Donating Your Baby's Cord Blood

What is cord blood donation?

Cord blood donation is a way for you to preserve the potentially lifesaving stem cells found in the blood of your newborn's umbilical cord and placenta in a public cord blood bank for the public good — in other words, for anyone who needs it. (To preserve your child's cord blood for your own family's use, you can pay to store it in a private bank.)

Cord blood stem cells can be used as an alternative to bone marrow to treat some cancers, blood diseases, and inherited disorders such as sickle cell anemia. Donated cord blood is also sold for research. To learn more about its medical uses, see Cord Blood Banking: An Overview.

Donating cord blood to a public bank is free, safe, and painless for you and your child because it's collected after your baby's born and the umbilical cord is cut. And there's a network of public cord stem blood banks that can take your donation.

If your baby's cord blood meets certain requirements, it's placed on a registry where it can be accessed by transplant surgeons to treat patients who need a stem cell transplant and are deemed a good match with your baby's blood. Cord blood that doesn't meet the requirements for transplant is used for medical research.

Why don't more families donate their newborn's cord blood?
It's a combination of the high cost of processing and storing donated blood at public cord blood banks and a lack of awareness about cord blood donation among parents-to-be

It costs a public bank about $1,000 to collect, rigorously test, freeze, and store a single unit of cord blood. With a price tag that high, and the public need for cord blood still relatively low, routine collection of cord blood has been a low priority. .

That's starting to change. A federal law passed in late 2005 set aside $79 million to expand cord blood collection and storage, establish a public cord bank network, and make it easier for doctors to access cord blood units for their patients. And several states are considering legislation to promote cord blood donations.

For the time being, however, "most public banks operate on a shoestring budget," says Mary Halet, cord blood program manager of the National Marrow Donor Program, a nonprofit organization that maintains the largest public listing of umbilical cord blood units available for transplantation in the United States.

"With 4 million births annually, the current system would be overburdened if even one-quarter opted for donation." As a result, most public banks work with a select group of collecting hospitals, so they can manage the volume, Halet says.

That doesn't mean the NMDP, which has facilitated more than 25,000 marrow and blood stem-cell transplants between unrelated people since 1987, doesn't welcome donations. But it can only accept them from participating banks and hospitals. The NMDP is particularly interested in cord blood donations from families whose children are not Caucasian.

Patients who need a stem cell transplant are more likely to find a matched cord blood unit in their own ethnic group, but not enough cord blood units have been collected from people in racial minority groups, says the NMDP. According to July 2003 figures, a Caucasian patient has an 88 percent chance of finding a matching donor on the NMDP registry, while an African American's chance is only 58 percent.

I want to donate my cord blood — how do I get started?
Ideally you're no more than 34 weeks pregnant — before 34 weeks is when most public cord blood banks and hospitals like to begin working with expectant moms. They need several weeks before your baby's due to process your paperwork and arrange for collection and processing of your cord blood.

If you're past 34 weeks and there's a public bank or collecting hospital in your area, call to discuss your specific case and options. You should also discuss your desire to collect and donate your baby's cord blood with your healthcare provider, and make sure that provider knows how to harvest cord blood.

Next, check to see whether the hospital where you plan to deliver your baby is on the NMDP list of affiliated collecting hospitals. If it is, call the public bank that serves it (the contact number is listed beside the hospital name) to begin the process.

You can also check the NMDP's list of nonparticipating banks. These banks maintain their own cord blood registries rather than listing their units on the NMDP national list, and they have a wider network of collecting hospitals.

If one of these banks is in your area, contact it to find out whether you can make a donation. This list includes prestigious organizations such as the New York Blood Center, which has provided nearly a third of the core blood units used for transplants worldwide.

Finally, if you can't find a facility serving your city in these databases, call the NMDP at (800) 627-7692 to see if any new options exist in your area. You can also try local university hospitals to see if they'll accept your donation.

Keep in mind that donating your cord blood to a public bank doesn't guarantee that the blood will be used for transplants. Ask the public bank you're considering whether it sells any cord blood units for research purposes. See below for more information on for-profit public banks.

