Cord Blood Banking – Are we discarding something valuable?

In the United States, cord blood banking is a common practice. It involves the cryopreservation of cord blood after birth. In other words, after a baby is born cord blood is drawn from the umbilical cord, processed and stored in liquid nitrogen for future clinical application. 

In the UK, there are still large parts of the population that are unaware of the value of cord blood. In 2018 only 27,000 samples were banked. The trend is, however, also increasing in the UK with more parents considering this option for their children (1).

The NHS has a public cord blood bank and actively promotes the donation of cord blood through its network. The NHS markets the fact that donation of cord blood after a baby’s birth could save someone’s life (2). Cord blood is a valuable resource that is often discarded with parent unaware of its value. 

Cord blood is a resource that is involved in several clinical trials (3). Results of these trials are very encouraging and suggest possible treatments of a variety of conditions including leukaemia, cerebral palsy and autism (4). 

One of the most controversial aspects revolving around cord blood is the fact that after birth, the placenta and the umbilical cord are often discarded without fully informing parents of potential benefits. However, advances in this particular field of science are compelling, with many trials showing that the use of cord blood is safe in children with several conditions (5).

Recently, Duke University carried out a phase II study of cord blood in cerebral palsy. Their results showed that children who received one intravenous dose of at least 25 million stem cells per kilogram of their body weight saw improvements in motor function one year after treatment. The improvements were more significant than those typically observed for children of similar age and condition. They also exceeded the gains made by children who received a lower dose of cells or a placebo (6). 

Cord Blood has been used to treat leukaemia since the 1990s with over 35,000 cord blood transplants worldwide. A study published in the New England Journal of Medicine (NEJM) in Sept 2016 compared cord blood transplants versus bone marrow transplants for leukaemia patients. Both groups had comparable survival rates after transplantation, however, the cord blood patients tended to live longer and were less likely to relapse (7).

In fact, to date, cord blood transplantation remains a common source of cells for pediatric patients undergoing allogeneic hematopoietic cell transplantation (8).

There are generally two models for cord blood preservation: private and public. Private Cord Blood Bank process and freeze cord blood in liquid nitrogen for the individual child, which ensures that the blood is available for treatment should the child require it. 

The public route, which in the UK is funded by the NHS through the NHS Cord Blood Bank, takes donations from patients and makes these available to patients who need them. 

Private banks usually accept any cord blood unit, but public banks have very stringent acceptance criteria which relate to the number of viable cells and various other measures. The results in an acceptance rate of under 30%, which means most donations are discarded (9). There are many ethical questions that could be addressed at this stage; however, the purpose of this post is to raise awareness of cord blood and cord blood banking.

While children may never need cord blood transportation, their bespoke resource is readily available at the time of birth, and the clinicians must inform parents about the potential benefits of cryopreserving their child’s cord blood. Research is very young in this particular area, and many uses of stem cells and cord blood have yet to be uncovered, but cord blood may be one of the resources that will soon be seen as incredibly valuable.