What is an umbilical cord blood unit? And how is it used in transplant?
A cord blood unit is the term used for the blood collected from the umbilical cord and placenta after a baby is born. Cord blood is rich in blood-forming cells that can be used in transplants for patients with leukemia, lymphoma and many other life-threatening diseases. Cord blood is one of three sources of cells used in transplant; the other two are bone marrow and peripheral (circulating) blood (also called peripheral blood stem cell or PBSC transplants). To learn more, see Cord Blood is Changing Lives and Cord Blood Transplants
Are umbilical cord blood cells the same as embryonic stem cells?
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.
How do doctors decide when to use cord blood for a transplant?
When a patient needs a transplant for a life-threatening disease, his or her doctor considers many factors:
Should the cells come from the patient (autologous transplant) or from a donor (allogeneic transplant)? The type of transplant used depends on which works best for that disease.
Which cell source (bone marrow, peripheral blood, or cord blood) is best for the patient? Each source has advantages and disadvantages.
Cord blood is especially useful for:
Patients who need a transplant quickly, because cord blood units are stored and ready to use.
Patients who have a hard time finding a matched bone marrow donor. Cord blood does not have to match a patient's tissue type as closely as donated bone marrow does.
Patients from racially or ethnically diverse communities who often have uncommon tissue types. Because cord blood does not have to match the patient as closely as bone marrow does, it may offer more people from diverse racial and ethnic communities a second chance at life.
Should I store my baby's cord blood in a private family bank or donate it for public use?
Donating cord blood for public use or storing it for your family's private use is a personal decision. You can find detailed information in these FAQs that can help you make an informed decision.
Who can use donated cord blood?
On any given day, more than 6,000 patients, their families and friends around the world are searching the National Marrow Donor Program (NMDP) Registry for a matching bone marrow donor or cord blood unit. These patients have leukemia, lymphoma and other life-threatening diseases that can be treated by a bone marrow or cord blood transplant.
If you donate cord blood to a public bank, the cord blood can be transplanted into any patient whose doctor selects the cord blood unit as the best match for that patient. The donated cord blood is not reserved for your family.
If I donate umbilical cord blood is it always stored?
The NMDP is committed to building an inventory of high-quality cord blood units to provide the best possible result for patients. When donated cord blood meets these standards for transplant, it will be stored and listed on the NMDP Registry:
The cord blood unit must be large enough (contain enough blood-forming cells) for a transplant. If there are too few cells, the cord blood may be used for research to improve transplants for future patients or it may be discarded.
The cord blood unit and the mother's blood sample must show no signs of infection or other medical concerns.
Approximately 50% of the cord blood units that are collected are not stored for transplantation. The most common reason a cord blood unit cannot be stored is because the cord blood unit does not contain enough blood-forming cells.
If the cord blood unit is suitable for transplant, it is tissue typed, then frozen and stored in a liquid nitrogen freezer. The cord blood unit is then listed on the NMDP Registry, where it is included in our research study and available to any searching patient in need.
If someone in my family needed a transplant, when would cord blood stored for my family be used versus unrelated cord blood?
If you stored your baby's cord blood in a private family bank and someone in your family needed a transplant, your doctor would consider a number of factors:
If the baby who provided the umbilical cord blood needs the transplant:
The doctor will decide if a transplant using that person's own cells (an autologous transplant) is the best choice. Many diseases that are treated with transplant may already be present in the cord blood. For some diseases, a transplant using cells donated from a relative or unrelated donor (allogeneic transplant) is the best choice.
If the sibling of the baby who provided the umbilical cord blood needs a transplant:
The doctor would first test to see if the sibling matches the brother or sister who needs the transplant. Because tissue types are inherited from parents, there is a 25% chance that siblings will match each other. (For more details, see the patient information on HLA matching).
If the siblings match: the doctor will decide between the stored cord blood or a bone marrow donation from the sibling; each has advantages and disadvantages.
If the siblings do not match: the doctor will search the NMDP Registry for an unrelated adult bone marrow donor or a cord blood unit that closely matches the patient.
If your child's stored cord blood is the best choice, the doctor would check to be sure that the cord blood unit is large enough (has enough blood-forming cells) and is free from disease and infection. If these standards are not met, then the doctor will consider the other options above.
Why are racially and ethnically diverse donors urgently needed?
