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A quandary over cord blood

Published:August 31, 2010, 12:00 AM

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Updated: August 31, 2010, 7:23 AM

Couples expecting a new baby will face dozens of important decisions and a seemingly endless to-do list.

Expectant parents will choose an obstetrician or midwife, a birth center and a car seat for their child. They’ll spend hours haggling over baby names, preparing the nursery, shopping for baby clothes and stocking up on diapers and other newborn essentials.

One of the most critical decisions new parents face is whether to collect and save their baby’s umbilical cord blood. They’ll only have one opportunity to do it: in the moments following their baby’s birth.

Umbilical cord blood is a rich source of stem cells, considered to be the master cells of the body. Under the right conditions, these immature, “undecided” cells can be transformed to virtually any type of cell in the human body.

For nearly two decades, these cells have been used in transplant medicine to treat more than 80 serious diseases, including leukemia and other blood disorders and cancers. Scientists at leading universities in the United States are exploring a growing list of other potential uses for cord blood stem cells.

One of the most promising areas of stem cell research is regenerative medicine, in which an individual’s own stem cells are used to repair damaged or diseased tissues and organs. Clinical trials are under way to evaluate the benefits of using a child’s cord blood stem cells in the treatment of type 1 diabetes, heart defects, cerebral palsy and other brain injuries.

“Cord blood stem cells are not the same as embryonic stem cells, which come from human embryos and are very controversial,” explained obstetrician-gynecologist Marra Francis of The Woodlands, Texas. “When cord blood cells are used to treat an illness, they’re administered to the individual intravenously, like a blood transfusion.”

In the body, stem cells can trigger natural repair processes by reducing inflammation and increasing blood flow to injured or diseased areas. They also can stimulate the growth of new blood vessels and other tissues.

“Parents have a right to be informed about cord blood banking so they can make the best decision for their child and their family,” said Gina Dado, an obstetrician-gynecologist in Scottsdale, Ariz., who banked her daughter’s cord blood with Cord Blood Registry over 11 years ago.

When deciding the fate of their baby’s cord blood, parents have three options. They may donate it to a public bank, store it in a private banking facility or allow it to be discarded as medical waste.

Donation to public banks may be free, but the cord blood is not reserved for the exclusive use of the child or the family that provided it. Parents who want to ensure that their baby’s cord blood will be available for their family’s use can store it with a private bank.

According to Dado, “For use in transplant medicine in the treatment of diseases such as leukemia or lymphoma, there’s a 75 percent chance that a baby’s cord blood will be a match for a sibling.”

For storage at a private cord blood bank, the initial cost for collection and processing is approximately $2,000, with annual storage fees of around $125. In some cases, interest-free payment plans and gift registries are available.

After the baby’s birth, the umbilical cord is clamped and cut in the usual manner. The end of the cord attached to the placenta is the source of cord blood and the valuable stem cells it contains.

Once the doctor or midwife has collected the blood, it’s delivered to a cord blood bank, where it is given an identifying number and frozen in liquid nitrogen. Theoretically, the stem cells can last indefinitely if stored properly.

“With all the advances in stem cell technology, it makes good sense to save your child’s stem cells today,” said Dado. “We can only dream of the ways this valuable resource will be used in the future.”

As the list of potential uses for cord blood stem cells continues to grow, it’s likely that medical treatment with the cells will become increasingly common.

“I believe that if a child born today has a heart attack as an adult, the nurse at the hospital will ask, ‘Do you have your cord blood banked?’ ” said Francis. “There’s an excellent chance that the answer to this question will determine the first step of treatment.”

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