After healthy expectant mothers deliver their healthy babies, they also have a unique opportunity to give others a second chance at life – by donating their umbilical cord blood.
After a baby is born, the umbilical cord is clamped and cut, separating the infant from the cord and the placenta, which is still inside the mother for a brief period of time. While they are waiting for the placenta to deliver is when the cord is cleaned for the donation.
“We provide them with a kit that has a bag in there and they just stimulate it with a needle and it just drains into the bag and they collect it until the cord blood stops flowing,” said Donna Regan, executive director of the St. Louis Cord Blood Bank.
Unless they are donated, umbilical cords and their valuable stem cells are normally discarded as medical waste.
“Do you want to throw it away or do you want to give the potential to save someone’s life?” Regan asked.
The amount of cord blood on average is about 90 milliliters, equal to six tablespoons or 3/8 of a cup. It is a relatively small amount of unneeded blood that can potentially heal an entire body.
“Primarily it used to be used in pediatrics because of the smaller volume of cord blood that’s available but we’ve been able to develop therapies where we can almost use it equivocally in adults with good success outcomes,” Regan said.
“Cord blood stem cells can be stored in the freezer virtually indefinitely as long as they are properly processed and maintained in liquid nitrogen,” said Dr. Bill Miller, medical director, St. Louis Cord Blood Bank.
They have been collecting cord blood and shipping it to hospitals for over 12 years. They have about 20,000 units of cord blood cryogenically frozen in liquid nitrogen.
“The cord blood from this bank alone has been sent out to treat over 70 diseases,” Regan said. They have shipped throughout the U.S., in European countries and in South Africa.
As a public cord blood bank, they send it wherever it is needed – they do not store cord blood as biological insurance for possible future use for individuals and families.
As with bone marrow matching, finding good matches for African Americans are more difficult, because of variations and mutations over time in human leukocyte antigen typing, known as HLA.
“We look at six different antigens on the stem cells and order to match, it is helpful to stay within the same ethnic group because there are differences as people migrated around the globe in the early days,” Regan said.
“The large number of variability that we see in African Americans probably had selective advantage in parts of Africa –disease resistance for malaria for example. We don’t know for sure … but clearly the HLA types for northern Europeans are different from Chinese and those are different from African Americans,” Miller said.
“Because we have so many African Americans in the States … and they get sick at about the same rate as Caucasians, we need about the same number in the bank to do a good job of matching.”
They collect donations from 29 hospitals in Missouri and 10 in Southern Illinois located within a 150-mile radius of St. Louis. Regan said their cord blood donation process is totally voluntary – from the mothers, to the health care providers that participate in the collection.
“The physicians and labor and delivery staff that actually participate and do the collections for us are not compensated – they do it because it’s the right thing to do, so that really makes us a community program.”
The St. Louis program is making a strong push in the African American and community and other ethnic minority populations in the area, including Hispanics, and Bosnians.
“We can apply this life-saving therapy to diseases that effect African Americans, such as sickle cell and we need to do a lot of work to move toward making that a viable option,” Regan said. “Without donations from the community, we are helpless to intervene.”
Cord blood stem cells are not a part of the embryonic stem cell debate.
“They are considered an adult source of stems cells, which means they come from a developed person, so we can operate here without any controversy, Regan explained.
Normal, healthy deliveries at 36 weeks and beyond from women who have gotten prenatal care and been screened for infectious diseases are best for cord blood donations.
There are medical and behavioral risk factors that would hinder a mother’s ability to donate cord blood, such as exposure to HIV or a history of a genetic disease that could be transmitted through a transplant.
There are other situations at delivery that can prohibit cord blood donations as well, emergency deliveries, twin deliveries, and caesarian sections at the physician’s discretion.
“No matter what – the mom can be signed up, but if something is going to be a little bit more challenging during the delivery, moms can bet that nothing is going to be more important than her safety and the safety of her baby, “Regan said.
Mothers interested in donating cord blood after they deliver should bring it up with their doctor if the doctor doesn’t bring it up first. The Bank hopes those conversations are taking place in the doctor’s offices well in advance of the big day so the consent form is signed and the medical staff is prepared.
“Mom has to give us some blood so that we can test it for infectious diseases,” Regan said. “If they tell the hospital ahead of time and they plan ahead, the hospital knows when they are admitted that they are going to be a part of the program. When they start their IV, they will draw one more tube of blood that we need so they don’t have to be stuck again.”
Regan said lack of awareness is the largest barrier to cord blood donation.
We have this incredible program here and people don’t know about it,” she said. “I don’t care what color your skin is –you have a unique HLA type that may help somebody. It’s a no-brainer as far as I’m concerned. If you’re going to throw it away, why not use it to help somebody?”
The St. Louis Cord Blood Bank is affiliated with the National Marrow Donor Program. For more information about cord blood donation, go to www.marrow.org or www.slcbb.org.
