More questions and answers regarding cord blood storage....

Róisín Deane completed her PhD in Dublin, Ireland in 1993 and worked as a research scientist in Ireland, Germany and Australia before moving to the commercial side of medical science. Involved with Cryosite since its inception in 2000, and with a successful background in molecular biology and diagnostics, Róisín managed the establishment of Australia’s first TGA licenced private cord blood service, offering expectant parents the opportunity to store their baby’s cord blood stem cells for potential future use.


-Are there any risks to storing cord blood?
Cord blood transplantation is a relatively new and experimental procedure that may offer possible future benefits to your child in treating diseases such as leukaemia, cancer, and genetic disorders. However, we cannot give any assurance about the long-term effectiveness of cord blood storage, nor about whether your child’s cord blood will be able to be used for any purpose in the future, including during the storage term for which you will pay. We also cannot know whether the future use of cord blood that has been stored may involve as yet undiscovered complications, and it cannot be guaranteed that the stored cord blood will offer a therapy for future disease.
The process of freezing and storing cord blood is also relatively new. Laboratory tests and studies thus far have indicated it is a successful method of preservation of cord blood. However, there may be risks and complications associated with the storage process that we do not yet know about, and which may affect the viability of your child’s cord blood and its efficacy as a treatment for future diseases.

-Can anybody store their cord blood or are there restrictions?
The only exclusion criteria for storage is where the maternal blood sample tests positive for HIV. These samples cannot be stored.

-Why don’t obstetricians talk about this option very much?
Most obstetricians believe that the decision to collect cord blood is a personal one and they choose not to get involved. However, it is interesting to note that in an independent market research survey carried out in 2004, 7 out of 10 obstetricians surveyed said they would store their baby’s cord blood.

-What types of diseases can be treated with cord blood?
Blood stem cells including those from cord blood have already proven valuable in assisting with the treatment of certain types of leukaemia, as well as a number of other life-threatening illnesses including (but not limited to) Fanconi’s Anemia, Severe Combined Immune Deficiency Sydnrome, Thallassaemia, Retinoblastoma, Neuroblastoma and a range of blood-related disorders. More recently blood stem cells have been used to help repair heart muscle after heart attack and injury.
The future of cord blood stem cell therapy is also promising with blood stem cells representing the most extensively studied and best understood population of adult stem cells in humans.

-Can you donate cord blood?
Yes. There is a national cord blood bank in Sydney, Melbourne and Brisbane with additional banks being developed in other states. Patients who deliver at participating hospitals may donate their baby’s cord blood to the public bank for use by any individual who needs a stem cell transplant. However, once donated, there is no assurance that the cord blood would be available if it were ever needed within your family.

-Is there a rural cord blood storage/collection service?
Private cord blood collections can take place at any hospital. Courier services ensure cord blood can be successfully shipped to Sydney from anywhere in Australia for processing and storage.

-Are there any risks to the baby and/or the mother when cord blood is collected?
Immediately after the birth of your baby (either by vaginal delivery or by caesarian section) the umbilical cord is clamped and cut in the normal manner separating the baby from the placenta and mother. The placenta is typically delivered a few minutes later. The portion of the umbilical cord still attached to the placenta is cleaned. A needle is then inserted into the umbilical vein and the placental blood is drawn, by gravity flow, into a sterile blood collection bag containing anti-coagulant to prevent the blood from clotting. The collection process is non-invasive, completely painless and does not present any risks to either mother or baby. Blood can also be collected after the baby’s birth but prior to the delivery of the placenta. In such cases, the placental blood yield is often greater as the placenta continues to pulsate during the collection process facilitating blood flow. A maternal blood sample is also drawn for infectious disease testing.

-Can cord blood be used to help other family members?
Private cord blood banks in Australia are licenced by the TGA to store blood for autologous use only. This means it is stored for the child from which it is collected. Cord blood does however have an excellent record of being a perfect or suitable match for siblings and if this were the case then the TGA would have to determine the release criteria.

-Do they let anyone use your cord blood or is it stored specifically for your use only?
Private cord blood storage is for your child only, it is not made available to the public. If you donate to the public bank there is then no assurance that the cord blood would be available if it were ever needed within your family.

-Do most hospitals (public and private) give you the option to store cord blood?
Private cord blood banking is available in almost every hospital in Australia providing you have a midwife or obstetrician who is prepared to collect the blood.

