Who benefits most?
Not everyone agrees that it makes sense to collect a baby’s cord blood and store it for the rest of her life. “The chance of actually needing to use the cord blood is low—one in several thousands,” says George A. Macones, M.D., head of the department of obstetrics and gynecology at Washington University School of Medicine in St. Louis. In fact, most families have only about 1 in 10,000 chances of needing a stem-cell transplant, according to the March of Dimes. However, families with a history of certain genetic diseases and blood disorders, such as severe anemias, immune-system disorders and some kinds of cancer, are more likely to need stem cells. A genetic counselor can help you determine whether your family is at increased risk.
Worldwide, about 6,000 people have received cord-blood cell transplants. But in the vast majority of these cases, the recipients were people other than the babies from whom the blood cells were collected. Cord blood is used most often in children because an adult usually needs more blood than can be collected from an umbilical cord.
Researchers say more study is needed before they can recommend that a person be given her own stem cells if she has a disease such as leukemia because of the possibility that her own transplanted stem cells would simply give rise to a new crop of cancerous blood cells.
Banking a baby's cord blood is a simple procedure: After your baby is born, the umbilical cord is clamped and 3 to 5 ounces of blood are drained from the cord and placenta. The blood is collected using a kit provided by the bank, then is sent to the bank, where it is tested for signs of infection and stored in a liquid-nitrogen freezer. So far, cord blood has been successfully stored for 10 years, and researchers say it may last indefinitely.
Private vs. Public Banks
If you decide to store your baby's cord blood, the next step is choosing a private or a public bank. Private collection of blood costs approximately $1,420 to $1,925, plus a storage fee of about $125 per year thereafter, and it provides you with exclusive access to your child's cord blood. The most compelling benefit of privately storing your baby's blood is that it will be there if you or your baby's sibling needs it (see "One Family's Story," left).
There is no charge to donate cord blood at a public bank, but it is available to anyone who needs it (so you won't have exclusive access to your baby's cord blood). For instance, when someone needs a stem-cell transplant, there's a 75 percent chance that no family member will have matching cells. In that case, the person could go to a public bank, which collects and stores cord blood from donors across the country. Public banks are funded by philanthropic donations and by revenues from patients who use them. On average, a patient pays between $18,000 and $28,700 for cord blood from a public bank, according to the NMDP. Check with your health insurance provider to see if they cover part of that fee. If you do need cord blood from a public facility, some banks may waive the customary fee if you've donated to them in the past.
Even with fees and donations, public cord-blood banks lack the resources to fund their operation. "The banks have really struggled," Halet says. However, NMDP recently committed $8 million to expand its cord-blood banking program. In late December, 2006, the federal government authorized $79 million toward the collection and maintenance of cord-blood stem cells for patients and research.