#20 | Cord Blood Banking and How It Can Help with Diabetes, Cancer, Alzheimer's and Autism: Interview with Marion Welch of Cryo-Cell International

April 22, 2020

When it comes to having babies we all agree health matters most. While the benefits of delayed cord clamping are well known, less understood is cord blood banking--that is, saving those stem cells for potential use later on. Marion Welch, cord blood educator from Cryo-Cell International is here today to share some of the promising new developments in this field.

Did you know cord blood is being used to treat Alzheimer's, diabetes, cancer and even autism? Marion is taking us on a deep dive to explain how and why an increasing number of parents are incorporating cord blood banking into their baby's birth plan.

Cryo-Cell International

Parents’ Guide to Cord Blood

Foundation for the Accreditation for Cellular Therapy

ACOG FAQ on Cord Blood Banking

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View Episode Transcript

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast.
Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

When it comes to having babies we all have the health matters most while the benefits of delayed cord clamping are well known less Understood is cord blood banking that is saving those stem cells for potential use later on. Marian Welsh cord blood educator from Cryo-Cell international is here today to share some of the promising new developments in this field. Did you know cord blood banking is being used to treat Alzheimer's, diabetes, cancer and even autism. Mary Ann's taking us on a deep dive to explain how and why an increasing number of parents are incorporating cord blood banking into their baby's birth plan. Marian, thanks so much for being here with us today. Can we just start off with you explaining for our listeners? What is cord blood?

cord blood is the blood that remains the umbilical cord after the birth of the baby and cord blood contains two master stem cells from that baby. It contains the hematopoietic master blood cell and it contains the mesenchymal master structural cell.

Is there a difference between one and the other of the two types that you just mentioned that that parents need to know about? Yeah So, cord blood carvers the master blood cell and that gives rise to as a stem cell it gives rise to white cells, red cells, T cells. It is a cell that differentiates into different cell types. It is indicated for over 80 disorders. Many of the blood disorders since it is a blood stem cell, but it's also indicated for metabolic diseases, enzyme diseases, inborn errors and solid tumors where we're using them to treat cancers. The mesenchymal stem cells actually in the cord tissue, which is the Wharton's jelly that surrounds the umbilical artery and vein, and that is abundant in these beautiful rich mesenchymal stem cells that will give rise to as I said, anything structural in the body including bone and cartilage, heart vessels. It's an important cell as we move into this new field of medicine called regenerative medicine or cellular therapy where we're using Our own cells or a matched donor cell to repair either inflammation or damaged tissue, and is cord blood, the only place that we can get these specialized cells.

No, you can get retrieve blood marrow cells from bone marrow from an adult. They do have the disadvantage of being older and having a higher exposure to vaccines and viruses and environmental toxins. So we do see when it's used for treating blood disorders, a higher rate of rejection. The mesenchymal stem cell is also available in in fat tissue. Again, it's an older cell and it's a little different method of harvesting it. But why the cord blood and core tissue are preferred is one because of its youthful nature. It's very pristine its telomeres which are the protective coatings over the DNA are intact. Whereas with an older person, our telomeres were, oh, they were over time. And that makes it more difficult for them to be able to differentiate and to you know, grow more cells differentiate more cells.

So what's the history of stem cell collection? And where are we today with what we're capable of accomplishing by collecting these cells.

So when I started in educating expectant parents close to 25 years ago, there were 30 approved indications by the FDA for cord blood was mostly the blood disorders because it is a master blood stem cell. That list in 25 years has grown to 80 approved indications. And by indications What do you mean those are approved diseases that they can use cord blood as treatment for and these are approved by the FDA. So considered standard indications that means if you go To use them, it should be covered by insurance, their standard protocols. For example, if you are diagnosed with a blood disorder, they are going to look at what's available for a stem cell transplant. If you get to that point of chemotherapy failed, drugs failed. And the last resort is to save your life is to use stem cells to reboot your immune system. And they're going to look at what's available. They always like to look for a genetic match first, because there's less graft versus host, which means rejection which could be fatal in its own right. With cord blood, we do see less rejection because of the use of the cell. So it's a major factor in deciding whether to use it. Also, we know now that it takes less markers to match up to a family member. So if I sibling is using their brothers or sisters cord blood, it doesn't have to be a perfect mess. So We have markers on our DNA, human leukocyte antigens. And that's what we're matching up without getting too technical, we do not match by blood type. Blood type plays no part in a stem cell transplant for the cancers, it's by tissue. And your tissue markers are typically based upon your ethnicity. So the more diverse you are, as far as your ethnicity in your family, I will get my own family as an example. So my children are 50% Jewish, which probably is Eastern European and and then their Irish, Scottish, Polish Welsh, those ethnicities make up my children's tissue markers. That would be a hard match to find in a public donate donor program. So for my children, it's important when they have their children that they bank their own cord blood because then they have a genetic match with those tissue markers in mind.

