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.
- How much blood and stem cells does a typical umbilical cord hold?
The median size of cord blood collections in family banks is 60mL or 2 ounces. That small volume of liquid corresponds to 470 million Total Nucleated Cells (TNC) or 1.8 million cells that test positive for the stem cell marker CD34. Thus, most healthy full-term babies have over a million blood-forming stem cells in their umbilical cord blood. By comparison, most public cord blood banks will only keep collections that are much bigger than average, and throw out the donations that are below a threshold of a billion TNC, corresponding to a blood volume of about 90-100 mL or 3 ounces.
Sun, JJ et al., Transfusion Sept. 2010; 50(9):1980-1987
- 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.
- Once we have stored cord blood for our family, how long should we keep it?
- Indefinitely. From an economic perspective, it does not make sense to invest in the up-front processing fee and pay for years of annual storage, and then throw out the investment. That would be like buying life insurance and then cancelling it because you have not died yet. Especially given that the probability of some one in the immediate family needing a transplant increases with age. Even if the cord blood collection was small, and the child becomes too large to use it for a transplant, it could still be enough cells for a regenerative medicine therapy. The science of cryobiology tells us that cells which are cryogenically preserved remain viable for decades. It has been confirmed that cord blood stem cells were still viable after being frozen 23+ years.
Broxmeyer, H.E. Cell Stem Cell 2010; 6(1):21-24
Mazur, P. Science 1970; 168(3934):939-949
Nietfeld, J.J. et al. BBMT 2008; 14:316-322