A guide to cord blood and cord blood collection

According to the Human Tissue Authority (HTA), there’s no legislation governing the specific techniques of cord blood collection. The Royal College of Obstetricians and Gynaecologists (RCOG) has released guidelines that state the importance of collection taking place in a clean environment once the planceta has been delivered, though there’s some suggestion that it can be done while the placenta is still in situ.

How is cord blood stored?

Cells are frozen in liquid nitrogen and are currently being stored for up to 25 years. Studies suggest the length of time samples could be stored is infinite, but more information is needed.

While the NHS extracts the stem cells before freezing (known as volume reduced storage) some private companies store all of the blood (known as whole cord blood storage). It’s suggested that whole cord blood storage is more beneficial, however it’s nine times more expensive to store and so isn’t always financially sustainable.

Why is cord blood useful?

The stem cells found in cord blood are called ‘naïve cells’ as they’re able to transform into other cell types when influenced by the right stimuli. Umbilical cord blood cells are some of the most naïve cells found in our bodies.

How is cord blood used?

Cord blood is used in stem cell treatment. Current uses include the treatment of many cancers, blood diseases, immune diseases and metabolic diseases in children and young adults. A cord blood transplant replaces diseased cells with healthy new cells, rebuilding an individual’s blood and immune system. Stem cell transplants can help patients whose own bone marrow isn’t working due to disease or after having chemotherapy or radiotherapy.

Bone marrow vs cord blood transplant

It’s often easier to find a match with stem cord blood than bone marrow and it’s also more readily available. However, the disadvantage is that there may not be enough cells for a transplant.

Is cord blood collection safe?

It’s extremely important to ensure cord blood is collected by an accredited Health Tissue Authority (HTA) regulated public or private body. Samples need to be traceable from collection to treatment in order to ensure legality and safety for everyone involved.

The HTA has recorded140 cases surrounding illegal cord blood collection.

The HTA states: “The Health Tissue Authority (HTA) regulates the collection (procurement) of cord blood in the UK under the Human Tissue (Quality and Safety for Human Application) Regulations 2007 (Q&S Regulations). HTA Directions require any person collecting cord blood to be acting under the authority of a HTA license or a Third Party Agreement (TPA).”

• Your newborn baby’s first tests and checks
• All about vitamin K for your baby
• Writing your birth plan

Is cord blood collection always successful?

No. Blood clotting can effect collection and if less than 40ml is collected the sample is unlikely to be large enough to be used for a stem cell transplant. If using a private cord blood collection service and if the cell count viability is below a certain level, storage isn’t recommended but it’s up to you and you could still pay to have it stored.

What tests are carried out on the blood sample?

Both your blood and the cord blood sample is tested for Hepatitis B and C, HIV, syphilis and HTLV (Human T-lymphotropic virus – a human RNA retovirus know to cause a type of cancer) if required in order to ascertain whether the blood sample is suitable for future transplant. In some instances the biological father’s blood may also need to be tested.

Cord blood collection may not be possible/advisable if…

• Your baby is premature
• You’re having a multiple pregnancy
• The cord needs to be cut because it’s around your baby’s neck
• You need to have an emergency caesarean
• Yourself or your baby’s biological father prove positive for transmissible infection
• If cord clamping is delayed cord blood collection may not be possible (some recent studies demonstrate the potential benefits of delayed cord clamping, so you’ll need to weigh up which is more important to you)

What’s the difference between public and private cord blood collection services?

There’s no charge to donate your cord blood when using the NHSBT (Nation Health Service Blood Transplant) facility. However, publicly donated cord blood means your cord blood sample is available to all patients in need of stem cell treatment around the world. There's no guarantee your cord blood sample will be available for your own family’s future use. There’s some evidence to suggest that another person’s blood sample may be of better use in tackling inherited diseases. Find out which NHS hospitals are equipped to take cord blood samples online. Many now have the facilities to provide 24/7 collection although this can’t be guaranteed and cord collection may not always be possible. You must register with the NHSBT before the 30th week of your pregnancy as by this stage they will need verbal confirmation as well as completion of a mini lifestyle assessment.

Private storage can cost up to £2,000 but your blood is stored purely for your child or family’s future use. Each hospital will have its own policy on private banking. You can find out what private cord blood facilities are available online. The Royal College of Gynaecologists (RCOG) states that it “remains unconvinced about the benefit of storing cord blood with a private bank for families who have no known medical reason to do so”.

What’s the likelihood of a cord blood sample being used?

Sources suggest that there’s between 0.005% and 0.037% chance of a cord blood sample ever being used. However, the NHSBT reports that if a full programme of stem cell treatments was to be used it could save 200 lives a year. So far 8,000 cord blood transplants have been carried out worldwide.