Cord blood

Umbilical cord blood is human blood from the placenta and umbilical cord that is rich in hematopoietic stem cells. Cord blood is collected after the umbilical cord has been detached from the newborn, and utilized as a source of stem cells for transplantation.

Cord blood is stored by both public and private cord blood banks. Public cord blood banks store cord blood for the benefit of the general public, and coordinate matching cord blood to patients through the National Marrow Donor Program (NMDP). Private cord blood banks are for-profit organizations that store cord blood for the exclusive use of the donor or donor's relatives.

Public cord blood banking is strongly supported by the medical community. However, private cord blood banking is generally not recommended unless there is a family history of specific genetic diseases. Private banking is unlawful in France and Italy, and opposed by the European Group on Ethics in Science and New Technologies. See cord blood bank.

Properties
Cord blood stem cells are more proliferate and have a higher chance of matching family members than stem cells from bone marrow. Fathers have a 25% chance of matching their child's cord blood stem cells. Siblings have a 25% chance of being a perfect cord blood match.

Collection, storage and costs
There are 2 main methods in cord blood collection from the umbilical vein; before the placenta is delivered (in utero) or after (ex utero.)

With ex utero collection method, the cord blood is collected after the placenta is delivered and the umbilical cord is clamped off from the newborn. The placenta is placed in a sterile supporting structure with the umbilical cord hanging through the support. The cord blood is collected by gravity drainage yielding between 40-150 mL.

A similar collection method is done for in utero except that the cord blood is collected after the baby has been delivered but before the delivery of the placenta.

After collection the cord blood units must be immediately shipped to a cord blood bank facility. At public cord blood banks, this blood is then analyzed for infectious agents and the tissue-type is determined. Cord blood is processed and depleted of red blood cells before being stored in liquid nitrogen for later use.

New parents have the option of storing their newborn's cord blood at a private cord blood bank or donating it to a public cord blood bank. The cost of private cord blood banking is approximately $2000 for collection and approximately $100 per year for storage as of 2005. The donation of cord blood may not be available in all areas, however the opportunity to donate is becoming more available. Several local cord blood banks across the United States are now accepting donations from within their own states. The cord blood bank will not charge the donor for the donation, but the OB/GYN may still charge a collection fee of $100-$250, which is usually not covered by insurance. However, many OB/GYNs choose to donate their time.

"According to research in the Journal of Pediatric Hematology/Oncology (1997, 19:3, 183-187), the odds that a child will need to use his or her own stem cells by age twenty-one for current treatments are about 1:2,700, and the odds that a family member would need to use those cells are about 1:1,400."

In 2005, University of Toronto researcher Peter Zandstra developed a method to increase the yield of cord blood stem cells to enable their use in treating adults as well as children.

Usage
When cryopreserved cord blood is needed, it is thawed, washed of the cryoprotectant, and injected through a vein of the patient. This kind of treatment, where the stem cells are collected from another donor, is called allogeneic treatment. When the cells are collected from the same patient on whom they will be used, it is called autologous and when collected from identical individuals, it is referred to as syngeneic. Xenogeneic transfer of cells (between different species) is very underdeveloped and is said to have little research potential.

Diseases treated with cord blood
Beginning in the late 1980s, cord blood stem cells have been used to treat a number of blood and immune-sytem related genetic diseases, cancers, and disorders. Because of medical issues around using one's own cells, in nearly every instance the treatments are done using cells from another donor, with the vast majority being unrelated donors.

The principal diseases and disorders currently treated are listed at the National Donor Marrow Program website.

How are umbilical cord stem cells obtained?

Stem cells also may be retrieved from umbilical cord blood. For this to occur, the mother must contact a cord blood bank before the baby’s birth. The cord blood bank may request that she complete a questionnaire and give a small blood sample.

Cord blood banks may be public or commercial. Public cord blood banks accept donations of cord blood and may provide the donated stem cells to another matched individual in their network. In contrast, commercial cord blood banks will store the cord blood for the family, in case it is needed later for the child or another family member.

After the baby is born and the umbilical cord has been cut, blood is retrieved from the umbilical cord and placenta. This process poses minimal health risk to the mother or the child. If the mother agrees, the umbilical cord blood is processed and frozen for storage by the cord blood bank. Only a small amount of blood can be retrieved from the umbilical cord and placenta, so the collected stem cells are typically used for children or small adults.

General

 * The March of Dimes - Umbilical Cord Blood
 * National Marrow Donor Program &mdash; Details on umbilical cord blood donation
 * National Cord Blood Program &mdash; Cord Blood Q&A
 * GentleBirth.org &mdash; Umbilical cord issues
 * Parents Guide to Cord Blood
 * Babies for Life Foundation &mdash; Public cord blood donation and education
 * Cryobanks International &mdash; Accepts collections throughout the USA
 * Alberta Cord Blood Bank &mdash; accepts collections throughout Canada
 * Cells Limited &mdash; Research, Processing & Storage of Stem Cells. Cord Blood & Bone Marrow Stem Cells

Diseases treated with cord blood

 * National Cord Blood Program &mdash; Frequency of patients transplanted with cord blood by disease
 * Cord Blood Center &mdash; The list of diseases treated with haematopoietic cells transplantation, including autologous cord blood, cord blood from a sibling, autologous bone marrow, and bone marrow from a donor

Clinical Trials

 * Clinical Trials.gov - Umbilical Cord Blood and Placental Blood Transplantation in Treating Patients With Hematologic Cancer or Aplastic Anemia