Frequently Asked Questions

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Do I need to store the cord blood in the country where I plan to use it?
No.  First, you must store blood in a lab that is permitted by the regulations of the country where you will give birth.  Second, you should store cord blood in a lab that can receive and process the collection within 48 hours of birth.  After cord blood is collected at birth, the stem cells start to die while the blood is waiting to be processed and frozen.  The quicker it gets to the lab the better.  By comparison, if you ever need the cord blood for therapy, it will be shipped in a vessel that keeps it frozen.  When cord blood is released for therapy can travel to the other side of the world with no loss of viability, because it travels frozen.  It is only thawed at the clinic where it will be used. 
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If I banked privately for one child, do I need to do it for additional children?
All the reasons that you banked for the first child are still valid for additional children. 
1. If you want the baby to have the option of using his/her own cells, then you need to bank them. 
2. If you are banking to cover siblings, then the ability to use cord blood from one child for another depends on whether they have matching HLA type.  Two full siblings have a 25% chance of being a perfect match, a 50% chance of being a half match, and a 25% chance of not matching at all.  For a cord blood transplant, donor and patient must match at 4 out of 6 (67%) HLA types.  The more siblings with banked cord blood, the more chance that they cover each other for possible transplants or other therapies for which sibling stem cells are accepted.

References:
Odds of sibling match are based on haplotype inheritence: that the child will receive 3 HLA types as a group from each parent.
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Recommendations from Parent's Guide to Cord Blood
  • Educate expectant parents about all their options for cord blood (Education)
  • Choose a family bank that meets all your national and local regulations, plus has been inspected by an accreditation agency (Lab Standards)
  • Choose a family bank that uses a specialized courier to transport cord blood (Find a Family Bank), or in some countries the family can hire a specialized courier directly (Shipping & Handling).
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What are the most important considerations in picking a family bank?
1. Nationality - You must follow the national regulations of the country where you will give birth.
2. Travel conditions - It is best to pick a bank that can receive and process the cord blood within 48 hours of birth.  It is also best for the cord blood to be shipped in a transport container that will maintain it at close to "room temperature". 
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What questions should parents ask a Family Bank about collecting cord blood?
  • What instructional tools are provided for the physician and delivery staff?
  • Will the cord blood company actively contact the labor and delivery staff for you -- or are parents responsible for keeping them informed and coordinated?  
  •  What collection method do they use: gravity drip or blood draw?
  • Is the collection blood bag sterile, both inside and out, so that it can be used in the operating room for a C-section?
  • Do they provide the option of collecting additional stem cells from the placenta or tissue of the umbilical cord?
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What questions should parents ask a Family Bank about Company Stability?
  • Is the family cord blood bank a publicly-held or privately-held company? 
  • Is the company affiliated with a hospital or research institution? 
  • Is the company involved in bio-technology research and development?
  • What other medical services does the company perform?
  • How long has the company been banking cord blood? 
  • Who directs the day-to-day business of the company?  Many cord blood banks have famous doctors on their Board of Directors; but they are not involved with the day-to-day operations.
  • What is the lab inventory of cord blood collections, both public and private?  This speaks to their staff's experience with storing cord blood.
  • How many cord blood collections has the bank released from their own lab for therapy?  This speaks to their staff's experience with releasing cord blood.
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What questions should parents ask a Family Bank about Laboratory Standards?
  • Is the cord blood laboratory accredited by an agency that has specific standards for cord blood banks and conducts inspections? (ex: AABB, FACT, ISO)
  • Some US states license cord blood banks (CA, MD, NJ, NY): Do they operate in those states?  Note that the California Biologics License is based on AABB accreditation, but lags behind the latest AABB updates.
  • Does the lab process cord blood around the clock, or only on selected shifts?
  • What tests does the lab perform on maternal blood?  
  • What tests does the lab perform for infectious disease markers?
  • What tests does the lab perform for contamination?
  • Does the lab ever reject cord blood collections on the basis of the tests of maternal blood, infectious diseases, or contamination? 
  • Does the lab maintain a "quarantine tank" for the storage of blood that might be able to transmit an infection?
  • What tests does the lab perform to measure the stem cell count of the processed cord blood and the stem cell viability?
  • Does the lab/bank inform parents, prior to storage, if the collection is too small for a transplant, and give them the option not to save it?
  • Does the lab/bank offer parents a refund if the cord blood collection has certain problems (contamination, low volume)?  These refunds are typically only offered if the bank performed the collection as part of their service.
  • What information will parents receive in the final report about their stored cord blood?
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What questions should parents ask a Family Bank about Prices?
  • Is the enrollment fee charged once per family, or for each birth?
  • Is the first year of storage included in the processing fee?
  • Is the storage fee guaranteed fixed?
  • Are there any coupons currently available?  Most banks are constantly running a "special limited time offer".
  • Are there any professional discounts?  Most banks offer discounts to medical professionals and military personnel.  Some banks have discounts for first responders or students.  It pays to shop for these deals.
  • Do parents have the option of a partial or full refund if they decide not to store the cord blood for any reason?  For example, if the lab tests show contamination and the cord blood should not be saved, what happens?  Full refunds are typically only offered in situations where the bank provided staff to perform the collection service.
  • Should the family ever need the cord blood, check that the bank does not charge to release it.
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What questions should parents ask a Family Bank about Shipping & Handling?
  • Is the cost of shipping included in the contract? 
  • Does the shipping company offer bed-side pick-up?  
  • On weekends, are the laboratory staff in-house or on-call?
  • Does the bank guarantee to get the blood to the lab and processed within a certain time window?
  • Does the shipping container have a temperature logger?
  • If the bank uses a courier, does the courier have possession of the cord blood throughout transit?  (ie: Does the courier sub-contract to another shipping company that is not a medical courier)? 
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Why is it important to choose a Family Bank that is accredited?
The Parent's Guide to Cord Blood Foundation recommends that parents select a Family Bank whose laboratory has been inspected and accredited by an accreditation agency specific to cord blood banking, as this provides a degree of quality assurance.

In some countries, national regulations hold Family Banks to the same standards as Public Banks, so an independent accreditation is not necessary (Examples: Germany, Israel).  But in most countries the federal requirements for Family Banks are not as strict as Public Banks, and then a voluntary accreditation is desirable.  For example, in the United States the FDA registers and inspects Family banks, but does not require them to have a BLA License like Public Banks. 

Caveat: The process of registering with an accreditation agency and getting inspected can take a year, so it is understandable if a brand new lab does not have an accreditation yet.
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Will my delivery hospital allow me to use any family bank?
In the US, the answer to this question is almost always YES.  However... a handful of hospitals have signed exclusive contracts requiring their patients to use certain family banks, so it is best to check in advance. 

Those hospitals who have made exclusive partnerships will argue that it improves their level of care, because their staff train with and stock the collection kits for the banks they have approved.  The hospital probably has a financial incentive too.  However, for parents it means a lack of consumer choice.
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What questions should parents ask a Family Bank about the Storage Facility?
  • What type of records do parents receive after storage?  
  • Does your contract state that the storage fee is fixed, or may it increase later?  
  • Does the bank reserve the right, in your contract, to change storage facilities?
  • Does the bank operate their own storage facility, or is it provided by another laboratory? 
  • What type of accreditation or other certifications does the storage facility carry?  In most banks the cord blood is stored in the lab where it was processed, and the accreditation of the lab covers the storage conditions.
  • What is the geographic location of the storage facility: Is it at risk for hurricanes, earthquakes, or other natural disasters?
  • What type of back-up systems does the storage facility have in case of power failure?
  • What type of security systems does the storage facility have?