Frequently asked questions about cord blood and cord tissue
Currently, there are over 80 different treatable diseases. For a full list please click here.
Traditionally, hematological disorders (blood cancers), immune disorders, and bone marrow failure represent the most common diseases treated through transplantation. Regenerative Medicine treating a wide range of diseases represent the next generation of treatments. Many of these are in the clinical trial or research stages.
Samples stored in a family (private) bank belong to the child and can only be released by the parents (until the child is 18 years old) or the child (when the child is 18 years of age or older). In terms of who can use the sample, it would depend on the disease being treated. Typically family banked samples will be used for a sibling, the child itself, or an immediate family member. In cases of early childhood leukemia, the child’s own cord blood would not likely be used; rather a cord blood unit from the child’s brother or sister would be best if the tissue match is adequate.
Banking a subsequent child’s cord blood is an excellent idea. Not only does it give that child a perfect stem cell match but it also increases the potential for use among other siblings or immediate family members. In family banking, it is often a sibling’s sample that is selected for transplant.
In all likelihood the entire sample would be used if there was a need for it. In the future, cell therapies for regenerative medicine (e.g. CP, brain injuries or diabetes) may only need a portion of the sample in which case we would take out the needed sample and continue to store the unused portion.
According to the latest scientific data, stem cells have been stored and successfully used after a period of 22.5 years, but there is reason to believe that stem cells can last indefinitely when cryopreserved.
Banking of stem cells from cord blood began in 1994 with the foundation of the New York Blood Center Cord Blood Bank. These stem cells can be stored for a substantial amount of time although the maximum storage time has been a moving target over the years. In fact, most cord blood banks do not label the units with an expiration date, as this will likely change.
Cord blood stem cells are frozen and stored at a temperature <-190◦C. A series of publications with samples stored at this temperature have been released addressing the subject of long-term cryogenic storage and its effects on stem cells from cord blood. The first was in 1992 where researchers showed that the number of stem cells and their potency (how well they function) were comparable after thawing with the number and potency before freezing in units stored for 5 years. The report was followed up in 1997 with similar results from units stored for 10 years.
In 2003, 15 year old cells were thawed. In this study, as in previous reports, the units were evaluated for recovery of the number of cells and their potency. The report showed that not only was the recovery of cells and potency highly efficient but also that the cells engrafted and repopulated the blood system in a way consistent with freshly isolated stem cells from cord blood. Further to this, in 2011 data from cord blood stored for 21-23.5 years was published. Again with the same result: stored cord blood stem cells behaved no different from fresh cord blood stem cells. The authors end the paper with “Thus, recovery of HSC, HPC [hematopoietic progenitor cells] and other early cells types bode well for CB banking and use.”
So in conclusion, the scientific literature has evidence that stem cells from cord blood can be stored frozen in liquid nitrogen for 21-23.5 years and still retain their potency. It is quite possible that the next publication will move the storage time even further.
When collecting cord blood the umbilical cord is first clamped and cut. After this the doctor/midwife disinfects the injection site and inserts a needle into the vein of the umbilical cord. The cord blood then flows into the collection bag. The bag is always placed lower than the placenta to allow gravity to help drain the blood into the bag.
The process of cord blood collection is painless and does not interfere with mother and baby bonding. Overall, the collection takes roughly 10 minutes to complete.
Following cord blood collection and when the placenta is expelled, the doctor will cut as much of the umbilical cord as possible and place it into the container supplied in the Cells for Life collection kit. The container will be sealed and placed in a medical biohazard bag and returned to Cells for Life for processing and storage.
If your child or another family member requires your cord blood or cord tissue for an approved use, your physician will contact our Release Manager and we will arrange the cord blood or cord tissue’s safe transportation. Cells for Life has extensive experience releasing cord blood units for clinical use both locally and internationally.
Cord blood and cord tissue can be collected at any hospital if you have your cord banking collection kit with you. Directions for collection are included in the collection kit for any doctor or nurse that may require it.
Occasionally, there are hospitals that do not collect cord blood or cord tissue. We will do our best to overcome this. We will even offer to help the staff with the collection.
No. But accreditation is the only guarantee a parent can have about the quality system and operating procedures at a cord blood bank. The standards recommended by AABB (formerly known as American Association of Blood Banks) and FACT have become the industry standard. Please note that membership in the AABB is not the same as accreditation by the AABB.
Bear in mind that the end user of cord blood, will be a transplant physician. That physician is unlikely to use a sample which is from a bank without accreditation, regardless of what reassurances the bank issues.
Approved uses of cord blood, or cord tissue, include approved therapies as per Health Canada & the FDA, approved clinical trials as per clinicaltrials.gov, or for therapeutic use approved by an independent ethics committee or Institutional Review Board.
Yes. Cord blood and/or cord tissue collection can be done in conjunction with delayed clamping. However, it is advised that the delayed clamping occur for 30 to 60 seconds (no more than one minute) in accordance with recommendations from the Society of Obstetricians and Gynecologists in Canada.*
Is my family healthy (it should be kept in mind this could change at any time)? Why should I continue storing? What does research show? Will this be helpful in old age? What is treatable at this point in time?
