ND, United States
North Dakota does not have any state legislation around cord blood education, but their Dept. of Health has officially adopted the educational materials from Parent's Guide to Cord Blood Foundation.
- 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.
- Processing: How is cord blood processed before storage?
The three main components of cord blood, like any blood collection, can be separated by weight: the heaviest layer is the red blood cells (RBC), the lightest is the plasma (a clear white liquid), and in the middle is a pinkish layer called the "buffy coat" which contains the white blood cells (WBC), including stem cells. When banks process the cord blood, the final separated component that goes into storage is the buffy coat, even though only about 1% of the cells are actually stem cells. There is no procedure to separate out the stem cells alone.
The vast majority of blood processing methods rely on the different density of the three main blood components. They can be separated by sedimentation, or by centrifuge, or by a combination of the two techniques. The procedure can be performed manually by trained technicians or by automated machine.
- 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.