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Umbilical cord blood banking has been with us for several years now. The new twist o the phenomenon is the explosion of private cord blood banking all around the globe. In the United States where this started, it costs anything between $1000 and $2000 for the service. Usually there is also an annual fee of around $100 – 200. In the UK, where this is relatively new, the private companies charge in the range of £1000 to £1600, with or without an annual fee, arguably considerably dearer than the US especially bearing in mind the sliding value of the dollar.

Cord blood contains Stem Cells. This means they carry the potential of treating patients afflicted with a variety of haematological, immunological and metabolic diseases. There is also a lot of research activity in their potential to treat degenerative diseases mostly associated with aging. Cord blood stem cells have been used successfully to treat a number of very serious diseases including some forms of leukaemia.

In Britain, the National Health Service (NHS) Cord Blood bank was established over a decade ago in 1996. There are dedicated hospitals in the country where trained staff collect cord blood from donors. Individuals who enrol to donate undergo a health check to ensure the collected blood does not have potential to cause harm to any future recipient. Donation is free. The collected blood is available to any suitable patient in the country or anywhere else in the world. There are many similar schemes in other countries and close collaboration of their work to maximise availability of this life-saving product to suitable matched patients anywhere in the world.

The major difference between those established schemes and private cord blood banking is that the latter is being promoted specifically for the potential benefit of that child or their sibling sometime in the future. It is a form of insurance or so it is suggested.

So what are the issues to consider?

High Risk families

In some cases, a child may have an inherited genetic disease where stem cell transplant may be the only remedy possible. Some such families have been encouraged to get cord blood from a newborn sibling to see if it turns out to be a tissue match for the older afflicted sibling. In some very rare cases, a child is planned via assisted conception technique which enables biopsy of the embryos created to choose one with a tissue match for the needy child. That embryo is then put back into the womb and with a successful pregnancy and delivery, cord blood is collected for the stem cells to be used to treat the older sibling. This service is not yet available in the UK and such families have to travel to the United States for part of the treatment.

Low Risk families

The flourishing commercial cord blood banking services are directed at the general low-risk families with no immediately identifiable risk. The pitch revolves around this being a form of long-term insurance for the child and his/her siblings.

In 2006, the Royal College of Obstetricians and Gynaecologists (RCOG) gave a detailed opinion statement about private cord blood banking. Among the highlights of what one needs to bear in mind before taking the plunge, the RCOG pointed out that:

On current trends, the possibility of an individual  (the child) needing his/her own cord blood for blood disorders by the age of 20 is extremely small

The potential  for using cord blood stem cells for other non-blood disorders is still speculative at present and it is by no means possible to predict whether this will turn out to be the case

In cases where the individual develops a disease which is genetic in origin, their own blood may not be appropriate.

Alternatives in the form of  national cord blood banks and bone marrow registries are available and there is international collaboration.

At adulthood, even if the banked cord blood was found to be suitable, the amount for anybody weighing more than 50 kg (most adults) may actually be inadequate and therefore next to useless.

In places like the UK, people need to be aware that legitimate practical issue may make it difficult or impossible for the cord blood to be collected. It is essential that the blood is collected by a trained professional and in a UK hospital, that person will be a midwife or doctor. In situations where the mother or baby’s health needs close immediate attention such as fetal distress, prematurity, haemorrhage etc, it may not be possible for the midwife or doctor to spare the time to deal with cord blood collection. It is therefore conceivable that even if a mother is decided on having cord blood banking, events on the day may prevent this.

There are some companies that suggest that a member of the family could get the kit and perform the cord blood collection thus freeing the hospital staff to do what they normally do. This approach is probably quite naive and impractical. Even if an untrained person was able to take the blood from the detached placenta, the risk of contamination is high and that will render the sample useless.

In some countries, Italy being an example, private cord blood banking is banned outright. The European Union in general discourages the practice. In its place, national cord blood banks are promoted as the ideal way forward.

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Last update: January 11, 2013

Umbilical cord blood banking