by Jonathan L Liss, M.D.
In this difficult economy and ever more confusing science atmosphere, it is very important for young couples to decide how best to spend their health care dollars. During pregnancy, options of 4-D ultrasound, high resolution ultrasound, pre-implantation genetic sampling and placental cord blood stem cell storage are several among many choices that will have to be considered. To make matters more difficult, our parents, who are often our most trusted advisors, are of very little help since these options were never possible during their time of pregnancy.
In this article, the fundamentals of cord blood stem cells will be discussed so that an informed choice can be made. If your obstetrician engaged you in this topic, count yourself as fortunate, as most obstetricians wait to be asked and then often reply "If you can afford it, then I would do it." Little else is typically discussed.
To begin with, cord blood stem cell science is a non-controversial topic from the standpoint of morals and ethics. The vast majority of members of both the conservative and liberal parties of our government are in favor of cord blood storage and usage. In 2007, the Catholic News Service reported that Pope Benedict XVI endorsed umbilical cord stem cell research and therapy. Given this, the question "Should I or shouldn't I store my newborn's cord blood" comes down to the value of the service.
So what are stem cells?
Stem cells are the basic building blocks of our bodies. They are cells that can become any tissue type within us. In other words, they can become blood cells, heart cells, brain cells, kidney cells, skin cells etc. They are similar to a blank canvas waiting to be painted. This is their great value and great promise.
Before these cells were discovered, it was thought that only an embryo contained these cells. Mistakenly, scientists believed that once the baby was born, each cell had already made an irreversible choice as to what kind of tissue to become.
In other words, the painting had already been completed. However, in the early 1980's these stem cells were found in the placental cord blood of newborns. All of a sudden, a risk free and pain free opportunity to obtain stem cells was found. However, one had to wonder, "Would they ever be useful?" Just because you have blank canvas and paint does not mean that art will be created. As you read later in this article they have indeed become widely used.
How are cord blood stem cells harvested and processed?
Couples that wish to store their baby's stem cells for family use must sign-up with a private cord blood bank. There are more than twenty such banks across the country. Most offer nationwide coverage in the continental U.S. Storage can be arranged as late as a day or two prior to delivery, but as with most things, the earlier that it is arranged, the easier it is to accomplish. For families that wish to donate their baby's cord blood for public use, some hospitals will offer this service at the time of delivery while others ask you to make arrangements on your own.
The process itself is pain free and essentially risk free. After the umbilical cord is cut and the baby is handed to the new mother, the obstetrician cleans the umbilical cord and drains as much placental blood into the specialized collection bag as possible. This can occur while waiting for the placenta to be delivered or after it has already been delivered.
The collected blood is then shipped to a processing lab. At the lab, the stem cells are separated from the other blood products and slowly frozen to 197 degrees below zero in liquid nitrogen or its vapor. The remaining blood products, along with a sample of the mother's blood, are tested for numerous infectious diseases.
Will these cells be used?
Currently, cord blood stem cell storage is viewed as an insurance policy for both your baby and close blood related relatives. In the 1980's, only one sample out of every 40,000 was used medically.
Today, it is still unlikely that you will use the stored cells, but the numbers are far more intriguing. It is estimated that one out of every 2,700 babies will use their own stored cord blood and one out of every 1,400 samples will be used to treat a sibling or other close relative.
There are now more than seventy diseases for which cord blood is the treatment of choice. This includes most leukemias, many cancers, and a host of relatively rare metabolic diseases. Researchers are currently testing these stem cells on virtually every major disease.
Duke University recently treated a toddler with cerebral palsy. Videos of this miraculous fifteen minute treatment show dramatic improvement in this child's speech and motor skills in just five days. A major trial for this disease using cord blood is now being planned.
CBS's Sixty Minutes not only documented the cure of a young man's sickle cell disease, but an actual change of his blood type.
Stork Medical, a private cord blood company, has launched a charity cord blood program for the military with "The hope, prayer, and expectation that the cord blood stem cells of a soldier's newborn will one day be used to repair wounds sustained in battle."
Whether or not these cells prove to be a cure of these dreaded diseases on a large scale and whether or not they become the treatment of choice for Diabetes, Alzheimer's disease, burns, paralysis, MS etcetera remains to be seen.
How much does it cost?
The best quality companies all perform the same services for a price that ranges from $1,700-$2,400 for the first year. After the first year, annual storage rates range from $99-$300/year. Payment plans and pre-paid multi-year storage discounts are typically offered.
Some companies make it difficult to determine the total charges and others make it easy. When storing, you need to make certain that the following services are included in the price quoted:
- Collection, processing, and storage through the first year.
- Overnight temperature controlled sample transportation. Discount companies will use overnight package delivery companies to cut costs. Temperature control, as opposed to delivery speed, is the single most important determinant of cell survival. Thus, you do not want to have your sample in the back of a metal truck where it will be exposed to non-standard temperatures. These cells do best at room temperature prior to processing.
- Sample pick-up from the post-partum room.
- Full coverage of the doctor's fee. Many companies with pass some or all of this cost onto you. This can substantially increase your initial fee.
- Free retrieval of your stem cells when needed.
In addition, the company should be FDA registered and the lab should be fully accredited.
Copyright © Jonathan Liss, M.D. Permission to republish granted to Pregnancy.org, LLC.