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89transam · 02-03-2004, 02:50 PM

http://www.redcross.org/faq/0,1096,0_104_,00.html#824

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What is cord blood?
Cord blood is the blood remaining in the umbilical cord and placenta after the birth of a baby. During pregnancy, oxygen and essential nutrients pass from the mother's blood into the blood of the baby. This lifeline between mother and child is provided through the placenta and the baby's umbilical cord. The blood found in the umbilical cord and placenta after birth is unique because it carries large numbers of blood stem cells – blood cells that create the red cells that carry oxygen, white cells that fight disease and platelets that help blood clot. When patients are treated for leukemia and certain other diseases, their stem cells often are wiped out.

Research indicates that cord blood replenishes these vital stem cells, making recovery possible.
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Why is there such excitement about cord blood?
There are special cells in cord blood that are present in bone marrow and only in tiny quantities in adult blood. These are the cells that make bone marrow transplants work.

Scientists hope that cord blood technology will help patients who can't find a matching marrow donor.
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Why should someone donate cord blood?
By donating cord blood, someone else can have a second chance at life. A patient who needs a marrow transplant but who cannot find a donor has effectively run out of medical options; the cord blood you donate could be the difference. We like to think of this as making the birth of your baby count twice; the new life of your new baby and the new life the cord blood could bring to someone else.
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How long can cord blood be stored?
We store the cord blood in a special freezer (-180°C; the temperature in your freezer at home is only around -20°C). Under these conditions, we believe that cord blood can be stored for long periods of time. However, because the field is new, we don't yet have precise data about exactly how long cord blood can be stored.
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How is the patient matched with the donated cord?
Almost all cells in the human body carry an "identification code" that is used by the immune system to confirm that the cells belong. One-half of this code is inherited from each parent in a set of genes called HLA. The identification code itself is called the HLA type. In the transplantation of blood stem cells, it is very important that the HLA type of the transplanted cells closely match the HLA type of the recipient. Cord blood cells are HLA-typed when they are placed in storage. This HLA information is entered into a database where it can be compared to the HLA types of patients in need of stem cell transplants. Technological advances have made this matching process practical and effective.
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How is this related to private cord blood banking?
It is not. The American Red Cross cord blood bank system is exclusively for non-related donation. We believe that the need for donations that exists now far outweighs the miniscule possibility that a family would ever need to use cord blood they have banked privately.
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What happens to donated cord blood?
The cord blood collected for our bank is tested and stored. Each unit is systematically reviewed to ensure all aspects of collections, processing and storage meet stringent quality standards. If a reason for exclusion is found, the unit may be used for research, quality control, or, depending on the severity of the issue, may be discarded.

If the unit is acceptable for transplant, we confidentially send the results of testing to a central databank using a coded identifier, not a name. When a doctor anywhere around the world has a patient who needs a transplant, the hospital contacts this databank. If one of our cord blood units is a match for that patient, they inform us and we send the cord blood to the doctor for the transplant.
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How can you be sure the donated cord blood is safe?
As with any blood donation, there is a careful screening process. For cord blood, this includes review of any maternal and paternal medical problems and risk behaviors. A blood sample from the mother is also rigorously tested for a variety of blood borne diseases.
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How does a person in need get access to the cord blood?
When a patient in need of transplantation is identified, their blood is drawn for Human Leukocyte Antigen (HLA) identification, or "tissue typing." Antigens are hereditary information that are located on the surface of almost all the cells in your body. They play a role in recognizing cells that are your own ("self") and not your own ("nonself"). By testing lymphocytes, the transplant laboratory is able to determine which six HLA antigens the patient has as a part of their genetic makeup. The patient's HLA identification is entered into a national database. Once a cord blood sample is processed, the cord blood HLA identification also is entered into the same database. When a match is identified, the patient's physician is notified. The stored cord blood can be shipped anywhere in the world for transplantation.
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Why cord blood instead of bone marrow?
First, collection of bone marrow is invasive and can be very painful. It requires extracting the marrow from the donor's bones with a needle and syringe. Because this procedure is expensive and involved, there is a shortage of donors.

