After the cord is cut: Understanding cord blood banking

Cutting the umbilical cord is one of the most significant and symbolic moments in the birth of a child.

With that moment comes a unique opportunity to save a life, through a process known as cord blood banking.

Dr. Efua Leke, assistant professor of obstetrics and gynecology at Baylor College of Medicine and chief of obstetrics at Ben Taub Hospital, offers insight into how the process works, options available to parents and the benefits of donating cord blood.

What is cord blood and how is it used?

Umbilical cord blood is the blood left in the cord and placenta after the baby is delivered. Within this blood are unique cells known as stem cells that can be used to treat cancer and other life-threatening blood disorders.

Getting those stem cells to the patients who need them involves collecting the cord blood after the baby’s birth and storing it for future use, a process known as cord blood banking. When the need for stem cells arises, the stored blood can be transplanted, replacing diseased or damaged cells in patients with conditions like leukemia, lymphoma and sickle cell anemia, rebuilding a healthy blood and immune system.

While stem cells also are found in bone marrow, cord blood offers several advantages:

• It’s easier to collect, store and access.
• It’s less likely to be rejected by recipients.
• It can be a match for patients across a wide range of racial and ethnic backgrounds, improving access to life-saving treatment.

Public versus private blood banks

Parents interested in cord blood banking have two options. They can donate their baby’s cord blood to a public blood bank at no cost, where it is stored and available to treat anyone in need of stem cells. Or they can choose to store the cord blood in a private blood bank for their own personal or family use. Private banks can be costly and the likelihood the stem cells will be used is low. In general, the American Academy of Pediatrics encourages parents to donate to public cord blood banks instead.

“Obstetrics patients at Ben Taub Hospital have had the opportunity to donate cord blood for years through MD Anderson’s Cord Blood Bank program,” Leke said.

Established in 2005, the program is one of the largest public cord blood banks in the world, collecting, screening and storing voluntary donations of cord blood from mothers at 14 partner hospitals across Houston and the nation – soon to be 15, Leke noted. “Plans are in the works to expand the program to include the large prenatal population at Texas Children’s Pavilion for Women.”

The collection process

The collection process is noninvasive, Leke said. “It doesn’t harm the mother or baby and doesn’t interfere with the birthing process. As clinicians, our priority is always the patient.”

“When moms are admitted to labor and delivery here, program coordinators meet with them to explain what the Cord Blood Bank is, how the collection process works, and how the donations are used to help those in need. If the patient consents to being a donor and they are approved by the study team, the coordinators are present at the time of delivery,” she explained.

“After the cord is cut, instead of going directly to delivering the placenta, we take a few extra minutes to collect the blood from the umbilical cord. We then deliver the rest of the placenta, and the coordinators collect any additional cord blood from the placenta to maximize the donation.”

Providing hope

Donations are stored in MD Anderson’s Cord Blood Bank and are accessible to transplant facilities worldwide, providing opportunity and hope for patients and families in need of donor stem cells.

Researchers are exploring the use of cord blood stem cells to treat a wide range of conditions, including cerebral palsy, sickle cell anemia, stroke, diabetes, spinal cord injury, and autism, among others. A top priority is increasing the quantity of stem cells available, since each cord blood donation yields a small therapeutic amount. In 2023, the FDA approved a new stem cell multiplication procedure designed to expand the number of stem cells in each unit of cord blood before transplantation.

“Our clinicians receive certificates showing the number of units collected and where they go,” Leke said. “It takes a lot of units to get even a small amount that is clinically important for a particular treatment, but every unit counts. If even one person benefitted from cord blood voluntarily donated by our patients, we see tremendous value in that.”

Education and awareness are key to helping parents make informed decisions. “When our patients learn about the program, they understand the value of having this additional stem cell treatment option in your arsenal when you’re fighting a life-threatening disease.”

By Sharon Dearman, a writer in the Department of Obstetrics and Gynecology