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Unique Aspects of Cord Blood Banking in the UK
Since the inception of umbilical cord blood stem cell cryopreservation, the number of public and privately banked units worldwide has grown to more than 800,0001 and 7 million2 respectively.
This new field of medicine has blossomed since the world’s first cord blood transplant took place in 1988, using sibling donor stem cells for a child with Fanconi Anaemia3. While the first cord blood transplant was performed in France, the transplanted cells were collected and cryogenically frozen in the US, and the patient was a US citizen. Researchers in the US pioneered the initial scientific and business practices for cord blood banking that have now been adopted in many other countries.
However, each country has its own healthcare system, cultural customs, and differences in the practice of medicine that lead to a unique approach to cord blood banking. One such example is the United Kingdom or UK. In this article we hope to clarify certain practices that are standard for cord blood banks operating in the UK. Oftentimes parents that have previously banked elsewhere, or have heard about cord blood banking from friends that banked elsewhere, are surprised to find that some things are different in the UK.
In the US, most births are attended by Obstetricians. In the UK, Midwives are the healthcare professionals that attend to routine births. A consultant Obstetrician would only be involved in complex cases. In addition, unless they are giving birth in a private hospital, parents in the UK do not have the opportunity to choose who will deliver their baby. Most parents are allocated Midwives or health visitors throughout the pregnancy based on the person that is available at the time of their appointment.
The lack of an established relationship between healthcare providers and expectant parents in the UK makes all efforts at patient education or discussion of birth plans less personal. There are a few situations where cord blood banks have established partnerships that enable them to provide more parent education. One exception to the rule is a small number of maternity units that collect cord blood donations for UK public banks. Another exception is partnerships between UK family banks and NHS hospitals, which enable the private cord blood bank to distribute educational materials to all prospective parents intending to give birth in that hospital. Both public and family banks in the UK have to seek opportunities to educate and engage with parents about their options for banking cord blood or birth tissues. As in most countries, public banks in the UK only collect from a limited number of hospitals, hence for most parents that are inspired by the value of cord blood their only viable option is family banking.
Unique to the UK, outside of private hospitals, cord blood is not collected by the Midwife or the Obstetrician. In the UK, parents that want to save their cord blood are required to arrange for a Phlebotomist to attend the birth to perform the collection. Parents may be shocked to learn that the Phlebotomist is mandatory and can cost over £300. Family banks will arrange this service for their parents and have agreements in place with private Phlebotomy companies to facilitate the service.
Due to these two circumstances in the UK, the lack of parent-provider relationships and the extra charges for cord blood collection, the adoption of cord blood banking in the UK is about ten times lower than the US, at 0.3% of births.
Customer contracts for private cord blood banking in the UK are also a point of difference compared to what parents are accustomed to in some other countries. In the US, family banks charge an initial fee for the collection kit and processing, followed by an annual storage fee for each year the stem cells are kept in cryopreservation. In the UK, until quite recently all family banks charged upfront for both processing and storage, with up to 25 years of storage included in the price. Some UK banks now offer the option to pay for storage annually, but often without fully discounting the upfront payment, effectively increasing the net price.
One aspect of cord blood banking that is common worldwide is bold and misleading advertising. In both the US and UK, some banks claim to extract several times more stem cells from cord blood than their competitors. The reality is that most banks use similar processing methods based on well-established protocols, and any method that really did yield much higher efficiency would be rapidly adopted by all banks. So, for expectant parents looking for a cord blood bank in any country, we would urge them to look at experience, accreditations, financial security and ethics when making a choice of family bank.
- 1- WMDA annual reports (access requires membership)
- 2- Parent’s Guide to Cord Blood Foundation newsletter Nov.2018: World’s Top 10 Cord Blood Banks by Inventory and Industry Consolidation
- 3- Parent’s Guide to Cord Blood Foundation newsletter Sept. 2015: Interview with Matt Farrow, Recipient of World's 1st Cord Blood Transplant
- 4- Parent’s Guide to Cord Blood Foundation newsletter Jan. 2020: Percentage of births banking cord blood by country