For a successful transplant, the tissue type of a bone marrow donor or a cord blood unit needs to match the patient's as closely as possible. Tissue types are inherited, so patients are more likely to match someone who shares their racial or ethnic heritage. And patients from racially or ethnically diverse communities can have a harder time finding a match.
Because cord blood does not need to match a patient as closely as donated bone marrow, cord blood transplants may offer hope to these patients. In 2007, nearly 35% of cord blood units used in transplants facilitated by the NMDP went to patients from racially or ethnically diverse communities.
Many more patients could be helped if cord blood is donated, especially from these communities:
Check our list of participating hospitals to see if your hospital works with a public cord blood bank to collect cord blood for public donation. Because of funding limitations, it is not possible to donate cord blood at every hospital at this time.
When should I contact the cord blood bank in my area about donating umbilical cord blood?
If you're interested in donating, ideally you should contact the cord blood bank by the 34th week of pregnancy.
What if I decide a month, or two weeks, or even the day of my delivery that I want to donate?
We recommend that if you are interested in donating, you contact the cord blood bank by your 34th week of pregnancy. However, some cord blood banks have on-site collection staff who can accommodate last-minute collections, so it's best to contact the cord blood bank, as they may be able to help.
Can I donate if my hospital is not on the list?
If your delivering hospital is not included in our list of participating hospitals and public cord blood banks, you can check a few other options:
If our list shows a cord blood bank in your area, you can contact the cord blood bank to ask whether they can still help you donate.
You may contact Cryobanks International at 1 (800) 869-8608 to ask about its eligibility requirements and process, or visit its Web site at cryo-intl.com/enroll/donating. Cryobanks International accepts donations from anywhere in the continental United States to be listed on the NMDP Registry. It is important to contact them before your 34th week of pregnancy to have time to make arrangements.
You can check whether there are other cord blood banks in your area that accept cord blood for public donation. These banks are not part of the NMDP Network of banks and do not list their cord blood units on the NMDP Registry.
You can ask your hospital whether it accepts cord blood donations for research purposes. Research leads to new treatments that can benefit more patients in the future.
There is no cost to you when you donate cord blood to a public cord blood bank. Public cord blood banks cover the costs of collecting, processing and storing cord blood units.
Will donating my baby's umbilical cord blood change my delivery experience?
Donating cord blood will not change your labor or delivery in any way. During delivery, all the focus is on you and your baby. No blood is taken from your baby, only from the cord and placenta after the baby is born.
NMDP Network public banks cannot accept donations if you are having twins. Tissue types are used to match a cord blood unit to a patient, and there could be a possibility of mixing or confusing the tissue types of the two umbilical cords.
How is my privacy and that of my baby protected after I have donated to a public cord blood bank?
The 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 baby's cord blood is identified by a number, never by name.
Are cord blood transplant patients ever given information about their donor?
No. Identifying information is never exchanged between a cord blood donor and a cord blood transplant recipient.
If I donate umbilical cord blood, does that mean my child and I will be on the NMDP Registry?
You and your baby will not be listed on the NMDP Registry. Only the cord blood unit will be listed. The collected cord blood unit will be given a number at the hospital. This is how it is identified on the NMDP Registry and at the public cord blood bank. No name is associated with it.
National Marrow Donor Program (NMDP) and cord blood
How does the National Marrow Donor Program support cord blood donation and transplantation?
The National Marrow Donor Program (NMDP) is committed to building a strong network and inventory of high-quality cord blood units available to any patient who needs a transplant. We work with expectant parents and public cord blood banks to increase the number and diversity of cord blood units available for patients.
We are also committed to improving transplant results for patients. That is why we are conducting a research study on cord blood transplantation and patient outcomes. Expectant mothers are asked to provide consent to have their baby's cord blood collected and listed on the NMDP Registry. Every cord blood unit on the Registry is included in our research study.
We are here to help answer any questions you may have about cord blood donation. You can reach us at 1 (800) MARROW2 (1-800-627-7692) — toll-free in the United States. Outside the United States, call (612) 627-5800.
What is the NMDP Registry?
The NMDP Registry is a listing of potential bone marrow donors and cord blood units available for patients in need of transplant.
I am unable to donate my baby's cord blood, but I would like to help. What else can I do?
Thank you for your willingness to help patients in need. To help, you can:
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