Umbilical cord blood banking is the process of saving and storing cord blood at the time of birth for its therapeutic stem cells.
Umbilical cord blood banking is something you might want to talk to your doctor about before your baby is born. Cord blood is the blood in your baby's umbilical cord following birth that is usually discarded. However, some parents are now saving and storing cord blood because it has been found to be rich in stem cells.
Stem cells are the building blocks of the blood and immune systems. They can divide to become other types of cells. The stem cells found in umbilical cord blood and bone marrow can divide and become all three types of blood cells: red blood cells, white blood cells, and platelets. Stem cells are able to restore function to the blood-making system and immune system. This is especially valuable when the systems have been damaged by radiation or chemotherapy. In a stem cell transplant, patients with a marrow or blood disease (such as leukemia) first undergo chemotherapy and/or radiation therapy to wipe out their diseased blood or marrow cells. Then, blood stem cells from a healthy donor are transplanted into the patient, where they grow and develop into healthy marrow and blood cells.
Stem cells are currently used in the treatment of nearly 40 life-threatening diseases including certain cancers (such as leukemia) and immune and genetic disorders. And researchers are now looking for ways to use cord blood to address medical problems such as stroke, heart disease, diabetes, and muscular dystrophy.
The blood collection process is easy and painless, and it does not interfere with the delivery or care of your newborn. (The collection process is essentially the same with a cesarean birth as it is for a natural birth.) After your baby is born, but before the placenta is delivered, your obstetrician or midwife cleans a 4- to 8-inch area of umbilical cord with an antiseptic solution and then inserts the blood bag needle into the umbilical vein. When the blood has been collected, the blood bag is clamped, sealed and labeled. The collection typically takes two to four minutes. Two tubes of maternal blood are also drawn at this time. The procedure is painless and noninvasive. There is no risk to you or your child.
The cells in your blood cord sample must then be processed and frozen within 48 hours by a laboratory specially equipped to handle umbilical cord blood banking.
Some parents choose to save and store umbilical cord blood so they will have a supply available in case it is ever needed by their child or a family member: Cord blood stem cells are a perfect match for the donor baby; they have 25 percent probability of being an exact match for a sibling, and can be potentially used for parents and grandparents. Others choose to save cord blood because of the possibilities that science might provide in the future. The blood can be collected only at birth and so many don't want to miss the opportunity. And some collect the cord blood and donate it to a public blood bank.
Umbilical cord blood donation is a new idea that is picking up after a slow start. Currently, there are just 11 public cord blood banks in the National Marrow Donor Program (NMDP) registry that accept donated cord blood. The NMDP website (www.nmdp.org) lists 10 non-NMDP centers around the country that also accept cord blood donations (but often only for related transplant recipients). The American Red Cross currently has seven active cord blood collection sites around the country, and The National Institutes of Health has committed $30 million to establish three national public donation banks.
Women who donate their cord blood can, theoretically, retrieve their own donation should they need it before the units have already been used by another individual who needs a stem cell transplant. Because donation is free, it is liable to be a more accessible option for many families. (But be aware that if your doctor charges a fee for drawing the blood, that will not be covered by the blood bank.) However, because cord blood donation is a newer stem cell option, donating is not available in all communities. If there is not a participating hospital in your community, you might want to try contacting a major university hospital or medical center in your local area to explore other options. Be sure to first check the NMDP's website for registered blood banks and more information about cord blood donations: www.nmdp.org; or call them at 1-800-MARROW2.
As the concept of umbilical cord blood banking becomes more popular and common, the methods of obtaining the blood will become more standardized and routine. But right now, here are some factors you should carefully consider.
The hospital where you deliver is unlikely to offer umbilical cord blood banking. You must make all arrangements yourself and supply your doctor with the collection kit. If you talk to your doctor well in advance of your baby's delivery about your interest in cord blood banking, he or she might be able to refer you to a reputable cord blood bank in your area who will give you all the information and collection equipment you need.
Not all umbilical cord blood banks are equal. The Federal government is in the process of developing industry standards for the collection, processing, and storage of cord blood, but at this time uniform regulations do not exist. You should, at the very least, make sure that the laboratory you choose is accredited by the American Association of Blood Banks.
There is no way of knowing at this time how long stored cord blood will last. One study out of Amsterdam produced viable cord blood stem cells from blood frozen for 15 years. But the "shelf life" of cord blood is still tentative.
In most cases, medical insurance companies do not pay for umbilical cord blood banking. This is an out-of-pocket expense that can be very costly. You will also pay an annual storage fee to the blood bank for storing the blood. If you choose to move the cord blood to a different blood bank, you'll have to pay preparation and shipment charges.
If you give birth to multiples and want to draw umbilical cord blood, each child needs his or her own collection—the only direct match is from the direct donor. This, of course, raises the cost. However, some cord blood banks offer discounts for multiples and for additional children the parents might have at a later time.
Find out who has access to the cord blood's hidden information-the diseases and genetic traits shared by both infant and parents. Ask questions about the bank's policy regarding screening cord blood and ask whether all identifiers are stripped from the blood samples in order to protect the donor's privacy. Many physicians will advise their patients against donating cord blood to a blood bank that retains patient identifiers.
Excerpted from The Complete Idiot's Guide to Pregnancy and Childbirth © 2004 by Michele Isaac Gliksman, M.D. and Theresa Foy DiGeronimo. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.
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