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Cord Blood Banking - Is It Worth It?
by Kim Green-Spangler

It's typically a parent's wish to provide their children with every opportunity for a happy healthy life, and let's face it, parents start laying the foundation well before birth. Umbilical cord blood banking is just one of the many ways parents can proactively plan to help keep children healthy. Once only a viable option for families with robust bank accounts, in recent years, umbilical cord blood banking has become more affordable and more readily available.

What is cord blood banking and why is it so important?

Patients who require stem cells have three potential sources: circulating blood, bone marrow, or umbilical cord blood. The first two come from adults and the last from newborns. Obviously there is a greater opportunity to acquire stem cells from adults through blood and/or bone marrow, but only a single chance of acquiring umbilical cord blood. The stem cells from umbilical cord blood contain white blood cells whose primary purpose is to fight off infections, red blood cells which oxygenate the cells throughout the body and platelets which promote healing and blood clotting. From these cells doctors may be able to generate new healthy cells to treat a number of diseases and disorders that compromise blood and immune systems.

The Benefits

  • In order for transplantation to occur with adult stem cells, donor and recipient must match HLA (Human Leukocyte Antigens) at a rate of 83%. However when using umbilical cord blood stem cells the required HLA match rate drops to 67%.

  • Each person receives one-half of their HLA from each parent. For a bone marrow transplant, siblings only have a 25% chance of being a perfect 6/6 HLA match, but cord blood transplants only require a 4/6 match and there is a 39% chance of a successful match.

  • Because umbilical cord blood transplants only require a 4/6 HLA match, different ethnic groups are more likely to find a match than from an adult stem cell donor which requires a 6/6 match.

  • Umbilical cord stem cells will be a 100% match for the donor and could be a 75% match for siblings, parents and grandparents.

  • There is no risk involved for either baby or mother, and truth be told, if cord blood is not used it is discarded as medical waste.

The Disadvantages

  • However, it should be noted that the amount of stem cells harvested from cord blood is minimal and is typically suitable for a large child or small adult. Thus, it is typically necessary for cells to be grown or multiple cord blood units to be utilized for transplantation.

  • Umbilical cord blood cells also take a longer period of time to repopulate a recipient's blood supply. Thus, the patient will be susceptible to risk of infection longer than with an adult stem cell transplant.

When is cord blood available?

Umbilical cord blood is taken right after the birth of the newborn by the doctor, midwife, or medical staff. The medical professional is provided with a collection kit from the cord blood bank. The kit contains a bag and as much blood as possible is secured within it. Once the bag is sealed and labeled, it must be kept at room temperature. The bag is then either transported to the blood bank, or picked up from the hospital by the blood bank, as there is a narrow 48 hour window for viability.

How does one bank cord blood?

Families have two options for banking cord blood - public or private storage. In both public and private storage the processes are basically the same. Blood is collected, brought to the facility, tested, processed, frozen and stored. However, some labs are known to grow cells, split samples, or go above and beyond in the storage process to try to insure maximum availability and security. Families should contact each bank facility and inquire about their process for banking.

Public:

Public cord blood banking is free and is a donation made by very generous parents. They are truly generous because public banking means their child's cord blood is available to anyone who may need it, not just to the family who has donated it. It is public donations of cord blood that can give the gift of life to someone in an easier and safer manner, than through bone marrow or blood transplants. The establishment of public banks has made the donation process more readily available, but the cost of collection, testing and storage is prohibitive to have collection available at every hospital.

In order to make a public donation, parents should check to see if their local hospital participates in the program. If so, contact the appropriate personnel to help facilitate the process, if possible, by the 34th week of pregnancy. However, if your hospital has staff on-hand, a last minute request may be possible.

If not, parents can contact other area hospitals, or contact Cryobanks International. Cryobanks International accepts donations from anywhere within the continental U.S., and can be contacted at 1-800-869-8608 collection information.

Additionally, parents can opt to contact hospitals to donate cord blood for research purposes, as it is research that has helped pave the way for such incredible discoveries.

Note: While all donations are appreciated, not every umbilical cord blood donation will be suitable. A good donation source depends on family health history, virus exposure and travel locations, in addition to the quantity of blood forming cells present in the sample. Nearly 50% of all donations will not be stored for transplantation because it has not met the criteria.

Private:

The private cord blood collection and storage is performed on an individual basis, paid for by the families of those who would be the beneficiaries of the stem cells, if ever needed, and are the property of adult guardians until children reach the age of 18.

The current average cost for cord blood banking is approximately $1,500 for the initial collection and $100 per year for storage. This is a nearly half the cost from ten years ago for the same procedure. In addition, many companies offer discounts for multiple births, families that have already stored cord blood, or families who opt to pay for multiple years in advance.

Note: As of 2004, all cord blood banks are required to be registered with the AABB (formerly the American Association of Blood Banks). As of 10/9/09, there are currently 33 registered companies across the U.S. and Canada.

Tooth Stem Cells - Another Possibility?

Recent research suggests baby tooth stem cells can also be utilized for transplants, as four types of stem cells - mesenchymal cells used to develop other reparative cells, chondrocyte cells which can be used in the treatment of joint injuries, arthritis, and the regeneration of cartilage, osteoblast cells to generate bone, and adipocyte cells to repair cardiac tissue. There is a great deal of excitement and criticism regarding this research. If indeed tooth stem cells can be used, this will open up new possibilities for parents who may not have been able to take advantage of umbilical cord blood banking.

However, as of right now there are no FDA approved applications for using tooth stem cells. The belief is that tooth stem cells may initially be used for the repair of teeth, bone regeneration, neural tissue injury and neurodegenerative diseases. However, for now parents may be banking tooth stem cells with the belief that these cells could be life saving, only to be disappointed if scientific research and technology does not make advancements quick enough for their possible use should the need arise. At $595 for initial collection and $95 a year for storage, parents may decide it's a small fee to pay for the possibility of eliminating a life threatening disease in the future.

So is cord blood banking worth it?

The decision to store or donate stem cells is a completely personal one. If deciding to bank umbilical cord blood, only after extensive research should parents select an AABB registered facility to use for cord blood collection and storage. Tooth stem cell banking could also be an after birth option for some parents. Recent advances in research and technology have made the process much simpler and even more affordable, and the benefits can be quite significant. However, it can also be viewed as a gamble because those storing blood may never need it. So is cord blood banking worth it? Only you and your family can decide.

Related Articles:
   • How to Choose a Cord Blood Bank
   • Cord Blood Banking - Members' Archive
   • Boston Globe Examines Debate Concerning Usefulness, Expense of
     Storing Umbilical Cord Blood

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