1. Rowley JD. Backtracking leukemia to birth. Nat Med. 1998;4(2):150–151. /
Yagi T, Hibi S, Tabata Y, et al. Detection of clonotypic IGH and TCR rearrangements in the neonatal blood spots of infants and children with B-cell precursor acute lymphoblastic leukemia.Blood. 2000;96(1):264–268.

2. American Medical Association. Code of medical ethics. Opinion 2.165—Umbilical cord blood banking. http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion2165.shtml. Accessed November 17, 2010.
3. https://www.rcog.org.uk/globalassets/documents/guidelines/scientific-impact-papers/sip-14.pdf

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