What is Public Cord Blood Banking?

Cord blood is the blood that's left in the placenta and umbilical cord after the birth of an infant. It is rich in hematopoietic progenitor cells (HPCs) — a blood-forming stem cell routinely used to treat over 70 diseases, including neural, genetic, blood and immune system disorders. HPCs are also found in peripheral blood and bone marrow. However, unlike other sources, research shows that transplants involving HPCs from umbilical cord blood cells are less likely to cause adverse reactions in the patient in case of a mismatch since the cells are primitive and immature. 

Because of its unique benefits and characteristics in treating diseases, umbilical cord blood is often recovered or collected after birth through a non-invasive procedure that neither affects the mother nor the infant. It is subsequently stored in a blood bank where it's frozen in a cryogenic nitrogen freezer pending a request for patient therapy. Parents who decide to save umbilical cord blood have the option to store it in a private or public cord blood bank. 

Although costly, private cord blood banking is recommended if the infant or their first- or second-degree relative has a medical disorder that may require treatment by stem cells. It is strictly for the family. In contrast, stem cells from public cord blood banks can be accessed by anybody suffering from life-threatening medical disorders. So from the humanitarian perspective, donating to the public cord blood banks can be a great way to support the community and public health initiatives. Your donation can offer a lifeline to someone. 

What is Public Cord Blood Banking?

Public cord blood banking involves donating your infants' umbilical cord blood to a public cord blood bank for processing and subsequent storage until needed by a transplant patient. Public cord blood banks are nonprofit blood repositories funded by the government and private individuals. Everything from collections through processing to the storage of the umbilical cord blood is free — you do not pay any money when you donate.

However, cord blood donation is not possible in every hospital. Suppose you've made up your mind to donate. In that case, you'll need to inquire if your birthing hospital collects umbilical cord blood for public donation. Assuming your birthing hospital is one of the participating hospitals in your state, you need to inform your birthing doctor or midwife roughly three months before your due date. You may also need to contact the public blood bank working with your birthing hospital to understand its procedure and instructions. 

Although various public cord blood banks have different procedures and instructions, generally, you must be healthy and pregnant with a single baby (not twins). Usually, you'll fill out a form that reflects your health history and that of your family. The medical staff of the public cord blood bank will review the form to certify that your blood is disease-free and can be given to another person. Suppose you've had diseases like hepatitis B, hepatitis C or HIV that transmit through blood. In that case, you may not be allowed to donate. Having other health conditions may not be a reason for disqualification. The bank staff will let you know either way. 

You may also need to provide information about your expected delivery type — vaginal or C-section delivery. Subsequently, you fill out a consent form stating that the donated cord blood can be used by anyone who needs it for medical reasons, research purposes, or both. Some banks may require you to send the consent form alongside the health history via mail. Others may want you to bring the original form to your birthing hospital or to fill it therein. Either way, you'll be instructed accordingly by the public cord blood bank. Remember, however, to keep a copy of the consent form. 

Once the paperwork is completed, you're good to go. The actual process takes less than 5 minutes on D-day. Immediately after delivery, your OB-GYN clamps and cuts the umbilical cord. At the same time, an assistant extracts some blood from the cord using a needle. The blood is placed in a designated sterile bag inside a kit where the required oxygen, pH and carbon monoxide levels depend on time and external conditions. Subsequently, it is sent via a courier, or the public cord blood bank sends their team to pick it up for processing and storage. It's as simple as that and costs $0.00. Public umbilical cord blood bank provides you with a hands-off approach to supporting the community and the public. 

Compare Cord Blood Banks

Why Choose Public Cord Blood Banking?

Many reasons make donating to a public cord blood bank beneficial. Public cord banks charge zero fees. Unlike private cord blood banks that charge wide-ranging fees, you do not pay any money when donating to a public bank. For instance, the collection and processing fees for private cord blood banks average $2,000 or more in addition to storage and maintenance fees of over $125 annually, according to the American Academy of Pediatrics (AAP). 

Most people argue that cord blood donated to the public bank isn't accessible to the child or their relatives when they suffer a disorder that needs a transplant in the future. However, in some cases, such stem cells are accessible. Some public cord blood banks offer siblings-directed donation programs that allow you to designate your donated infant's blood for use by their siblings. However, the sibling must be diagnosed with a disorder where a cord blood transplant is the standard treatment. 

There's a widespread belief that the stem cell from an infant's cord blood stored in a private bank helps treat the child if they develop leukemia much later in life. However, scientific research shows that for such a child, their stem cells most likely contain pre-malignant leukemia cells from infancy. The implication is that leukemia may reappear later when they're treated with the stem cell.

