What is the purpose of saving or collecting umbilical cord blood?
Umbilical cord blood (UCB) is being collected for the purpose of preserving stem cells for future transplants. The collection of stem cells are easier to obtain from UCB than from bone marrow transplant.
So what are stem cells?
Stem cells are undifferentiated cells that are capable of giving rise to all tissue and organ cells of the body. There are three main sources of stem cells in humans: embryonic stem cells, adult stem cells, and umbilical cord stem cells. 
What diseases can stem cells transplant treat?
There are 4 main groups of diseases which stem cells transplant can treat: cancers, blood disorders, congenital metabolic disorders, and immunodeficiencies. [1,2]
Examples of Conditions Treated With Stem Cell Transplants 
|Acute lymphocytic leukemia||Sickle-cell anemia||Adrenoleukodystrophy||Adenosine deaminase deficiency|
|Acute myelogenous leukemia||Fanconi’s anemia||Gunther’s disease||Wiskott-Aldrich’s syndrome|
|Chronic myelogenous leukemia||Thalassemia||Gaucher’s disease||Duncan’s disease|
|Myelodysplastic syndrome||Evan’s syndrome||Hurler’s syndrome||Ataxia-telangiectasia|
|Neuroblastoma||Congenital cytopenia||Hunter’s syndrome||DiGeorge’s syndrome|
|Hodgkin’s disease||Aplastic anemia||Krabbe’s disease||Myelokathexis|
|Non–Hodgkin’s lymphoma||Diamond–Blackfan anemia||Sanfilippo’s syndrome||Hypogammaglobulinemia|
|Burkitt’s lymphoma||Amegakaryocytic thrombocytopenia||Tay-Sachs’ disease||Severe combined immunodeficiency|
What are the indications of UCB collection?
When expectant families have a relative or immediate family member with a known disorder that is already treatable by stem cell transplants and infant is not preterm and not for potential future use. 
Advantages of Umbilical Cord Blood Stem Cells Versus Bone Marrow Stem Cells 
- Ease of collection
- Almost no risk for mother or child
- Less time needed for processing (more quickly available for use)
- Less costly than bone marrow collection
- Less risk for transmission of infection
- Less need for stringent antigen typing
- Less rejection
What are the contraindications of UCB collections?
Umbilical cord collection in Preterm infant (< 37 weeks gestation) is contraindicated. 
The reason is that delayed cord clamping is necessary in preterm infants to prevent complications at birth, as per World Health Organization (WHO) recommendations. 
For UCB collection, delayed cord clamping implies in less amount of blood, with less quality stem cells, therefore collection may render useless by either amount of quality.
Disadvantages of Umbilical Cord Blood Stem Cells
- Slow engraftment (Ability of blood-forming cells start to grow and make healthy blood stem cells that show up in your blood – speed is important for transplant recovery)
- Limited cell dose, yielding small volume of unit and additional cell doses are usually unavailable
- Specimen from the same individual donation may have limited benefit owing to hereditary disorders
- Storage issues
- Unknown length of long-term storage
- Cost related to long-term storage can be high
- Quality control is unknown.
Public versus Private Blood banks
If you choose to collect UCB you can either donate to a public bank or pay to a private bank to store it for you.
Key differences between Public and Private banks [1,2,4]:
|no charges associated with cord blood banking||Charges around $1125 upfront + $125 per year of storage|
|makes stem cells available to anyone who needs them||Only available to you. Not available for transplant centers to search HLA type database.|
|increases the number and diversity of cord blood units available for patients making it easier to find a match||No diversity available if needed|
|Your cord blood may not be available to you/family||Only available to you/family|
|Units not approved for transplant are donated to research||Private banks typically do not use the same banking criteria as public banks in terms of collection volume and total nucleated cell doses|
Public Cord Blood Banks in Canada:
Canadian Blood Services
Collection Centers in Canada:
- The Ottawa Hospital General Campus and Civic Campus;
- William Osler Health System’s Brampton Civic Hospital;
- Alberta Health Services’ Lois Hole Hospital for Women in Edmonton;
- BC Women’s Hospital + Health Centre in Vancouver.
Info vídeo: https://youtu.be/K5WRgK9L52M
It is recommended that expectant families only consider cord blood banking in private banks when they have a relative with a known disorder that is already treatable by stem cell transplants.
Moreover, expectant families should not rely on commercial cord blood banks as their sole source of information about cord blood banking.
Other important points an expectant couple need to consider:
- They should not base their decision to bank the umbilical cord blood on the type of anticoagulant used to preserve the sample;
- They should not obtain all of their information on cord blood banking from the private cord blood bank, whose major agenda is to gain another client;
- They must be encouraged to research various resources for reliable information;
- Consider private banking only if they have evidence that stem cells are used currently to treat a specific disease process affecting a family member, but be aware that simply banking the cord blood does not ensure a cure, and they would most likely be banking the blood not for the current baby, but for some other family member;
- They must also be aware of the cost involved in the banking process;
- Finally, if they do not have a relative with a disease process treated with stem cells or there is no evidence that stem cells are used to treat the diseases that are known to be in their family, then they could consider public banking of the umbilical cord blood (if they have access to a public cord blood bank).
- Renece Waller-Wise, Umbilical Cord Blood: Information for Childbirth Educators, The Journal of Perinatal Education, 2011, vol 20, 1
- Anthony Armson, David S. Allan, Robert F. Casper, SOGC CLINICAL PRACTICE GUIDELINE – Umbilical Cord Blood: Counselling, Collection, and Banking, J Obstet Gynaecol Can 2015;37(9):832–844
- World Health Organization (WHO) Recommendations http://who.int/iris/bitstream/10665/120074/1/WHO_RHR_14.19_eng.pdf