Will I be screened before I can donate?
Yes, the public cord blood bank will ask you to complete a consent form and a health questionnaire. You'll also need to provide a small sample of your blood to be screened for infectious diseases.

Under certain conditions, you won't be able to donate your baby's cord blood. If you're expecting twins, for instance, most public banks will reject you because typically not enough stem cells are recovered from twin pregnancies to facilitate a successful transplant.

Other conditions that are likely to keep you from donating include most cancers, most cases of medication-dependent diabetes (but not necessarily gestational diabetes), hepatitis or a history of hepatitis, HIV/AIDS, and being the recipient of an organ or tissue transplant. If you're at risk for HIV/AIDS or have had a tattoo in the last 12 months, you'll also be rejected.

Public cord blood banks also evaluate any history of sexually transmitted infections and the circumstances and timing of any ear, skin, or body piercings. You'll be required to take an HIV test.

How is the blood collected, and what happens to it afterward?
Your baby's umbilical cord blood is collected shortly after you deliver. Your doctor or nurse clamps the umbilical cord and cuts it (your partner can do the cutting if you prefer), and then drains the blood from the cord and placenta into a storage bag or vials. (See a slide show of a collection procedure provided by LifebankUSA, a private cord blood bank.)

Most umbilical cords yield 3 to 5 ounces of blood. If your baby's cord produces less than that, the blood may be used for research purposes.

Next, the blood goes to a lab, where it's tested to see how many cells it contains and for its HLA-tissue type. This is a set of six antigens (substances that cause immune responses in the body) used to match your cord blood with patients needing transplants. The cord blood is also tested for bacterial or fungal contamination.

As required by U.S. law, donated blood is tested for certain infectious diseases such as AIDS — and depending on the bank, other tests may be performed as well. The details should be spelled out in the paperwork you sign. But in any case, be sure to inquire about confidentiality and find out exactly what the bank that's receiving your donation will test for and how you'll be informed (and who else will be informed) if the tests uncover anything that's unusual or might affect your child's health.

Once testing is complete and the cord blood meets the bank's criteria, it's stored in a liquid nitrogen freezer until someone needs a transplant. The storage life of cord blood is still unknown, but a 2003 study showed that 90 percent of the stem cells recovered from cord blood stored for 15 years (the oldest blood available) were still viable.

Should I avoid for-profit public banks, and how can I spot one?
If you're donating your child's cord blood in the hope that a sick child will receive it for a transplant, you might want to avoid these types of banks, says Frances Verter, an independent volunteer researcher of cord blood facilities and a founding board member of the Umbilical Cord Blood Education Alliance. But if your main goal is to donate the blood for the general public good, including medical research, this may not be a problem.

Like nonprofit public cord blood banks, for-profit banks accept donations for free, says Verter. Both types of banks also sell cord blood for research purposes. What's different is that for-profit banks expect to make a profit from these sales, while nonprofit banks aim to cover their operating expenses. Selling cord blood to researchers for a profit is not illegal in the United States.

It can be tough to spot a for-profit public cord blood bank. Ask if the company operating the bank is registered as a nonprofit or for-profit organization and read a copy of the informed consent form provided by the public bank. This form should stipulate whether cord blood units can be sold for research.

If I donate my baby's cord blood and I change my mind, can I get it back?
If the cord blood hasn't been used for a transplant or research, the answer is "probably." According to the Cord Blood Donor Foundation in San Bruno, California, if you requested your child's cord blood for someone in your family, or if your child developed one of the conditions that can be treated with cord blood, the foundation would try to locate it. If the unit turned out to be a good match for the person needing the transplant, the foundation would release it and charge the cost to the patient's health insurer.

StemCyte, a cord blood bank with both a public and a private division, has a similar policy. "If the cord blood you donated is the optimal one for a given transplant, it will be available to you unless it has already been used by another person. The likelihood of it having been used is low since only about 1 to 5 percent of banked units are used," says Lawrence D. Petz, StemCyte's chief medical officer.

It's always a good idea to ask the public cord blood bank you're considering about its retrieval policy.

source from http://www.babycenter.com