Being a nonprofit institution serving the general public, public cord blood banks are subject to the highest regulatory oversight and quality control. Various external accreditation agencies work to ensure that the preparation of stem cells from public cord blood banks follows strict adherence to policy and regulatory guidelines. These guarantees ensure that the best and purest quality of stem cells is produced. And as such, it is the recommended or preferred type of bank for most medical professional bodies, including the American Medical Association (AMA) and the AAP.

There's also a question of underutilization. An infant's cord blood stored in a private bank may not be put to use since the chances of a disorder arising that may require it in a family is about 1 in 1,000. When stored in a public bank, cord blood is 30 times more likely to be used by as many people in the pipeline are looking for a matching donor. So there's a higher probability that your infant's stem cell will match one of the numerous donors whose life may depend on it. Donating to a public bank is also a great way of supporting the community and public health. That's a noble thing to do. By donating your infant's blood to a public cord blood bank, you're delivering hope to transplant patients out there, giving them a second shot at life. And that's a heroic feat for you and your little one.

What is Cord Blood Used for?

As a highly enriched stem cell source, umbilical cord blood is beneficial in treating various immune disorders, genetic deficiencies and blood malignancies. With a current global birth rate of 17.668 per 1,000 persons, cord blood might be the most bountiful cell reservoir with regenerative potential for many clinical applications. Nevertheless, cord blood's field of application is still expanding as scientists try to unravel its application outside the spectrum of medicine. Two primary use cases are regenerative medicine and transplant medicine. Here’s a look at some of the uses.

Regenerative Medicine 

Regenerative medicine aims to heal or replace organs and tissues damaged by disease, trauma and age and normalize congenital disabilities. Unlike in transplants where stem cells from the cord blood are used to rebuild a new healthy immune system and blood damaged by diseases, in regenerative medicine, the stem cell is infused to help stimulate the body's repair system. A current use case is in the treatment of autism and cerebral palsy. However, this research is still in the clinical stage.

Transplant Medicine 

Although cord blood contains diverse stem cells, its dominant stem cell — hematopoietic stem cells (HSCs) — are the primary blood-forming cells making up human blood and immune systems. These cells can grow into either of the three blood cells — red blood cells (or erythrocytes), white blood cells (or leukocytes) and platelets (or thrombocytes). When used in transplants, HSCs help to rebuild new a healthy blood and immune system in the patient that needs it from its inherent ability to grow into a new cell. 

For instance, in treating cancer, many normal blood cells are destroyed through chemo or radiation therapy while destroying the cancerous cells. Stem cells can re-grow or replace cells destroyed by cancer or its treatment. As of today, stem cells have proven effective in treating nearly 80 medical conditions, including blood disorders, various cancers, metabolic disorders and immune disorders.

There's often confusion regarding who can use the infant's stem cell from the cord blood for treatment — the infants or their siblings? Both the infant and siblings can use it. The infant can use it for certain non-genetic diseases like autism, neuroblastoma and cerebral palsy, where research is still ongoing. Aside from being primitive and devoid of infections, it provides the infant with an exact match of the vital human leukocyte antigen (HLA). A sibling with a medical disorder requiring a stem cell transplant can also use it. A perfect HLA is not needed in this situation. Treatment using cord blood from family members has more potential for success than otherwise.

Umbilical cord blood offers families immature and non-contaminated stem cells that can be used to treat varieties of diseases both for the siblings and the infant.

Can You Do Public and Private Cord Blood Banking?

Public banking is the most endorsed by various professional bodies and organizations in the health industry because of its holistic screening and processing procedures. Private cord blood banking is nevertheless a great option, especially if your family has a long history of medical disorders that may require a stem cell transplant or if you're aware of any relative to your child (first or second-degree) that may need it in the future.

In this situation, it might be a good idea to inquire first whether the public bank your birthing hospital collects for offers a sibling-directed donation program. If it does, then absolutely go for it since it costs nothing, and you're guaranteed to get the purest and most viable stem cell. You can leverage the private bank if the public bank your birthing hospital collects for doesn't offer a sibling-directed donation. 

That's if you can afford the cost, though. However, the best idea is to go for both. Since you'll end up paying only for the private bank, a little bit of selfless humanity can go a long way. So while banking for your family privately, you can save a life by equally banking publicly. That way, you support the community's health. Speak to a trusted health professional or consultant before making a decision.

Frequently Asked Questions