Cord Blood Banking: What Are Your Options?
Jul 14, 2017 Cedars-Sinai Staff
Families expecting a new baby face hundreds of decisions that will affect their child's future—like finding the perfect name, figuring how to manage breast or bottle feeding, childcare, and a host of other parenting decisions.
One decision increasingly on the list for new parents: whether they should bank their newborn's umbilical cord blood for future medical use.
Cord blood is the small amount of blood left in the umbilical cord following a child's birth and it can be collected immediately after a baby is delivered. This blood is rich in stem cells, the basic building blocks of blood cells and the body's immune system—similar to the ones found in bone marrow.
In 2016, cord blood was used to help 29% of patients who received a transplant in the US.
Stem cells may be used in transplants to treat people with blood cancers and other blood malignancies. These transplants can help the body replenish the blood stream with healthy cells. Stem cells are already used in the treatment of more than 70 diseases—lymphoma, sickle cell anemia, immune deficiency, and metabolic diseases. Researchers at the Cedars-Sinai Regenerative Medicine Institute also are looking into their potential to treat Alzheimer’s disease, diabetes, multiple sclerosis, spinal cord injuries, and heart disease, among other conditions.
Families generally have 3 options for cord blood:
- Donate the blood to a public bank, where it could be used by anyone who needs it.
- Pay to store the cord blood privately for use by your family.
- Do nothing, and the umbilical cord blood will be discarded safely.
Which is best for your family?
The American Academy of Pediatrics (AAP) recommends families choose to donate their cord blood to public banks in most cases. Private banking should be considered for family use where there is a full sibling in the family with a condition that could potentially benefit from a transplant as siblings have a 25% chance of being a match.
"It's critically important for patients to get balanced information and answers to their questions about cord blood banking. Because there are so many companies advertising their services, it can be difficult to understand information on the internet."
Both AAP and the American College of Obstetricians and Gynecologists have discouraged private storage as "biological insurance" in most other cases. For some blood cancers and other blood diseases, such as leukemia, a person's own blood could most likely not be used for treatment—their stem cells would have the same mutation that caused the disease.
Stem cells are said to last 20-25 years once they are frozen. However, there is no data on how effectively a cell will function after two-to-four decades on ice, Cedars-Sinai researchers say.
Pros and cons
Donated cord blood must meet criteria set by the Health Resources and Services Administration (HRSA). Units that don't meet their standards may not be stored in public banks, and may be discarded or used for research.
"One of the biggest concerns families have about publicly banking cord blood is: Will it be available to them, if needed? The answer is a little complicated."
Once cord blood is in a public bank, it is listed as available on a national registry. People who need stem cell transplants and are looking for a match may be able to use it. In 2016, cord blood was used to help 29% of patients who received a transplant in the US, according to the HRSA.
That means it might not be available to the family of origin if they ever need it.
Private banking guarantees the blood always will be available. However, the fees can include a first-year charge of $1000-3000, plus annual storage fees of $90-175. Most of the time, stored blood is eventually discarded or donated for use in research.
"One of the biggest concerns families have about publicly banking cord blood is: Will it be available to them, if needed? The answer is a little complicated," Dr. Aghajanian says. "Cord blood donated to a public bank can be pulled for a family of origin." As long as it is still available, of course.
When do you need to decide?
Decide early in pregnancy what you want to do.
All families should decide what they want to do with their cord blood well before delivery and make the arrangements accordingly. Because the issue is complex and the decision is a personal one—it's best to speak with your doctor about what's right for your family.
"It's critically important for patients to get balanced information and answers to their questions about cord blood banking," says Dr. Aghajanian. "Because there are so many companies advertising their services, it can be somewhat difficult to understand information on the internet. We recommend that patients discuss this issue with their physicians."