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Cord blood and transplant

Q. When is umbilical cord blood used for a transplant?
A. When a patient needs a transplant, their doctor will determine the source of cells that best meets their needs. Cord blood is one of three sources of blood-forming cells used in transplant. The others are bone marrow and peripheral blood stem cells (PBSC).

Q. Are umbilical cord blood cells the same as embryonic stem cells?
A. 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.

Q. What is the Be The Match Registry®?
A. The Be The Match Registry is a listing of potential bone marrow donors and donated umbilical cord blood units. Doctors can search the registry to find a match for their patients who need a transplant but don’t have a matched donor in their family.

When you donate cord blood, it’s listed on the registry and stored at a public cord blood bank. Cord blood is especially useful when:

  • There is no adult donor who is a close match for a patient. Patient outcomes are improved when the cells for transplant closely match the patient. However, studies show that cord blood does not need to match as closely as bone marrow or peripheral blood for a successful transplant.
  • A patient needs a transplant quickly. Sometimes a patient can’t wait several weeks or months for a donor to be contacted and the marrow donation to be collected. Cord blood units are stored in a public cord blood bank and ready to use.
  • A patient's ethnic background is important in predicting the likelihood of finding a match.

Q. Why is it important to increase the ethnic diversity of the registry?
A. Studies show that when donated cells closely match a patient, their chances of transplant success improve. Patients are more likely to match someone of the same ethnic background.

Increasing the diversity of cord blood units on the registry makes it possible for more patients to receive a transplant. In 2019, 30% of umbilical cord blood transplants were for patients of color.

Options for umbilical cord blood

Q. Should I store my baby’s umbilical cord blood for my family or donate it for public use?
A. Donating cord blood for public use or storing it for your family’s private use is a personal decision. Typically the umbilical cord and placenta are discarded after your baby is born – unless you decide otherwise. You can also choose to have the cord blood collected and donated to a public cord blood bank, stored in a family (private) cord blood bank, or saved for a biological sibling who has a diagnosed medical need. Learn more about your cord blood options.

Q. If I donate umbilical cord blood for public use, will it always be stored and ready for a transplant?
A. Yes, if the cord blood unit meets specific quality standards:

  • Cord blood must contain enough blood-forming cells for a transplant. If there are too few cells, the cord blood unit cannot be listed on the registry, but may be used in research related to the use of cord blood in transplants.
  • Your (the mother’s) health must meet basic guidelines.
  • Cord blood unit and the mother’s blood sample must be free from infection or other medical concerns.

Q. Will umbilical cord blood stored privately for my family always be used if someone in my family needs a transplant?
A. This depends on several factors. If your baby’s cord blood is stored privately and someone in your family needed a transplant, your doctor would consider:

  • The disease. For some diseases, the patient’s own cells can be used for transplant. However, many diseases treated with transplant may already be present in the baby’s cord blood. For these diseases, a transplant using cells donated from a relative or unrelated donor is the best choice.
  • The match between the cord blood unit and the patient. There is a 30% chance that siblings will match each other. (Learn more about HLA matching). The doctor will determine how close the match needs to be.
  • The quality of the cord blood. The cord blood unit must be large enough (have enough blood-forming cells) and be free from disease and infection.

For more information, read the American Academy of Pediatrics Frequently Asked Questions about Cord Blood Banking

Q. If umbilical cord blood is stored in a family bank, can it be listed on Be The Match Registry at a later date?
A. No, currently cord blood stored privately cannot be listed on the registry at a later date.

Basic Guidelines

Q. If I deliver my baby in a hospital outside the continental U.S., such as in Alaska, Hawaii or Puerto Rico, can I donate the cord blood?
A. Generally, donors must deliver within the contiguous U.S. (not Alaska, Hawaii or Puerto Rico). Cord blood units need to arrive at a cord blood bank within 48 hours of collection. It’s possible that delays can occur outside the contiguous U.S. due to issues with transportation and shipping. The exception is if you deliver at a participating hospital in Hawaii. 

Q. If I’m under 18 years old, can I donate?
A. Donors usually must be 18 or older, but some states have laws allowing donations from younger women. Check with a public cord blood bank in your area to determine if you can donate.

