Cord blood? Here’s what we are talking about. After childbirth, there is a small amount of blood left in the umbilical cord, the blood vessel pipeline that connects the baby to the placenta and mother. This cord blood and the cord tissue are special because they contain millions of stem cells, just like Bone Marrow. The stem cells are considered building block cells that are capable of dividing and renewing themselves and becoming not only new red and white blood cells, but many other types of cells. Stem Cell transplants from Umbilical Cord or Bone Marrow that have been used for many years to treat leukemias, lymphomas, and many other blood disorders.
How Can Cord Blood Be Used?
Cord Blood contains both Hematopoietic Stem Cells (HSC) and Mesenchymal Stem Cells (MSC). Hematopoietic means blood-forming, so these cells can turn into the 3 types of blood cells: white blood cells, red blood cells, and platelets. The transplantation of these cord blood stem cells promotes healthy regeneration of these blood-forming cells within the recipient patient. In addition to blood cancers, Hematopoietic stem cells can also treat other illnesses of the blood and immune system, such as sickle cell disease and Wiskott-Aldrich syndrome.
The first UCB transplant was performed in 1988, and since then instead of tossing the umbilical cord away with the placenta as medical waste, more and more ob-gyns, midwives, and other providers have encouraged the trend of cord blood retrieval and banking. Over 40,000 transplant procedures have been performed using this harvested blood.
Clinical trials are in the works for even more possibilities for the use of stem cells. We know that the Mesenchymal Stem Cells are capable of turning into other types of cells and building tissues, including nerves and muscles. There is hope that they will aid in treating neurological disorders including cerebral palsy, multiple sclerosis, Parkinson’s, Alzheimer’s, and spinal cord injury. Advocates hope more and more blood will be saved so it can be used in research and therapies.
Should You Bank Your Cord Blood?
If you are pregnant and trying to decide about this procedure, here are the basic steps:
- After the baby is safely delivered, the cord is clamped in two places, about 10 inches apart.
- The cord is cut, as usual, close to the newborn who can then be cleaned and handed to the mother.
- The provider then inserts a sterile needle into the cord which remains attached to the placenta and collects at least 40 milliliters of blood.
- The blood is sealed in a bag and sent to a lab or cord blood bank for testing and storage.
Delayed Cord Clamping
Delayed cord clamping is still possible when collecting cord blood. Research has shown that delaying cord clamping by 30-60 seconds to allow for more umbilical cord blood to flow to the baby still provides enough stem cells for banking.
Umbilical Cord Blood and COVID19
The Mesenchymal stem cells found in cord blood have been shown in animal studies to reduce inflammation, particularly in pneumonia-like lung injury that is seen in COVID19 cases. The hope is that these stem cells will help to repair damaged tissues in the respiratory systems of patients and promote a faster recovery. There are clinical trials going on right now studying this, so stay tuned.
Cord Blood Storage Options:
- Public Cord Blood Banking – Families can choose to donate their baby’s cord blood to a public cord blood bank where there is no charge to the donor and the blood is available to anyone who needs it, including researchers. The identity of the donor is not part of the record, only the genetic information. Once donated, the family does not have access to it. The number of public banks is limited and may only be available in certain areas.
- Private Cord Blood Banking – Families who choose this option are guaranteed to have access to their child’s cord blood for that child or for a sibling. The fees can range from $1000-3000 for collecting, testing, and processing with additional storage fees of $90-175 each year.
- Direct-donation Banks – These are usually associated with a University and are a combination of private and public banks. They do store cord blood for public use, they also accept donations reserved for families, and do not charge a fee.
To Bank or Not, Public or Private?
Some parents are eager to get insurance against a future disease their child might have by storing blood privately. According to research, the way in which the blood is stored indicates that the cells should be viable for the life of the child. The first cord blood banks have found that the cells are still viable at > 20 years.
The American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics recommend families consider donating their cord blood to public banks to help others. Be The Match is a free national registry and coordinates with other registries globally. The gift of stem cells could help a person with a blood cancer from anywhere.
Why I recommend Cord Blood Banking
While working in Pediatric Intensive Care for many years, I cared for many children with leukemias and other blood cancers who were waiting for a stem cell match. Many of the children I cared for had parents and grandparents from different parts of the world. Genetically, these children had a mix of genes making it very difficult to find a perfect stem cell match.
Tragically, many of these children never found a match. Even if they had a sibling with a full or partial match, they still had a very high risk of graft versus host disease. With umbilical cord blood, the stem cells are preserved at birth, making them very immunologically forgiving, meaning they produce significantly less graft versus host disease.
With new advances in regenerative medicine, cord blood has shown significant promise in helping to treat many conditions. I recommend both family banking and public donation depending upon each family’s circumstances.
If you are considering banking your cord blood the best advice is to make the decision early and have everything set up well ahead of time with your obstetrician or midwife. All should be coordinated with the bank you have chosen and the technician handling the procedure.
To learn more about cord blood banking, visit Parent’s Guide to Cord Blood Foundation at https://parentsguidecordblood.org/en/donate-cord-blood
Disclosure: I have been working with Cord Blood Registry for over 15 years to educate the public about Umbilical Stem Cells.
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