There are two main types of cord blood banks, public and private.
In general, public banks are nonprofit entities supported by federal or private funding. After the mother consents, public banks collect cord blood from healthy full-term pregnancies at no cost to the donor’s family.
In giving consent, the infant’s mother acknowledges that the donation is voluntary and gives up all rights to the cord blood for the public good. The mother also agrees to allow her medical records and the baby’s newborn records to be reviewed, gives a detailed family medical history, and allows a sample of her own blood to be taken for infectious disease testing.
Units passing screening tests designed to eliminate risks of transmitting genetic or infectious diseases are typed, placed in the search registry, and are available to any suitable patient in need of transplantation. Units that do not meet criteria for public banking may be discarded or used for research purposes.
Private cord blood banks are generally for-profit companies that store “directed donations” intended for future use by the child or a family member. Using a kit provided by the bank, the cord blood is collected by the physician, midwife, or nurse delivering the baby and shipped back to the company’s banking facility. The parents of the infant are charged an initial fee for collection and processing of the cord blood and then an annual fee for storage.
Varying degrees of testing is performed on the units, and minimal standards are used to determine whether a unit is eligible for processing and banking. The majority of private collections are undertaken as an investment in the unknown potential for cord blood to be used to treat serious illnesses in the future.
Most obstetricians and pediatricians feel that routine cord blood storage in healthy babies is unnecessary. In this regard, it is important to note that a child’s own cord blood would not be used for transplantation of a child with leukemia or other cancers, in part due to concern for contamination with cancerous cells, and it would not be used to treat a genetic condition because the cord blood would contain the same genetic problem.
Currently, directed donation of umbilical cord blood for another family member is recommended when a first-degree relative has a high risk pediatric cancer that can be treated with transplantation therapy, a hemoglobinopathy or other transfusion-dependent blood disorder, a congenital immune deficiency, or an inborn error of metabolism.