Giving Life Twice

Most mothers only give life to one child at a time, but about 800,000 women worldwide give life to two… and I’m not talking about twins. I’m talking about the donation of their umbilical cord blood, the blood that remains in the umbilical cord after childbirth. Most commonly, the umbilical cord and the placenta are thrown away after birth, but these organs contain precious stem cells that have the capacity to save lives… to give a second life to someone else.

Harvesting umbilical cord blood and utilizing it for treatment is a relatively new scientific advancement that started in the late 1980’s. Scientists and doctors have realized that umbilical cord blood is rich in stem cells, specifically multipotent hematopoietic stem cells. These are big words to describe a simple yet incredible cell. Multipotent hematopoietic stem cells are cells that can give rise to all the blood cells, which is why these cells are invaluable to someone suffering from a blood disease. So, how does all this work and what does it treat? Well, first of all, the procedure is painless for both the mother and the child, and it takes 2-5 minutes. To collect the umbilical cord blood after a baby is born, the physician first cuts the umbilical cord then simply puts a needle into the blood vessels of the umbilical cord before drawing out the blood. This blood is then stored and frozen at -196°C. Mothers who have donated this blood have described it by saying that they did not even know it was being collected until after the doctor told them that they were done. After this blood is tested and stored, it can be matched with a blessed patient somewhere around the world who needs a blood transplant. Umbilical cord blood can be used to treat patients with various types of common blood cancers and diseases, such as leukemia, lymphoma, as well as sickle cell anemia.

Numerous advantages exist for umbilical cord blood, including the following:

  • No/very little risk to donor
  • Easily stored
  • Cells collected are immunologically immature and have a high growth potential
  • Low incidence of Graft vs Host Disease, which is a disease where the grafted stem cells detect the normal cells as foreign, resulting in the stem cells attacking the healthy body cells
  • Blood type matching is easier with stem cells harvested from cord blood compared to the conventional stem cells harvested from bone marrow

Now, you may be wondering where all this blood is stored, and this is where the debate comes in. There are two options you can choose from for where your cord blood goes: public banks or private banks. Public banks are completely free, and this is where your cord blood goes into a world registry where a matching donor can be found and treated. However, private umbilical cord blood banks make up a several hundred-million-dollar industry. When the private bank option is chosen, the blood is collected and stored for the sole use of that family. These blood banks say that their service is “biological insurance” for your kid if anything goes wrong in the future, and this is simply misleading. Numerous marketing techniques are used on pregnant mothers to sell them a cord-blood bank plan, but the chance of the child ever actually using this cord blood is trivial. Some studies show the rate of private bank blood used being 0.09% while other studies show that public bank blood is 30 times more likely to be used than private. Furthermore, numerous studies have shown that the quality of cells and the number of stem cells are lower when kept by private cord banks versus public. As one study published in the journal Transfusion said, “Quality parameters of privately banked umbilical cord blood are inferior to those stored in public banks.”

Very few blood diseases can be treated with one’s own umbilical cord blood because if the disease is genetic, then the stored blood has the same genetic abnormality, thereby rendering it useless for the kid. Almost 90% of transplants are between unrelated people with the remaining 10% being between family members, which is another powerful benefit of umbilical cord blood. For example, if you have a kid who has been diagnosed with leukemia, and you also have another kid on the way, then the umbilical cord blood for the second child can be harvested and used for the baby’s brother. This can be done through public bank systems at little to no costs. I keep talking about how public banks do not cost you anything because of the striking difference between public and private banks. Private banks are very expensive! For example, let me tell you about one of the several well-known private cord blood banking companies. According to the company’s website, to store your cord blood, the company charges $1,575 for the collection of the blood and an annual storage fee of $175. That already sounds like a lot, but a greater opportunity cost exists here. At the time of your child’s birth, if you put $1,575 dollars into a mutual fund that grows at a conservative rate of 8%, and you contribute just $175 to that fund every year, here’s how much your kid will have after….

20 years: $15,000

40 years: $80,000

65 years (retirement): $560,000

Many people never attain more than half a million dollars in their entire life, and now your kid can have it just for them at the time of retirement. The sad reality is that while 800,000 women have publicly banked their blood, 5 million have used private banks. Umbilical cord blood is much better off in the hands of a public bank, and this notion is supported by the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and many more. As Dr. Paul Harker-Murray at UT Southwestern said, “Umbilical cord blood is an underutilized medical resource with immediate life-saving clinical applications,” which is why it is so important for pregnant women to strongly consider donating their umbilical cord blood to a public bank.

Sources:

Ballen KK, Verter F, Kurtzberg J. Umbilical cord blood donation: public or private? Bone Marrow Transplantation. 2015;50(10):1271-1278. doi:10.1038/bmt.2015.124.

Kurtzberg J. (2017). A History of Cord Blood Banking and Transplantation. Stem cells translational medicine6(5), 1309–1311. doi:10.1002/sctm.17-0075

Newcomb, J. D., Sanberg, P. R., Klasko, S. K., & Willing, A. E. (2007). Umbilical cord blood research: current and future perspectives. Cell transplantation16(2), 151–158.

Shenoy S. (2013). Umbilical cord blood: an evolving stem cell source for sickle cell disease transplants. Stem cells translational medicine2(5), 337–340. doi:10.5966/sctm.2012-0180

Sun, J., Allison, J., McLaughlin, C., Sledge, L., Waters-Pick, B., Wease, S., & Kurtzberg, J. (2010). Differences in quality between privately and publicly banked umbilical cord blood units: a pilot study of autologous cord blood infusion in children with acquired neurologic disorders. Transfusion50(9), 1980–1987. doi:10.1111/j.1537-2995.2010.02720.x

Waller-Wise R. (2011). Umbilical cord blood: information for childbirth educators. The Journal of perinatal education20(1), 54–60. doi:10.1891/1058-1243.20.1.54