- Umbilical cord blood contains immature blood-forming cells. It can be an alternative to bone marrow for patients who don’t have a matched bone marrow donor.
- Donating umbilical cord blood is safe and painless. The National Marrow Donor Program offers guidelines for ensuring the safety and health of donors and recipients.
- Donating umbilical cord blood requires some preparation before your baby’s birth. Talk with your doctor about the options available at your hospital.
Donated umbilical cord blood is a possible treatment for people with certain life-threatening diseases and cancers. This includes leukemia, other types of cancer, and immune and genetic disorders. It is often an effective alternative to bone marrow transplantation  for people without a tissue-matched donor.
The importance of umbilical cord blood
The growth of a fetus while in the mother's womb requires nourishment and oxygen. These essential substances pass from the mother's blood to the fetus' blood through the placenta. The placenta is a temporary organ that connects the mother and fetus. These essential substances travel from the mother to the developing infant through the umbilical cord. The blood found within the umbilical cord is the baby's, not the mother's. Typically, the umbilical cord, placenta, and any blood still in the cord are thrown away. Researchers have discovered that umbilical cord blood is rich in hematopoietic stem cells. Hematopoietic stem cells are the immature blood-forming cells also found in blood and bone marrow. Bone marrow is a spongy, fatty tissue inside larger bones. Hematopoietic stem cells can differentiate or change into red blood cells, white blood cells, and platelets. Red blood cells carry oxygen to all parts of the body. White blood cells help the body fight infections and diseases. Platelets help blood clot and prevent bleeding.
A bone marrow transplantation replaces diseased marrow with healthy bone marrow from the patient or from a volunteer donor. Cord blood transplants may have several advantages over other types of bone marrow transplants. Previously stored cord blood is easily available for patients who need a life-saving transplant. Bone marrow donation can take some time. Patients must wait for the donor to have the bone marrow harvested or blood stem cells collected. Research suggests that patients receiving a cord blood transplant are less likely to have significant side effects.
Who can donate umbilical cord blood
The National Marrow Donor Program  (NMDP) recommends the following guidelines for cord blood donation. The NMDP is a nonprofit organization that has a nationwide bone marrow and cord blood registry. These guidelines determine who can donate and protect the health and safety of the person receiving the cord blood. Contact the cord blood bank that you choose to use for specific eligibility requirements.
Women must be at least 18 years old (16 years old in some states) and healthy. Healthy means that a person feels well and can perform normal activities.
Those who cannot donate include:
- Women who are at higher risk for or who have HIV/AIDS
- Women who have a history of cancer, except cured local skin cancer or early-stage cervical cancer
- Women who had malaria within the last three years or a full course of antimalaria treatment within the past six months
- Women who have a positive test for hepatitis C antibody or hepatitis B surface antigen
- Women who have had an organ or tissue transplant
- Women who have gotten tattoos or body piercing within the last year.
The cord blood bank will evaluate all other medical conditions and medications you are taking. Mothers who are expecting twins may not be able to donate. There are typically not enough stem cells recovered from the umbilical cord that are useful in transplantation.
How to become an umbilical cord blood donor
Donating cord blood requires some advance preparation. Before the 34th week of pregnancy, you should contact the cord blood bank your hospital works with. The NMDP lists hospitals that participate with cord banks in its network . If your hospital does not have an official relationship with a cord blood bank, contact a cord blood bank in your area to ask if it can help you donate. AABB (formerly known as American Academy of Blood Banks) provides a list of accredited cord blood banks .
A cord blood bank will require you to provide consent before you donate and store cord blood. In addition, you will need to complete a health history questionnaire. You will also need to give a small sample of blood to test for infectious diseases.
The urgent need for donations from minority populations
A successful transplant depends on the donor's cord blood matching the recipient's. So, there is a better chance of finding a matched donor within the same racial and ethnic group. People from minority populations are underrepresented in donor registries. This means they have less chance of finding a matched donor. The likelihood of finding a match for people with Hispanic, American Indian, Alaska Native, Asian, Native Hawaiian, black/African American, and multi-race backgrounds has increased. However, there are still many people who are unable to find a match.
Public versus private use
You can choose to donate cord blood to a public cord blood bank or store it for private use. Private storage of umbilical cord blood reserves your baby's cord blood for use within your own family. Public storage makes cord blood available for any person in need.
The American Academy of Pediatrics (AAP)  recommends public storage of umbilical cord blood unless a child’s older sibling has health condition that could benefit from transplantation. The likelihood that a child will need his or her own cord blood in the future is between one in 1,000 and one in 200,000. Also, a child’s own cord blood is not an option to treat genetic disorders he or she had at birth. This is because the cord blood may carry the same genes linked to the disorder. Talk with your doctor your reasons for wanting to store or donate your baby's umbilical cord blood.
Donating cord blood to a public cord blood bank is free. Initial fees for private storage of cord blood may range from $500 to $2,000. In addition, annual storage fees can cost about $100 per year.
Collection of umbilical cord blood
Donating umbilical cord blood is safe for the mother and the baby. It is a painless procedure that does not change the birth process. Public cord blood banks processing and store your baby's cord blood for free.
After the baby's birth, the umbilical cord is clamped and cut. Approximately three to five fluid ounces of blood is drained from the umbilical cord and placenta. The blood is placed into a collection bag or vial, called a unit. If the blood doesn’t contain enough blood-forming cells for a transplant, the cord blood unit will not be stored. Instead, it will be used in medical research if you have consented for this use. The entire process of umbilical cord blood collection takes approximately five minutes. However, cord blood will not be collected if a delivery becomes complicated. In these situations, the focus remains on the health and welfare of the mother and baby.
Umbilical cord blood testing and storage
Shortly after collecting cord blood, it is taken to a laboratory for processing, testing, and storing. It is tested for infectious diseases. In addition, the "tissue-type" of the cells is determined. This information helps match the cord blood unit with patients who need it. The test is called human leukocyte antigen (HLA) typing.
HLAs are proteins on the surfaces of all cells in the body, especially on white blood cells. The special combination of HLA proteins makes each person's tissue unique. The HLA type of the cord blood unit is listed on the donor registry. Doctors can access this information when they are looking for an HLA match for a patient who needs a transplant. All personal information is confidential. Cord blood banks will contact you about test results that are important for your and your baby’s health.
After the screening tests, the blood bank stores the cord blood unit, labeled with HLA type, in a freezer. Cord blood can be stored for a long time in this environment. Research shows that, even after 10 years, enough cells remain for transplant. Research to learn more about cord blood stored beyond 10 years is ongoing.
Donating Bone Marrow