A baby’s umbilical cord contains blood-forming stem cells that, when transplanted, can rebuild the bone marrow and immune system and save the life of a patient with a serious blood disease such as leukemia, lymphoma or sickle cell disease. Infusion of these cells can also treat patients with inherited genetic disorders, bone marrow failure or inherited immune deficiencies.

More than 40,000 patients with serious diseases and disorders have benefited from cord blood treatments since the first transplant in 1988.

Cord blood is collected from the umbilical cord and placenta (often called “afterbirth”) after the baby is delivered and the cord has been cut.  No blood is taken directly from your baby. The collection procedure does not interfere in any way with labor or the baby’s delivery, and poses no risk to the mother or baby.

Preparations need to be made in advance of delivery for the collection of cord blood. Expecting parents should talk to their obstetrical physician or other health care provider between the 28th and 34th week of pregnancy about their interest in storing or donating a baby’s cord blood.

Some public donation programs allow mothers to consent to donate their baby’s cord blood after they are admitted to the hospital to deliver their baby, if they are in early labor.

Unfortunately, not every hospital offers the option of cord blood donation. The National Marrow Donor Program/Be The Match maintains a website that lists many of the U.S. hospitals that collect cord blood for public banks.  Similar information for many other countries is available on the website of the Parent’s Guide to Cord Blood Foundation.

 If you are considering donation, ask your health care provider if donation is possible at the hospital where you plan to deliver your baby.

Cord blood is an accepted source of blood stem cells for patients undergoing a blood transplant. As such, they are used in treating more than 80 blood cancers, inherited genetic diseases, bone marrow failure, and immune diseases. A list of these diseases is available online.

In other areas, cord blood therapies are being studied for nerve, heart, bone and metabolism diseases, especially in the rapidly advancing field of regenerative medicine. The value of cord blood therapies for these diseases is being determined by ongoing studies.

Cord blood stored in a family bank cannot be used to treat just anyone in the family. Cord blood cells have genetic markers called human leukocyte antigens (HLA) that need to closely match those of the patient.  Brothers and sisters with the same biological parents have a 25% chance of being a perfect match, and a 50% chance of being a partial match. Other family members are much less likely to be a match.

Cord blood is one of three sources of blood-forming stem cells used in transplants. The other two sources are bone marrow and the blood that circulates through the body (called peripheral blood). Each source has advantages and disadvantages for various diseases, stages of disease and patients. Among other advantages of cord blood are:

• Unlike cells from adult donors, cord blood has not been as exposed to viruses, chemicals and environmental pollutants that can alter cell function.
• Cord blood immune cells are immature and can tolerate a recipient better than adult cells, so cord blood cells do not have to be matched as closely to the patient as do cells from adult donors.
• Cord blood may be accessed more quickly than stem cells from an adult donor who may have registered for donation years ago.  The donor must be located, consented, tested and harvested.

Consequently, cord blood may be the preferred source for patients who have an urgent life-threatening genetic disorder, need a transplant quickly, or have an uncommon tissue type because of their racial or ethnic heritage. Cord blood also can be easier to access during pandemics and travel restrictions. The transplant physician team, together with the patient, can determine the best stem cell source from the available options.

There are no known reports of coronavirus transmission in a transplant. In fact, there has never been a documented case in which any kind of respiratory virus has been transmitted to a patient by implantation, transplantation, infusion or other transfer of cells or tissues.

Delayed clamping can reduce the volume of stem cells remaining in the umbilical cord, but that does not necessarily make the volume unsuitable for donation or private storage. 

Several obstetric organizations in the United States, the United Kingdom and Canada have recommended a delay of 30-60 seconds between delivery and umbilical cord clamping in healthy, full-term babies. It is believed that delayed clamping may have a beneficial effect in the newborn.

However, if the baby’s cord blood is being stored for a known use – such as transplant of another family member with leukemia – delayed clamping is not advised.

Expectant parents should discuss options for delayed clamping with their obstetrics provider.

Regulations in most countries do not allow cord blood that has been stored in a family bank to later be donated to a public bank. However, a few countries do allow privately banked cord blood to be used publicly if the family who stored the cord blood unit agrees.

Cord blood transplantation is an accepted treatment for blood diseases such as leukemia, lymphoma or sickle cell, as well as inherited genetic disorders, bone marrow failure and immune deficiency diseases.

In addition to these, research is under way to determine whether components of cord blood can treat other medical conditions such as birth asphyxia (brain damage from lack of oxygen), cerebral palsy and autism.  Cord blood therapies for these brain injuries and diseases are not standard medical practice, but are being evaluated in ongoing clinical studies and may prove useful in the future.

In the early years of cord blood transplants this was true because of the limited dose of stem cells in a typical umbilical cord unit. However, as dosing of cord blood cells has become more completely understood, it is known that about 12% of adults can be transplanted with a single cord blood unit. But most adult patients typically require more cells than are contained in a single cord.

Yet, in recent years treatment of adults has become more common, in part because of “double cord” transplants in which the cells from two umbilical cords are transplanted. Also encouraging are processes now under investigation that expand the number of cells in a unit of cord blood. With increased doses of stem cells, more adult patients can be transplanted.

Theoretically, properly frozen and stored cord blood may remain useful for a lifetime. This isn’t known for certain, however, because cord blood banking has existed for fewer than 30 years. Cord blood stored for more than 20 years has been used for successful transplants.

For a child born into a family that has no history of blood diseases, the chances of ever needing a privately stored cord blood unit are small, but not zero. 

Of the estimated 4 million privately stored cord blood units in the world, more than 400 units have been used for donor transplants. In addition, hundreds more have been used in promising clinical trials in areas such as brain injury, among others.

Every year, new uses for cord blood and cord tissue are proposed or discovered. Umbilical cord blood, as well as other birthing tissues, hold promise for treating a range of diseases, and you may wish to consider saving both at the same time.

There is no standard method to store birthing tissues other than cord blood at this time. You should ask your cord blood bank about how the cord tissue is stored and how it might be used in the future.