Q. What is the definition of a fetal abnormality?
A. An abnormal test result from an amniocentesis, blood test or ultrasound or during any other prenatal visit would be considered a fetal abnormality. Some examples include cystic fibrosis, malformed arms, legs, feet or hands, and chromosome abnormalities such as Down syndrome. Also, any genetic predisposition to certain disorders could place a patient at risk, and would cause your baby’s cord blood to be excluded from the registry. However, certain minor abnormalities including clubbed feet, cysts on kidneys or cleft palate do not exclude you from being able to donate.

Q. Can I donate if I’m having twins?
A. No, public cord blood banks can only accept donations when one baby is expected. With twins, each umbilical cord has different tissue types and it’s possible the two cord blood units could be mixed up during collection.

Q. What if I have diabetes?
A. If you have gestational diabetes, you will usually be allowed to donate. If you have medication-dependent diabetes, check with a public cord blood bank to determine if you can donate.

Q. Can I donate if I had cancer?
A. If you’ve ever had any type of cancer or leukemia (including skin cancers), you will not be able to donate.

Q. I had an organ or tissue transplant. Can I still donate?
A. It depends on the length of time since you received the transplant. If you received a heart, lung, kidney, bone marrow or other organ or tissue transplant within the last 12 months, you are not eligible to donate cord blood. If it’s been more than a year, check with a public cord blood bank.

Q. What if a donor egg (or sperm) was used? Can I still donate?
A. It depends on the facility where the egg or sperm was handled and the medical history of the donor. The donor egg or sperm needs to be from a facility that is accredited by the American Association of Tissue Banks. And the medical history of the person who donated the egg or sperm must be reviewed by the public cord blood bank.

Q. If I cannot donate my baby’s umbilical cord blood, how else can I help?
A. Thank you for your willingness to help. You can give hope to patients by:

Q. How can I donate umbilical cord blood?
A. First, answer a few basic questions to learn if you can donate. If you meet these guidelines, check the list of hospitals that collect cord blood for a public cord blood bank. If your hospital is listed, contact the cord blood bank that works with your hospital for more information.

Q. What if my hospital does not collect cord blood for a public cord blood bank?
A. Unfortunately, there is not an opportunity to donate if your hospital does not collect cord blood for a public cord blood bank.

Q. How far ahead of my due date do I need to contact a public cord blood bank about donating umbilical cord blood?
A. Ideally, you should contact your cord blood bank after the start of your 28th week of pregnancy. If you are still in the early stages of your pregnancy, please contact your cord blood bank or return to when you reach your 28th week of pregnancy.

Q. Does it cost me anything to donate cord blood?
A. There is no cost to donate to a public cord blood bank. Public cord blood banks cover the costs of collecting, processing and storing cord blood units. If you opt to use a family cord blood bank, you will be charged a fee for collection as well as annual storage fees.

Q. How will my delivery experience be affected by donating?
A. Your labor and delivery will not be affected in any way. During delivery, all of the focus is on you and your baby. It’s only after your baby is born that blood is collected from the cord and placenta. No blood is ever taken from your baby.

Q. What are the current recommendations for delayed umbilical cord clamping after birth? 
A. The American College of Obstetrics and Gynecology (ACOG) has recommended a delay of 30-60 seconds between delivery and umbilical cord clamping in healthy, full-term babies. It is believed that delayed clamping may have a beneficial effect in the newborn. If expectant parents wish to donate or store cord blood, delayed clamping may impact the volume and quality of cells. Expectant parents should discuss options for delayed umbilical cord clamping with their obstetrics provider. 

Q. What happens at the cord blood bank?
A. After the cord blood unit arrives at the cord blood bank, it is:

  1. Checked for the blood-forming cells needed for a transplant. If there are too few cells, the cord blood unit may be used for research related to the use of cord blood in transplant.
  2. Tested to be sure it is free from infection or disease.
  3. Tissue typed and listed on Be The Match Registry, a listing of potential marrow donors and cord blood units available for patients in need of a transplant. The cord blood is identified only by a number, never by a name.

Protecting your privacy

Q. If I donate umbilical cord blood, will my name or my baby’s name be on the Be The Match Registry?
A. No. Only the number identifying the cord blood unit will be listed on the registry. A number will be given to the cord blood unit at the hospital. This number identifies the cord blood unit on the registry and at the public cord blood bank. No name is associated with it.

Q. How is our family’s privacy protected after the umbilical cord blood unit is used for a transplant?
A. The public 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 cord blood unit is identified only by number, which means that you and the patient will not be able to exchange any personal or identifying information.