Cord Blood Banking: Deciding About Public or Private Donations

Cord blood banking can be a priceless investment.

After birth, your baby no longer needs the umbilical cord or placenta. But the blood that remains could be a lifesaver for a patient who needs it, including a member of your own family. That's because this blood is rich with blood-forming stem cells. As with bone marrow transplants, these cells can be transplanted and help save the lives of patients with leukemia or other life-threatening diseases.

Should you consider donating your infant's cord blood to a public bank? Or should you bank it for your own family's use? Here is information that may help you decide.

What You Should Know About Public Cord Blood Banking

If you make a donation to a public cord blood bank, you can't reserve it for your family, so it may not be available for your future use. Both the American Academy of Pediatrics (AAP) and American Medical Association (AMA) recommend public cord blood banking over private cord blood banking. Here's why:

  • Public cord blood banking is free.
  • Public cord blood banking makes stem cells available to anyone who needs them.
  • Public cord blood donation will increase the number and diversity of cord blood units available for patients. Widespread donations by minorities will expand the available pool of minority cord blood units in the public system and make it easier for the following groups to find matches:
    • American Indians and Alaska Natives
    • Asians
    • African-Americans
    • Hispanics
    • Native Hawaiians and Pacific Islanders
    • People who are multiracial

If you choose to donate cord blood for public use, you should be aware that the blood will be tested for both genetic abnormalities and infectious diseases. If any are found, someone will notify you.

What You Should Know About Private Cord Blood Banking

The American College of Obstetricians and Gynecologists (ACOG) neither recommends nor advises against cord blood banking. But along with the AAP and AMA, it cautions parents about private cord blood banking. Here's why:

  • Collection and storage costs at private cord blood banks are high.
  • Other effective treatments may be available that are less expensive.
  • The chance of privately banked cord blood being used by your child is extremely low.
  • Stem cell transplant using an individual’s own cord blood (called an autologous transplant) cannot be used for genetic disorders such as sickle cell disease and thalassemia, because the genetic mutations which cause these disorders are present in the baby's cord blood. Other diseases that are treated with stem cell transplant, such as leukemia, may also already be present in a baby’s cord blood.

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Because of these limitations and the uncommon occurrence of the diseases treatable with stem cell transplant, there have been just more than 400 autologous cord blood transplants in United States in the last two decades. In contrast, more than 60,000 unrelated donor cord blood transplants have been performed worldwide.

In short, the AAP and the AMA recommend against storing cord blood as a form of "biological insurance," because the benefits are too remote to justify the costs.

Are there situations where private cord blood banking might make sense? Some parents choose to bank their child's blood if they don't know his or her medical background -- for instance, if a parent was adopted or the child was conceived with a sperm or egg donor.

The AAP does recommend cord blood banking if an infant has a full sibling with a malignant or genetic condition treatable with cord blood transplantation. These conditions include :

Even so, a brother or a sister has only a 25% chance of being a perfect genetic match. Thus, a sibling may require a bone marrow or cord blood transplant from a unrelated donor.

The AMA also suggests considering private cord blood banking if there is a family history of malignant or genetic conditions that might benefit from cord blood stem cells. Keep in mind, however, that to find a suitable match for any type of transplant, 70% must look outside their family.

What the Future Holds

No one knows how stem cells will be used in the future, but researchers hope that they may be used to treat many conditions, like Alzheimer's, diabetes, heart failure, spinal cord damage, and other conditions.

It's possible that storing your child's cord blood cells now may be useful one day in combating these diseases. For now, these treatments are only theoretical. It's also not clear if stem cells from cord blood -- as opposed to stem cells from other sources -- will be useful in these potential treatments.

WebMD Medical Reference Reviewed by Trina Pagano, MD on September 16, 2014

Sources

SOURCES:

Arthur Caplan, PhD, chairman, department of medical ethics, director, Center for Bioethics, University of Pennsylvania.

Jeffrey Ecker, MD, high-risk obstetrician, Massachusetts General Hospital; assistant professor of obstetrics, gynecology, and reproductive biology, Harvard Medical School.

Stephen Feig, MD, professor of pediatrics, UCLA.

Ecker, J. and Greene, M. Obstetrics and Gynecology, June 2005; vol 105: pp 1-3.

Rottman, G. Pediatrics, 1997; vol 99: pp 475-476.

Rogers I. and Casher, R. Human Reproduction Update, 2003; vol 9: pp 25-33.

National Marrow Donor Program web site.

American College of Obstetricians and Gynecologists web site.

National Academy of Sciences web site.

National Cord Blood Program Website

National Library of Medicine

WebMD Medical Reference from Healthwise: "Umbilical Cord Blood Stem Cells."

Pediatrics, January, 2007; vol 119 no 1: pp 165-170.

American Medical Association web site.

Parent's Guide to Cord Blood Foundation web site.

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