Washington 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 Washington bill was enacted 18 Mar. 2008 and became effective 1 July 2010.
- 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.
- What is HLA Type and how is it used?
The term "HLA" is short for Human Leukocyte Antigens, and these are proteins in the immune system that determine whether a patient will react against a donor transplant. A very good basic tutorial about HLA types is on the Stanford Website, and the national Be The Match program (aka NMDP) has more info on the role of HLA type in transplants of stem cells from bone marrow or cord blood.
Briefly, there are 6 HLA types that are important for stem cell transplants: in a bone marrow transplant the patient and donor must match at all 6 (100% match), whereas a cord blood transplant is just as effective at curing patients with only a 4 out of 6 match (67% match) between donor and patient. This is the reason that donations to the national cord blood inventory managed by NMDP are so important to help patients who come from minority or mixed racial backgrounds.
The HLA type of cord blood is always measured by public banks, and then the type is listed on a registry that can be searched by patients seeking a transplant. Family banks typically do not measure the HLA type at the time of banking, because it is an expensive lab test and and can always be checked later from a testing segment of the stored cells.
- Who is able to donate cord blood?
In theory, any expectant mother who passes the medical screening is eligible to donate. In practice, the biggest hurdle faced by families who wish to donate is finding a bank to accept their donation. There are only about 200 hospitals in the US that collect cord blood donations from births, and most of them require you to register for donation weeks ahead of the birth. The handful of programs that accept mail-in donations are opening this opportunity to the rest of the American public.