-Is there a certain amount of cord blood required in order for the storage to be successful?
The past decade has seen a rapid expansion in the therapeutic application of cord blood stem cells. While the advantages are significant it is important to ensure that as much cord blood as possible is collected at the time of birth. One of the critical factors in determining the success of a transplant is the number of stem cells transplanted and this correlates to the volume of cord blood collected.
Typically 60-150ml cord blood can be collected with a minimum volume of approximately 45ml required before processing can begin. This is to ensure a sufficient quantity of stem cells in the final frozen product.
Researchers are looking at ways to expand the number of stem cells that have been collected and already there have been some significant successes and several stem cell expansion protocols are in human clinical trials. The ability to expand the number of stem cells present in a cord blood sample is now a real possibility and gives hope that one day cord blood stem cells will be expanded and used for a variety of different therapies.

-I would like to know whether it is necessary to store your own baby's cord blood, or is it possible to use anyone's cord blood that has been stored provided it matches with your child?
Providing the cord blood matches, then it can be used. The advantage of using one's own cord blood is obviously it is a perfect match and there will be no issues with rejection.

-What are the benefits to store cord blood?
Should your child develop cancer or leukaemia, these diseases are generally treated with heavy doses of chemotherapy or radiation. While radiation and chemotherapy treatments are often successful in destroying cancer cells, they may also destroy the patient's healthy cells and bone marrow. Bone marrow is essential for the production of blood cells and, if depleted or destroyed, a stem cell transplant may be necessary. If successful, the transplanted stem cells will re-populate the bone marrow thereby replenishing the body’s supply of blood-forming cells and immune function.
Cord blood stem cells continually replicate and differentiate into the cells of the blood and immune systems and are increasingly becoming regarded as a viable and useful alternative to stem cells collected from bone marrow or circulating blood. Cord blood stem cells represent a perfect match for the baby that they were collected from so the risks of rejection are eliminated. Furthermore, cord blood has an excellent record of being a perfect or suitable match for a sibling so may potentially be suitable for the treatment of other family members.
Unlike embryonic stem cells which continue to cause much ethical debate in the community, cord blood stem cells are adult stem cells, their collection is seen as non-controversial and is accepted throughout the world. Blood stem cells including those from cord blood have already proven valuable in assisting with the treatment of certain types of leukaemia, as well as a number of other life-threatening illnesses including (but not limited to) Fanconi’s Anemia, Severe Combined Immune Deficiency Syndrome, Thallassaemia, Retinoblastoma, Neuroblastoma and a range of blood-related disorders. More recently blood stem cells have been used to help repair heart muscle after heart attack and injury.
Thankfully, the chances of your baby developing any of these conditions are small, but should your child ever require a transplant of stem cells to treat a specific illness, finding a compatible donor can take valuable time or at times be unsuccessful – however, the cells stored from your baby, if appropriate for the illness, are a guaranteed match, and are immediately available. The future of cord blood stem cell therapy is also promising with blood stem cells representing the most extensively studied and best understood population of adult stem cells in humans.
While cord blood may never be used many parents see the storage of their baby’s cord blood as a worthwhile investment for potential future treatment of diseases in children or adults. The knowledge that their child’s stem cells are stored and readily available if ever required gives enormous peace of mind and makes their decision to store their baby’s cord blood a highly satisfying one.

-Do most doctors know about this process?
Yes – most doctors are aware of cord blood storage and in fact over 800 have participated in collecting cord blood for our clients at more than 250 hospitals and birthing centres throughout Australia, New Zealand, Hong Kong, Singapore, New Caledonia and Japan.

-Why are not all hospitals familiar with this process?
Public hospitals vary in their ability to collect cord blood for private storage. In NSW, public hospitals are not allowed to be involved, however, they must permit a collector to attend and carry out the collection.

-What is the likelihood of finding a compatible match?
Approximately 90-95% probability of finding a compatible match.

 -I am expecting my second child in September and have often wondered whether or not I should store the cord blood? My reservations are that I have Hep C I know that the likelihood of my child contracting it through birth are low, but have never been able to obtain clear answers as to whether or not the cord blood is infected with Hep C or not? What are the pros and cons if my child needed it in the future in regards to infection possibilities?
While you are Hep C positive, this is not an exclusion criteria for collection. You need to test your baby when it is born to determine whether it is also positive.

-I believe that cord blood cells can be used in the treatment of some forms of leukaemia but are the cells non-differentiated enough to be used for other degenerative diseases?
It will depend on the disease.

-I read that research on cord blood at the University of Michigan found the stem cells can be used to cure/suppress diabetes in children and adults.  Is this true?
Clinical trials are taking place which show promising results in the area of diabetes. It is probably a little bit too early to say we can cure diabetes, but the results certainly support the continued investigation of the role of cord blood stem cells in treating diabetes.