Cord blood and transplantation
Options for umbilical cord blood
Basic guidelines
Donating umbilical cord blood
Protecting your privacy
Cord blood and transplantation
Q: How is umbilical cord blood used in transplants?
A: Cord blood is rich in the blood-forming cells that can be used in transplants. (Cord blood collected from the placenta and umbilical cord is called a cord blood unit.)
Transplants are needed by thousands of patients with blood cancers like leukemia and lymphoma and other life-threatening diseases. Donated cord blood units are listed on the Be The Match Registry®. When a patient needs a transplant, the registry is searched for cells that match the patient.
Q: Are umbilical cord blood cells the same as embryonic stem cells?
A: No, umbilical cord blood cells are taken from the baby's umbilical cord and placenta after the baby is born, and not from an embryo.
Q: What is the Be The Match Registry?
A: The Be The Match Registry is a listing of potential marrow donors and donated umbilical cord blood units. Doctors can search the registry to find a match for their patients who need a transplant but do not have a matched donor in their family.
When you donate cord blood, it is listed on the Be The Match Registry and stored at the public cord blood bank. (The donated cord blood is not reserved for your family.)
The Be The Match Registry is operated by the National Marrow Donor Program (NMDP).
Q: When is umbilical cord blood used for a transplant?
A: Cord blood is one of three sources of blood-forming cells used in transplant. The other two are bone marrow and peripheral (circulating) blood.
When a patient needs a transplant for a life-threatening disease, the patient’s doctor will determine the source of cells that is best for the patient. Sometimes bone marrow or peripheral blood is best for the patient; sometimes cord blood is better.
Cord blood is especially useful when:
- A patient’s cells do not closely match an adult donor. Patient outcomes are improved when the cells for transplant closely match the patient. However, studies show that cord blood does not need to match as closely as bone marrow or peripheral blood--and the patient outcomes are still good.
- A patient needs a transplant quickly. Cord blood units are stored in a public cord blood bank and ready to use. Sometimes a patient cannot wait several weeks or months for a donor to be contacted and the marrow donation to be collected.
- A patient from a diverse racial or ethnic background has a difficult time finding a suitable match. Again, because cord blood does not need to match as closely as bone marrow or peripheral blood, finding a suitable match may be easier.
Related Links:
Cord Blood Transplants
Q: Why is there an urgent need for racially and ethnically diverse donors?
A: The urgent need is based on what makes a successful transplant. Studies show that patient outcomes are improved when patients closely match the donated cells. And patients are more likely to match someone who shares their racial or ethnic heritage.
Increasing the diversity of cord blood units on the Be The Match Registry makes it possible for more patients of diverse racial and ethnic backgrounds to receive a transplant. In 2012, thirty-nine percent of minority patients who received a transplant used cord blood.
Related Links:
Cord Blood is Changing Lives, The Need for Donors
Options for umbilical cord blood
Q: Should I store my baby's umbilical cord blood for my family or donate it for public use?
A: Donating cord blood for public use or storing it for your family's private use is a personal decision.
The umbilical cord and placenta are routinely discarded after the baby is born—unless you decide otherwise. Your may choose to have the cord blood collected and:
- Donated to a public cord blood bank. The cord blood will be listed on the Be The Match Registry®, where it is available for anyone in need of a transplant. (If the cord blood cannot be used for transplantation, it may be used for research studies or it will be discarded.) Donating your baby’s cord blood to a public cord blood bank is free.
- Stored in a family (private) cord blood bank. The cord blood can only be used for your family. The cord blood unit cannot be moved to the registry at a later date. People who use a family cord blood bank are charged a fee for collection as well as annual storage fees.
- Saved for a biological sibling who has a diagnosed medical need. This cord blood can only be used for your family; if the cord blood is not used, it cannot be moved to the registry. Collecting and storing blood for sibling-directed donation is offered at little or no cost to eligible families.
Learn more about your Cord Blood Options.
Q: If I donate umbilical cord blood for public use, will it always be stored and ready for a transplant?
A: To provide the best possible result for patients, the cord blood unit must meet these quality standards:
- The cord blood unit must contain enough blood-forming cells for a transplant. If there are too few cells, the cord blood unit cannot be listed on the registry, but may be used in research related to cord blood and the use of cord blood in transplants.
- Your (the mother's) health history must meet basic guidelines.
- The cord blood unit and your (the mother's) blood sample must be free from infection or other medical concerns.
- When the cord blood unit meets quality standards, it is frozen and stored at a public cord bank. The cord blood unit is then listed on the Be The Match Registry, where it is available to any patient in need of a transplant.
Related Links:
How to Donate Cord Blood
Q: Will umbilical cord blood stored privately for my family always be used if someone in my family needs a transplant?
A: The answer depends on several factors. If your baby's cord blood is stored privately (usually in a family bank) and someone in your family needed a transplant, your doctor would consider:
- The disease. For some diseases, the patient’s own cells can be used for transplant. However, many diseases treated with transplant may already be present in the baby's cord blood. For these diseases, a transplant using cells donated from a relative or unrelated donor is the best choice.
- The match between the cord blood unit and the patient. There is a 25% chance that siblings will match each other. (Tissue type is inherited from parents. See the patient information on HLA matching). The doctor will determine how close the match needs to be.
- The quality of the cord blood. The cord blood unit must be large enough (have enough blood-forming cells) and be free from disease and infection.
