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19 October 2022

Public or family cord blood banking - which one to choose?

By Cherie Daly, MD, SLD Consulting
Advisor - Parents' Guide Cord Blood Foundation
Scientific Board ITERA (International Tissue Engineering Research Association)

When having a baby, parents must make many decisions, ranging from material ones (what pram to buy, what cot to buy, what colour to paint the room) to more serious medical ones.

One of these medical decisions is what to do with the blood from the newborn baby's umbilical cord.

Today, parents delivering in Singapore have three choices relating to their baby's cord blood:

  1. Donate to a public bank
  2. Store privately in a family bank
  3. Throw it away

So where do parents “go” for accurate, non-bias information to assist them with this decision and to empower them to make an educated decision based on accurate facts.

I always say that each family is unique and what might be the right decision for one family may be wrong for another.

Parents should carefully research the topic, discuss the options, and make their own decision based on non-bias facts.

A good place to start is The Parents' Guide to Cord Blood Foundation (parentsguidecordblood.org). This website gives non-bias accurate information about both public and family cord blood banking. The founder is a mother, with a scientific background, who lost her daughter to cancer and has dedicated her life to this website and informing other parents about cord blood banking and all the options.

It's important to know that public and private cord blood banks store umbilical cord blood for different reasons.

Public cord blood banks accept donations of cord blood to be tissue typed and listed on the International Donor Registries (like NMDP and WMDA) for haematopoietic (blood) stem cell transplants from people who are not related to the donor.

Parents store umbilical cord blood with a family cord blood bank for related haematopoietic stem cell transplants (most likely sibling transplants) and for a few current indications for the need of autologous (one’s own) stem cells (i.e. solid tumors and aplastic anaemia)

Besides the current indications, parents can also store cord blood samples privately for the emerging applications using umbilical cord blood stem cells for non-haematopoietic diseases that are currently being research in clinical trials. An example is cerebral palsy, which is currently being explored in an FDA-approved phase 11 clinical trial at Duke’s University in North Carolina, USA.

Below, I have summarised a few facts in table form to help you to understand the differences:

PUBLIC CORD BLOOD BANK VS
PRIVATE/FAMILY CORD BLOOD BANK

PUBLIC CORD BLOOD BANK

PRIVATE/FAMILY CORD BLOOD BANK
Family donates cord blood and as such relinquishes all rights to the unit.Family store cord blood privately for their use only.
No cost to donate cord blood.Family pays the private cord blood bank that they choose a fee to process and store the cord blood for them.
Sample gets HLA typed and listed on international donor registries where it is publicly searchable for an unrelated transplant.Sample is not HLA typed, and not listed on any international lists. Unless requested by the family, the unit is for the child (autologous) and the family only.
60% -80% of public cord blood donations are rejected and discarded due to numerous reasons.Each private cord blood bank has its own set of criteria and procedures for accepting or rejecting samples. Typically, the family is fully informed and given the option to continue storing.
Storage is available for both autologous and related transplants (family members with a HLA match-most likely siblings).
Once the family donates the cord blood, they relinquish all rights to the sample. The sample is released if a match is found and purchased by one of the international registries.Sample is released only on request of the family and normally at no cost to parents.

As mentioned previously, this topic should be fully researched and understood. Parents should ensure they understand all the facts, including knowing exactly what cord blood can be used for in both settings. All the pros and cons should also be carefully considered.

After this, each family should feel comfortable making a decision that is right for them.

No choice is the right or wrong decision. Each family is unique, and the decision they make is the right one for them.

Reference:

1.parentsguidecordblood.org

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