Umbilical cord blood stem cell transplants are used to treat a variety of oncologic, genetic, hematologic, and immunodeficiency disorders. Physicians have an important role in educating, counseling, and offering umbilical cord blood donation and storage options to patients.
TMA has provided the following information to help you inform and educate your patients about cord blood banking.
Benefits of Cord Blood Collection and Use
Umbilical cord blood is the blood that drains from the placenta and umbilical cord after the delivery of a stable infant. Cord blood can be collected without risk to mother or baby. Cord blood stem cells are not embryonic stem cells. If not donated to a bank, this material is discarded as waste. Umbilical cord blood has many advantages over traditional stem cell sources, but one of the most important is its quick availability once a match is identified for a patient.
Public Versus Private Banking
Cord blood banking can be done with a private or public cord blood bank. There is no cost to donate to public cord blood banks, and donated units are available for any patient listed on the national registry.
Private banks charge patients a collection and storage fee. Collected units are available only for use by the person who provided the cord blood or her immediate family members, greatly limiting the potential usefulness of the blood. Patients also should be aware that private banks may vary greatly in their processing and storage procedures and quality control measures.
Donating Cord Blood
In Texas, there are two public banking facilities that collect, process, and store umbilical cord blood: the Texas Cord Blood Bank and MD Anderson Cord Blood Bank. These banks partner with hospitals locally and throughout Texas for the collection of donated cord blood. Donation services are not offered in all hospitals or all cities. These participating hospitals accept donations.
Patients should check with their intended delivery hospital before the 34th week of pregnancy if they wish to have their cord blood donated. If the patient’s hospital does not participate in the program, the patient may contact the Be the Match registry between her 28th and 34th week of pregnancy to request a cord blood donation kit.
Among racial and ethnic minority populations, including African-American and Hispanics, there is a disproportionate need for stem cell transplants due to the lack of minority donors on the cord blood and bone marrow donor registries. Educating these patients on cord blood donation and encouraging all eligible patients to donate is recommended to ensure an adequate supply for Texas’ large and diverse population.
State Requirements and Resources for Physicians
In 2007, House Bill 709 was passed requiring physicians practicing in Texas to provide a patient a brochure on umbilical cord blood options “before the third trimester of the woman’s pregnancy or as soon as reasonably feasible.”
The Texas Department of State Health Services (DSHS) provides the brochure Information on Umbilical Cord Blood Banking and Donation in English and Spanish, free of charge.
To order brochure copies, visit www.dshs.state.tx.us/mch/, call (512) 250-7116, or fax DSHS using Form No. AG-30 to (512) 250-9360. In the blank text box provided at the top of the fax form, include your name, address, stock number 6-73, and quantity requested. Brochures will be mailed and delivered to your office in approximately one week.
TMA Policy TMA Policy 45.017 Umbilical Cord Blood encourages families to donate umbilical cord blood for public supply (Amended Res. 305-A-06).
National Guidelines and Recommendations
The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists (ACOG), the American Medical Association, the American Society of Blood and Marrow Transplantation (ASBMT), and the World Marrow Donor Association have published guidelines regarding umbilical cord blood.
Key recommendations are:
- Parents should be encouraged to donate umbilical cord blood to public banks, which accept donations free of charge and provide stem cells to anyone who needs them.
- Cord blood banking should be recommended through the Related Donor Cord Blood Program when the donor's sibling has an illness that may be treated with a cord blood transplant (this program stores cord blood units for the exclusive use of the donor family).
- Private banking for unidentified possible future use is not currently recommended.
Additional Information and Resources
American Academy of Family Physicians — Umbilical Cord Blood: A Guide for Primary Care Physicians
ACOG — Umbilical Cord Blood Banking: Committee Opinion
AMA — Opinion: Umbilical Cord Blood Banking
ASBMT — Should You Store Your Baby's Umbilical Cord Blood?
Be the Match — Cord Blood and Transplants
Cord Blood Center
Your Guide to Cord Blood Banking
Sources: Be the Match. Key Facts. Jan 2013.