North Carolina has state legislation around cord blood education that follows the Institute of Medicine guidelines and mandates/encourages physicians to educate expectant parents about ALL forms of cord blood banking. The North Carolina bill was enacted 8 June 2009 and became effective 8 June 2009.
- How does the Institute of Medicine influence cord blood education?
- Congress commissioned an Institute of Medicine study on the ideal structure of a national cord blood
program. Based on the IoM report, Congress passed the Stem Cell Therapeutic and Research Act of 2005 that was signed into law 20 Dec. 2005. The key language regarding education is the requirement: Information provided to the maternal donor regard(s) all of her medically appropriate cord blood options. ie: Education of expectant parents and Informed Consent of maternal donors should cover all options, not just donation.
- How much cord blood is needed for a transplant?
The crucial thing is not the volume of the cord blood collection, but the number of stem cells it contains. Transplant doctors develop recommendations based on the Total Nucleated Cell count, or TNC, because it is the easiest measure to reproduce between different labs. For treating cancer, the transplant dose should be at least 25 million TNC per kilogram of patient body weight (1 kilogram equals 2.2 pounds). The average cord blood collection holds 8.6 million TNC per mL. Thus, the optimal transplant dose requires harvesting:
1.3 mL of cord blood for every pound of patient weight, -or-
2.9 mL of cord blood for every kg of patient weight
However, as more transplant centers are adopting the practice of giving adult patients "double cord blood transplants" with two cord blood units, it is less critical for both units to have adequate cell dose.
Reed, W et al., Blood 2003;101(1):351
Barker, JN et al., Blood 2005;105:1343-1347
Eapen, M et al. Lancet 2007;369:1947-54
Rocha & Gluckman Brit. J. Haematology 2008;147:262-274
Delaney, C et al., Brit. J. Haematology 2009;147:207-216
Michallet et al. 2010 Blood 2010;116:Abstract#361
- If I donate my baby's cord blood, will that child have free access to cord blood for a transplant?
- No. When a mother signs the Informed Consent to donate cord blood, she gives up any guaranteed access to that blood. The blood may not be banked, and if it is banked, it may be released to some one else. There have been cases where families needed their child's cord blood and got it back from a public bank, but it is important to realize there are no guarantees of access to donated cord blood. Cord blood donors also do not receive guarantees of priority treatment or waived fees if your child later needs a donor. The reward for donating cord blood is the possibility that your baby may Be The Match that saves a life.