New York has state legislation around cord blood education that follows the Institute of Medicine guidelines and asks (but does not mandate) physicians to educate expectant parents about ALL forms of cord blood banking. The New York bill was enacted 7 Aug. 2007 and became effective 7 Feb. 2008.
- 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.
Odds of sibling match are based on haplotype inheritence: that the child will receive 3 HLA types as a group from each parent.
- How is cord blood collected?
It literally only takes minutes to save the stem cells in cord blood. Once the cord is clamped, the cord is wiped with antiseptic and a needle is inserted into one of the veins in the umbilical cord to withdraw a few ounces of blood.
There are two methods of collection in common use. One is to hang a blood bag lower than the mother and let gravity draw blood down the tube into the bag. This method is used in most countries of the world, because it has the fewest steps, and therefore the fewest opportunities for mistakes or contamination.
The second method is to actively draw the blood out, just like when a person has a blood draw for a medical test. The draw can be done with a standard syringe or with a bulb in the bag tubing that creates suction. Studies have shown that actively drawing the blood will collect a larger volume faster.
- 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.
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