Here is an excerpt from an article on kidshealth.org
After a baby is delivered, the mother’s body releases the placenta, the temporary organ that transferred oxygen and nutrients to the baby while in the mother’s uterus. Until recently, in most cases the umbilical cord and placenta were discarded after birth without a second thought. But during the 1970s, researchers discovered that umbilical cord blood could supply the same kinds of blood-forming (hematopoietic) stem cells as a bone marrow donor. And so, umbilical cord blood began to be collected and stored.
What are blood-forming stem cells? These are primitive (early) cells found primarily in the bone marrow that are capable of developing into the three types of mature blood cells present in our blood — red blood cells, white blood cells, and platelets. Cord-blood stem cells may also have the potential to give rise to other cell types in the body.
How It Works
Collection of the cord blood takes place shortly after birth in both vaginal and cesarean (C-section) deliveries. It’s done using a specific kit that parents must order ahead of time from their chosen cord-blood bank.
After a vaginal delivery, the umbilical cord is clamped on both sides and cut. In most cases, an experienced obstetrician or nurse collects the cord blood before the placenta is delivered. One side of the umbilical cord is unclamped, and a small tube is passed into the umbilical vein to collect the blood. After blood has been collected from the cord, needles are placed on the side of the surface of the placenta that was connected to the fetus to collect more blood and cells from the large blood vessels that fed the fetus.
During cesarean births, cord-blood collection is more complicated because the obstetrician’s primary focus in the operating room is tending to the surgical concerns of the mother. After the baby has been safely delivered and the mother’s uterus has been sutured, the cord blood can be collected. However, less cord blood is usually collected when delivery is by C-section. The amount collected is critical because the more blood collected, the more stem cells collected. If using the stem cells ever becomes necessary, having more to implant increases the chances of engraftment (successful transplantation).
After cord-blood collection has taken place, the blood is placed into bags or syringes and is usually taken by courier to the cord-blood bank. Once there, the sample is given an identifying number. Then the stem cells are separated from the rest of the blood and are storedcryogenically (frozen in liquid nitrogen) in a collection facility, also known as a cord-blood bank. Then, if needed, blood-forming stem cells can be thawed and used in either autologous procedures (when someone receives his or her own umbilical cord blood in a transplant) or allogeneic procedures (when a person receives umbilical cord blood donated from someone else — a sibling, close relative, or anonymous donor).
How long can blood-forming stem cells last when properly stored? Theoretically, stem cells should last forever, but cord-blood research only began in the 1970s, so the maximum time for storage and potential usage are still being determined. Blood-forming stem cells that have been stored for more than a decade have been used successfully in transplants.
Some serious illnesses (such as certain childhood cancers, blood diseases, and immune system disorders) require radiation andchemotherapy treatments to kill diseased cells in the body. Unfortunately, these treatments also kill many “good” cells along with the bad, including healthy stem cells that live in the bone marrow.
Depending on the type of disease and treatment needed, some kids need a bone marrow transplant (from a donor whose marrow cells closely match their own). Blood-forming stem cells from the donor are transplanted into the child who is ill, and those cells go on to manufacture new, healthy blood cells and enhance the child’s blood-producing and immune system capability.
Pros and Cons
Cord-blood banking isn’t routine in hospital or home deliveries — it’s a procedure you have to choose and plan for beforehand, so be sure to consider your decision carefully before delivery day.
The primary reason that parents consider banking their newborn’s cord blood is because they have a child or close relative with or afamily medical history of diseases that can be treated with bone marrow transplants. Some diseases that more commonly involve bone marrow transplants include certain kinds of leukemia orlymphoma, aplastic anemia, severe sickle cell anemia, and severe combined immunodeficiency.
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In most cases, stem cell transplants are performed only on children or young adults. The larger the size of the person, the more blood-forming stem cells are needed for a successful transplant. Umbilical cord blood stem cells aren’t adequate in quantity to complete an adult’s transplant.
In addition, it’s not known whether stem cells taken from a relative offer more success than those taken from an unrelated donor. Stem cells from cord blood from both related and unrelated donors have been successful in many transplants. That’s because blood-forming stem cells taken from cord blood are naive (a medical term for early cells that are still highly adaptable and are less likely to be rejected by the recipient’s immune system). Therefore, donor cord-blood stem cells do not need to be a perfect match to create a successful bone marrow transplant.
Is It Right for You?
As parents evaluate their reasons for banking their newborn’s cord blood and begin to research cord-blood bank facilities, there are many considerations and cautions to keep in mind.
Some doctors and organizations, such as the American Academy of Pediatrics (AAP), have expressed concern that cord-blood banks may capitalize on the fears of vulnerable new parents by providing misleading information about the statistics of bone marrow transplants. Parents of children of ethnic or racial minorities, adopted children, or children conceived through in vitro fertilization may be especially encouraged to bank cord blood because it’s statistically harder to find a match in these cases.
Other doctors and researchers support saving umbilical cord blood as a source of blood-forming stem cells in every delivery — mainly because of the promise that stem-cell research holds for the future. Most people would have little use for stem cells now, but research into the use of stem cells for treatment of disease is ongoing — and the future looks promising.
If you do decide to bank your newborn’s cord blood, be sure to discuss your options with your obstetrician. Here are a few questions to consider before choosing a cord-blood bank:
- How financially stable is the cord-blood bank? (Financial stability means a reduced chance that you will have to transfer your sample if the facility closes.)
- How many samples are processed in the facility? (A larger number of samples usually means that there are more collection and handling procedures in place.)
- Do I have the option of switching to another facility if I choose?
- What happens to my sample if the facility goes out of business?
- What are the yearly fees and maintenance costs involved? Will these fees increase, or are they fixed?
Like community or hospital blood banks, cord-blood banks are regulated by the U.S. Food and Drug Administration (FDA), which has developed standards regulating future cord-blood collection and storage.
Above all,do research, find the bank that works for you financially and make sure it is accredited by the FDA as stated above.
Reviewed by: Steven Dowshen, MD