Some people suggest that the chance of using a cord blood sample is 1 in 10,000. Others estimate 1 in 2,700. There is a recent publication by Neitfeld et al, (2008) that estimates that the chances of a person using a stored cord blood sample before the age of 70 is about 1 in 400 based on current treatments. When the addition of future treatment applications for diseases is discovered these odds of use will increase.*
Yes. Bone marrow, adipose tissue and cord blood all contain MSCs. However, there is evidence that MSCs from cord tissue offer distinct advantages to other MSC sources. Due to the immature nature of the MSCs from cord tissue they have a higher proliferation capacity, meaning they can grow more rapidly than MSCs from other sources.*
Family banking in Canada costs, on average, $1,100 – $1,200 (plus tax) for the first year and $143/year thereafter. Many banks offer financing or payment options which make it more affordable for parents.
Parents who wish to donate their baby’s cord blood must complete an extensive screening process to review potential exposure to infectious and inherited diseases. Some parents do not qualify for public banking but may be eligible for private (family) banking. This is because the public bank does not have future access to medical information about the parent(s) and the child after the donation; family banking allows future contact and verification of health status.
In Canada, the ability to bank publically also depends on the expectant parent’s physical location. For example, those delivering at hospitals not serviced by a public bank cannot donate.
Many transplant physicians will choose to use a good quality cord blood sample from a family member before they would consider using a public sample. Scientific studies have shown two-times (2x) better survival rates when a sample is used from a family member (from a related donor) than from a stranger (unrelated donor 63% vs 29% survival rate).*
In addition, GvHD is one of the most serious, painful and fatal side effects of transplant. Studies have shown that this is reduced significantly when using a family-related sample.
As well, sick patients do better if the transplant is completed early in their disease process and before the disease progresses too far. Family samples can be located and transported within days as opposed to the several weeks/months that it takes to access a public sample.*
Frequently asked questions about Cells for Life
As a Cells for Life client, once the sample has been picked up at your bedside, we will let you know when it has safely arrived to the lab. Then you will receive an email within 5-6 business days after birth confirming that the sample has been processed and stored. If there is any missing information that we need, we will ask you to provide this at that time.
Yes, Cells for Life has FACT accreditation and is Health Canada inspected and compliant (CTO#100044). We are also FDA registered.
Note: FACT accreditation is the international standard for Cord Blood Banks. Health Canada and FACT complete a thorough audit of all laboratory and administrative practices and our quality control system. FACT and Health Canada maintain on-line lists of facilities which have been inspected and accredited.
At Cells for Life we store cord blood as a single unit. Currently there are no advantages to storing a sample in several units, as the entire sample would be used in a transplant. Should a smaller sample be needed, e.g. for amplification or for use in regenerative medicine, we can take out a small portion and continue to store the remainder.
If your sample is lost in transit, all efforts will be made to retrieve the sample in a timely manner. This being said, Cells for Life has no liability if anything happens on the way to our laboratory. We will always follow best practices to ensure a safe and timely delivery of your sample.
To protect all samples from possible cross contamination during storage we over-wrap all samples with a bag that is durable at low temperatures. In addition, we store all samples in the vapour phase of liquid nitrogen instead of liquid phase, which protects against cross contamination.
After numerous attempts to contact the client and after a written warning regarding termination is sent, storage of the sample will be terminated or used for research purposes, depending on when the client signed their contract.
All cells will go into storage; No part of the sample can be used for anything you have not given your consent to.
The processing and storage of cells and tissues is regulated by Heath Canada. They will ensure that our process is safe for future users. Before use, the cells will have to be treated and manipulated, and this process will also be over-seen and approved by Health Canada.
We are working according to our already established FACT standards for cord blood. These standards will be applied in our cord tissue procedures which will be evaluated during our voluntary accreditation inspections.
Frequently asked questions about registering with Cells for Life, collecting and storing cord blood and cord tissue
Cells for Life does not charge any fees for retrieving a sample for transplant, however there may be shipping fees charged depending on where the sample needs to be sent. If the treating physician orders additional testing of the sample (in order to meet current standards or the standards of another country at the time of use) there may be additional testing fees.
We do not advise opening the biohazard bag. The only acceptable reason to open the biohazard bag is to affix the appropriate label to the cord blood bag or to close any clamps that have accidently been left open. Please use precaution. Many times clamps can be closed without opening the biohazard bag.
Depending on the time of year and exposure to hot/cold temperatures, some parts of your kit may have to be replaced. If you suspect your kit was subjected to extreme temperatures please call our customer service department.
It is the parent’s responsibility to inform the hospital staff that they are collecting cord blood and/or cord tissue. The parent’s instruction checklist reminds you to do so upon arrival at the hospital.
It is preferable to collect before but the cord blood may still be collected afterwards. Both methods are routinely used, and the volumes collected are comparable.
No problem, if the box seal is broken let us know and continue to send your kit to Cells for Life to be processed.
Please make a note on the cover page of the registration package letting us know you had to open the box.
After removing all personal documents the kit should be taken to a doctor’s office, hospital location or pharmacy for disposal.
This normally does not happen as our kits are inspected before being distributed but it could be misplaced at the hospital. If this does happen we need the following information from you:
Please make a note in your kit letting us know that the cord blood and/or tissue label was missing.
The tubes must be PURPLE/LAVENDER TOP TUBES (these tubes contain EDTA which is an anti-coagulant).
Tube size should be either 7mL or 10mL and we need three (3) full tubes. These are common blood tubes and can be found at most hospitals. Ask your nurse for the tubes. Just be sure that the birthing mother’s name is clearly printed on the side of each tube.