Based on these factors, your doctor would choose the cells that provide the best outcome for the patient. Sometimes the cells could be your baby’s; sometimes an unrelated marrow donor or cord blood unit is the better choice.
For more information, see the American Academy of Pediatrics Frequently Asked Questions about Cord Blood Banking: http://www.healthychildren.org/English/ages-stages/prenatal/decisions-to-make/Pages/Should-We-Store-Our-Newborns-Cord-Blood.aspx
Q: If umbilical cord blood is stored in a family bank, can it be listed on the Be The Match Registry at a later date?
A. At this time, cord blood stored privately cannot be listed on the Be The Match Registry at a later date.
Basic Guidelines
Q: If I deliver my baby in a hospital outside the continental US, such as in Alaska, Hawaii or Puerto Rico, can I donate the cord blood?
A: No, donors need to deliver within the contiguous (not Alaska, Hawaii or Puerto Rico) US. Cord blood units must arrive at a cord blood bank within 48 hours of collection. It is possible that delays can occur outside the contiguous US due to transportation and shipping.
Q: If I’m under 18 years old, can I donate?
A: Donors must usually be 18 or older. However, some states have laws allowing donations from younger women. Check with a public cord blood bank in your area. They will determine if you can donate.
Q: What is the definition of a fetal abnormality?
A: If you have had an abnormal test result from an amniocentesis, blood test or ultrasound or during any other prenatal visit, that would be considered a fetal abnormality. Some examples include cystic fibrosis, malformed arms, legs, feet or hands, and chromosome abnormalities such as Down syndrome. Also, any genetic predisposition to certain disorders could place a potential recipient at risk, and would cause your baby’s cord blood to be excluded from the Be The Match Registry.
However, certain minor abnormalities, including clubbed feet, cysts on kidneys or cleft palate, are acceptable for cord blood donation.
Q: Can I donate if I'm having twins?
A. No, public cord blood banks can only accept donations when one baby is expected. With twins, each umbilical cord has different tissue types; it’s possible the two cord blood units could be mixed up during collection.
Q: What if I have diabetes?
A: If you have gestational diabetes, you will usually be allowed to donate. If you have medication-dependent diabetes, check with a public cord blood bank; they will determine if you can donate.
Q: Can I donate if I had cancer?
A: If you have had local skin cancer (simple basal cell or squamous cell) or cervical cancer and it is cured, you may be allowed to donate. The public cord blood bank makes this decision.
Q: I had an organ or tissue transplant. Can I still donate?
A: It depends on the length of time since you received the transplant. If you received a heart, lung, kidney, bone marrow or other organ or tissue transplant within the last 12 months, you cannot donate cord blood. If it’s been more than a year, check with a public cord blood bank.
Q: What if a donor egg (or sperm) was used? Can I still donate?
A: Whether you can donate cord blood depends on the facility where the egg or sperm was handled and the medical history of the donor.
The donor egg or donor sperm needs to be from a facility that is accredited by the American Association of Tissue Banks. And the medical history of the person who donated the egg or sperm needs to be reviewed by the public cord blood bank.
Q: If I cannot donate my baby’s umbilical cord blood, how else can I help?
A: Thank you for your willingness to help. You can give hope to patients by:
Donating umbilical cord blood
Q: How can I donate umbilical cord blood?
A: First, learn if you meet cord blood donation guidelines by answering these basic questions. If you meet donation guidelines, check the list of hospitals that collect cord blood for a public cord blood bank. If your hospital is listed, contact the cord blood bank that works with your hospital for further evaluation and more information.
Q: What if my hospital does not collect cord blood for a public cord blood bank?
A: Answer these basic questions. If you meet the cord blood donation guidelines, you have two options. You can complete the Contact Information page, which will be forwarded to a cord blood bank that may be able to send you a cord blood collection kit. The cord blood bank will contact you 7 to 10 days after you submit your information. Or, you can contact one of these cord blood banks directly for further evaluation and information.
Q: How far ahead of my due date do I need to contact a public cord blood bank about donating umbilical cord blood?
A: Ideally, you should contact your cord blood bank between your 28th and 34th weeks of pregnancy. If you are still in the early stages of your pregnancy, please contact your cord blood bank or return to BeTheMatch.org/cord when you have reached your 28th week.
Related Links:
How to Donate Cord Blood
Q: Does it cost me anything to donate cord blood?
A: There is no cost to donate to a public cord blood bank. Public cord blood banks cover the costs of collecting, processing and storing cord blood units.
People who use a family cord blood bank are charged a fee for collection as well as annual storage fees.
See Options for Umbilical Cord Blood
Q: How will my delivery experience be affected by donating?
A: Your labor and delivery will not be affected in any way. During delivery, all the focus is on you and your baby. It is only after your baby is born that blood is collected from the cord and placenta. No blood is ever taken from your baby.
Related Link:
How to Donate Cord Blood
Protecting your privacy
Q: If I donate umbilical cord blood, will my name or my baby’s name be on the Be The Match Registry?
A: No. Only the number identifying the cord blood unit will be listed on the Be The Match Registry.
A number will be given to the cord blood unit at the hospital. This number identifies the cord blood unit on registry and at the public cord blood bank. No name is associated with it.
Q: How is our family’s privacy protected after the umbilical cord blood unit is used for a transplant?
A: The public cord blood bank keeps the mother's name confidential, and it protects the privacy of the family. Names are not shared with any patient or transplant center.
The cord blood unit is identified only by a number on the Be The Match Registry, never by name. This also means that you and the patient will not be able to exchange any personal or identifying information.