Second, it is difficult to match between donor and recipient. Current potential for a bone marrow match may be as low as one in a million for Caucasians and even lower for ethnic minority patients. The matching problem is further compounded by the fact that minorities are under-represented in the unrelated bone marrow donor programs. Third, cord blood transplant patients may have a higher survival rate, a higher quality of life after transplant and less frequent hospitalization due to fewer complications such as Graft Versus Host Disease (GVHD). This makes the overall cost of cord blood transplantation significantly lower than traditional bone marrow transplants.
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What is (GVHD)?
GVHD is one of the most common and life threatening side effects of a bone marrow transplant. GVHD occurs when the transplanted material recognizes the recipient's body as foreign and rejects it. This reduces the survival rate of the patient to less than 50 percent at two years post transplant. Cord blood transplants have been noticeable for reduced incidence of serious GVHD.
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What about donor confidentiality?
No identifying information is exchanged between a cord blood donor and cord blood transplant recipient. The identity of the cord blood donor is kept confidential at the cord blood bank.
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How would the cord blood be used?
Cord blood stem cells can be transfused into patients with blood diseases after chemotherapy and/or radiation have destroyed their own stem cells. Research indicates that cord blood can be used in place of bone marrow stem cells. This is important when a matching bone marrow donor cannot be found. Studies show that once transplanted, these cells migrate to the bone marrow, where they begin creating healthy blood cells. This process has enabled study recipients to reconstitute their immune systems.
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How much cord blood is collected?
About 80 milliliters (approximately five to six tablespoons) of cord blood can be collected from each donor. Because cord blood is rich in stem cells, this relatively small amount is enough to provide a transplant for a child or most teenagers. Work is underway to maximize the amount of cord blood collected in each donation. Additionally, researchers are investigating ways to expand the volume of collected blood in the laboratory.
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Who will be helped by cord blood donation?
Every year, about 30,000 patients are diagnosed with diseases that might be treatable with cord blood. This includes leukemias, neuroblastoma, refractory anemia, Hodgkin's Disease and other cancers. Research also shows promise that cord blood can also treat genetic diseases such as sickle-cell anemia, aplastic anemia, thalassemia and Fanconi anemia.
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What do donors need to do?
Women who decide to participate will be asked to sign a consent form. We will take a blood sample and ask them to complete a brief questionnaire exploring their family's medical history. All information and files will be kept in strict confidence. Immediately after the baby is born and the cord is clamped and cut, the umbilical cord blood will be collected by an American Red Cross cord blood collection specialist or by an obstetrician or midwife trained by the American Red Cross.
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Who can donate?
Prospective donors must fill out a medical and family history questionnaire. The mother's blood, usually taken with other hospital blood samples, also is tested. Cord blood initially may be collected from routine deliveries at selected hospitals. However, because of the extraordinary expense of collections, not all new mothers will be able to donate cord blood.
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Is it a complicated process?
Far from it. The collection process does not affect the baby because the cord blood is collected after the baby has been born and the umbilical cord has been clamped and cut. At this point, instead of discarding the umbilical cord, a trained cord collection staff person, obstetrician or midwife collects the blood that remains in the umblical cord and placenta.

It is a painless, noninvasive donor procedure that usually takes from one to three minutes to complete. The small amount of blood remaining in the umbilical cord, typically about 80 to 100 mL (5 ounces), will be drained and taken to the American Red Cross cord blood bank to be frozen.
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Is there any cost for donating?
There is no cost for donating this gift of life. The American Red Cross, with the financial support of generous donors, will take care of the procedure and cover the cost of donation.
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How new is this procedure? Has it been tested?
It is a relatively new procedure. Fewer than 1,000 people worldwide have had cord blood transplants. The first cord blood transplant took place in France in 1988, for a child with Fanconi Anemia. In 1991, a transplant was performed on a child with chronic myelogenous leukemia.

Both transplants were successful, opening the doors to use cord blood for situations in which traditional bone marrow was routinely utilized. Since then, approximately two-thirds of cord blood transplants have been performed for malignant conditions. The other third have been for a variety of genetic blood disorders.

Overall, cord blood transplants boast an optimistic success rate. However, cord blood transplantation is still a developing medical technology and research on collection and transplantation is by no means complete. The American Red Cross Cord Blood Program is part of ongoing research monitored by the FDA.
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What about the health and safety of the baby?
The collection process does not affect the baby because the cord blood is collected after the baby has been born and the umbilical cord has been clamped and cut. The collection is both painless and safe. Average collection time is one to three minutes. Until now, cord blood and placenta routinely have been discarded following births. Even so, no donation can occur until the baby's mother agrees, on behalf of her child, to the collection and storage of the cord blood for possible transplantation.
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Where can people donate?
Because of the extraordinary expense related to collecting cord blood donations, the American Red Cross is collaborating with a select group of hospitals where donations are being collected. Anyone interested in donating cord blood should call the America Red Cross.
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How is the cord blood used after donation?
Cord blood is sent to an American Red Cross cord blood bank, where it is typed, analyzed and categorized, frozen and stored until it is needed. When a match is identified, the stored cord blood can be shipped anywhere in the world.
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How do patients receive stem cells?
Like all other stem cell transplants, cord blood stem cells are administered to the patient directly into the blood stream. This takes place once the patient's own stem cells and immune system have been destroyed through a rigorous treatment of chemotherapy and/or radiation to wipe out the diseased cells. Once infused, the new stem cells travel to the bone marrow spaces, where they take up residence and begin to multiply.
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A good read. I had no idea you could donate your babys umbilical cord blood , but apperantly they can be a real lifesaver. I think for all of us that are gonna hve kids in the next decade or so its a good thing to remember.

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