How Donating Cord Blood Contributes to Medical Research and Saves Lives

The decision to save a newborn's cord blood, a source of stem cells that could potentially save lives, is one of the most important choices new parents can make. Cord blood, which is collected from the umbilical cord after childbirth, is rich in hematopoietic stem cells that can develop into various types of blood cells. These cells are invaluable in treating a variety of diseases, including leukemia, lymphoma, and certain inherited metabolic disorders. However, an emerging trend and recommendation among healthcare professionals is not just to save the cord blood but also to consider donating it to public cord blood banks. This approach serves both a personal and societal benefit by supporting a valuable medical resource that could save many lives.

What is Cord Blood, and Why is it Valuable?

Cord blood is the blood that remains in the umbilical cord and placenta following the birth of a baby. Unlike peripheral blood, cord blood is an abundant source of hematopoietic stem cells (HSCs). These cells are precursors to all types of blood cells, including red blood cells, white blood cells, and platelets. This unique property allows cord blood stem cells to be used in regenerative medicine, specifically in bone marrow transplants and treatments for various hematological diseases and immune disorders.

Cord blood is particularly valuable because it is:

1. Easily Accessible: Cord blood is collected after delivery without any risk or pain to the mother or baby. The collection process is simple and non-invasive.
2. Rich in Stem Cells: It is a potent source of HSCs, which are less mature and more adaptable than stem cells derived from bone marrow or peripheral blood.
3. Lower Risk of Graft-Versus-Host Disease (GVHD): Cord blood transplants are less likely to cause GVHD, a condition where the donated cells attack the recipient's body, compared to other sources of stem cells.
4. Diverse Applications: It is used to treat more than 80 diseases, including various forms of leukemia, anemia, metabolic disorders, and immune deficiencies. Research is ongoing to explore its potential in treating conditions like cerebral palsy, autism, and type 1 diabetes.

Public vs. Private Cord Blood Banking: Understanding the Options

There are two primary options when it comes to cord blood banking: private banking and public donation.

• Private Cord Blood Banking: This involves storing cord blood for personal or family use. Parents pay an annual fee to keep the cord blood reserved in a private bank, which ensures that it is available should a family member need it. However, the likelihood of using privately banked cord blood is relatively low, estimated at 1 in 2,700 to 1 in 200,000 by various studies.
• Public Cord Blood Banking: In contrast, public cord blood banks collect and store donated cord blood for use by anyone who may need a stem cell transplant. Donated cord blood is available to any patient worldwide and is especially useful for patients who lack a matching bone marrow donor.

Donating to a public cord blood bank is a charitable act that has the potential to save lives. It increases the chances for patients who are searching for a match, especially among ethnic minorities who are underrepresented in donor registries.

Why Donate Cord Blood to Public Banks?

There are several compelling reasons why parents should consider donating their baby's cord blood to public banks:

1. Contribute to a Life-Saving Resource: Donated cord blood has been used in thousands of successful transplants globally. With public cord blood banks, the donations are available to any patient in need, regardless of nationality or background.
2. Expand Treatment Options for Patients: A more diverse and extensive cord blood bank increases the likelihood of finding a match for patients with specific genetic backgrounds. This diversity is essential because finding an exact match is more challenging among certain ethnic groups.
3. Reduce the Risk of Graft-Versus-Host Disease (GVHD): The stem cells in cord blood are less mature, leading to a lower risk of GVHD. This advantage is particularly crucial for unrelated donor transplants, where the risk of complications is generally higher.
4. Support Ongoing Research: Cord blood donations are also essential for advancing medical research. Researchers are investigating the use of cord blood stem cells in regenerative medicine, which includes treatments for conditions such as cerebral palsy, diabetes, and even spinal cord injuries.
5. Unused Cord Blood Goes to Waste Otherwise: If cord blood is neither stored in a private bank nor donated, it is usually discarded as medical waste. Donating to a public bank ensures that this valuable resource is not wasted.

Ethical Considerations and Social Responsibility

While private banking may provide a sense of security for some families, the chances of actually needing that specific cord blood are low. On the other hand, donating to a public cord blood bank can save lives. In some cases, private banks may use fear-based marketing tactics to convince parents to store their baby's cord blood. However, from a societal and ethical standpoint, public donation represents a more altruistic choice.

Healthcare professionals often advocate for public banking due to its broader societal impact. Public donation allows the benefits of stem cell therapy to reach a more extensive network of patients. This approach is especially crucial in the context of limited healthcare resources and disparities in access to advanced treatments.

The Process of Donating Cord Blood to Public Banks

For parents interested in donating their baby's cord blood, the process is straightforward and typically involves the following steps:

1. Pre-Delivery Registration: Parents need to register with a public cord blood bank well before delivery, usually around the 28th to 34th week of pregnancy.
2. Health Screening: A thorough medical history of both parents is taken to ensure that the donated cord blood is safe for use.
3. Collection at Birth: After the baby is born and the umbilical cord is clamped and cut, the remaining blood in the cord is collected in a sterile collection bag. This procedure is quick, painless, and does not interfere with the birthing process.
4. Testing and Storage: The collected cord blood is then tested for any infections or genetic abnormalities. If it meets all the criteria, it is processed and stored in cryogenic conditions at the cord blood bank.
5. Availability for Transplants and Research: Once stored, the cord blood becomes available for patients in need of a stem cell transplant or for use in research.

Why Some Parents Still Opt for Private Banking

Despite the advantages of public donation, some parents still choose private banking. The primary reason is the perceived insurance policy that private storage offers. For families with a history of certain diseases or genetic conditions that might benefit from stem cell therapy, private banking might appear as a precautionary measure. However, it is essential for parents to make an informed decision, understanding that the chances of using privately banked cord blood are low. Moreover, many diseases that could potentially be treated with cord blood stem cells may already have underlying genetic mutations that render the baby's own cord blood less effective.

Cost Considerations: Public Donation vs. Private Storage

The cost is another significant factor in the decision-making process. Public cord blood donation is generally free for parents, as public banks are usually funded by governments or non-profit organizations. In contrast, private cord blood banking involves an initial processing fee, which can range from $1,000 to $2,000, along with annual storage fees of around $100 to $200. This cost can add up over time, especially considering the low probability of needing the cord blood for personal use.

Conclusion: A Call to Action for Healthcare Professionals

Healthcare professionals play a pivotal role in guiding expectant parents in making an informed decision about cord blood banking. While private banking may seem appealing for its "insurance" value, the broader societal benefits of public donation cannot be overlooked. By donating to a public cord blood bank, parents contribute to a life-saving resource that can benefit countless patients worldwide.

Encouraging public donation helps create a diverse and robust stem cell registry, supporting both immediate medical needs and future research opportunities. As awareness grows, the hope is that more parents will see the value in giving away their baby's cord blood — a decision that extends beyond their family to impact countless others in need.

For more information, please visit the Harvard Health Blog article on this topic: https://www.health.harvard.edu/blog...abys-cord-blood-and-give-it-away-201710312518.