So you mentioned a few of the illnesses in the beginning kind of ran through a few of the things that cord blood and cord tissue is used to treat but can you just sort of reiterate what the top illnesses are that are most commonly successfully treated?

There are indications but primarily historically, these have been used for blood disorders on the leukemias, they'll see me a sickle cell. Oh my gosh, it's cord blood is so successful in children that have a sickle cell and have stem cell transplant and they do try to like, try to match it up to a family member, you would not use the child's own cord blood for a genetically based blood disorder. And that's why families bank each child's cord blood because if one of a sibling comes down with sickle cell, the other sibling may be sickle cell free, they could still be a carrier. But if they're sickle cell free, they can use that child sickle cells to treat the sickle cell and it's usually huge success, you know, usually successful in sickle cell.

So that's a really important reason to bank more than one child. Exactly. And when you say a really high success rate, what is what kind of percentage are we talking about?

Well, the success rate, Gen Gen is similar to bone marrow, but we're seeing somewhere between I would say about 70 to about 85 90% success rate, but it also is dependent upon the match. How how, you know, how well the cells matched up the age of the recipient, if you're going to be transfusing, somebody who's you know, late 80s, early 90s, you know, that's may factor into the success rate as well. So there, it's, it's not a flat, it's not applied to everybody. It's a very individual, but the research studies coming out are showing that there's, you know, we're improving success rates, and because of the low risk of graft versus host we can see higher success rates and cord blood

What is the primary age group that's being treated with stem cells or cord tissue?

So cord tissue, I'll start with that.

Primarily older adults, you know, who have had bone and cartilage and that's off label. So I want to make sure people understand that that is not a standard indication. It's not approved by the FDA. So if you go into an orthopedic office today, which I see quite a bit and they are offering to do a basic highmaul, stem cell transplant, they're using the mesenchymal stem cell in the peripheral blood. That's we're seeing right now in the orthopedic community B cost of you know, as we get older, we're seeing damage to the bone and cartilage. in clinical trial, the mesenchymal stem cell, which means that we are it's under the auspices of the FDA we're reporting results we're learning about dosage and safety we're looking at Ms. I always bring up ms core tissue has shown to reduce the plaque on the spine combined with immunotherapy, the mesenchymal stem cell to reduce the plaque on the spine. And I think anybody who has a family history of MS should strongly consider preserving the quarter show. It's think it's very, very important. So some of the new origin diseases.

Now these these people that you're talking about her being treated in their 80s and 90s 80 or 90 years ago that weren't storing.

So they are using donor donor donor card because we do have public registries. And if you, your hospital, your physician will, you know, inquire as to what you have stored for yourself. If you haven't, then you are able to access the bone marrow registry through the National Marrow Donor program. And they also have a registry for cord blood as well and they would, you know, your hospital, your doctor would then start to search they would do it themselves. Got it.

So you can donate your Yes, you have a sample that you have saved for yourself. Yeah. So you can you do have, in some cases, not all hospitals an option to donate. You have to work with a hospital that has a donor program now, you could find out if your hospital that you're delivering at has a donor program. You can also go on the national Marrow Donor program and there's a list of public banks in what hospitals for cord blood. It's basically a process that starts earlier than family banking, you have to be screened prior to 34 weeks of pregnancy and you have to have a maternal blood test to show that there's no infections. There's been no travel to a Zika zone or Ebola zone, any kind of concerns. There's been no tattooing or piercing within the year pregnancy. It pretty much follows the blood donation guidelines if you pass that initial screening Then they will send that your hospital will be able to collect your cord blood. And if it meets the stem cell recovery, it will can be stored in the public registry.

So just to summarize what we've heard so far, that if you bank your baby's blood at birth, that can potentially be beneficial to any family member of that baby. We're not talking about the public directories, but not for that baby him or herself.

So it depends on the disorders. So if you are banking, family banking, if you have a genetic disease, that cord blood would not be used for that baby. If it's a solid tumor like a neuroblastoma, right and and blastoma they would use the baby's own stem cells, but for many of the blood disorders that are genetic, or genetic cancers, they would use a sibling and if they didn't have a sibling, they would look at it. Family Member for bone marrow. And if they couldn't find that, then they would go into the public banks and see what they can find.

And the reason for that is that being that these are genetic illnesses, the cord blood and cord tissue would have the same genetic inheritance.

It would not be effective. Well, you would, yes, they would have the gene so you wouldn't want to transfer that back. But you know, the core tissue is typically not used for genetic disorders is mostly used for Regenerative so it doesn't apply to the record tissue.

Can you explain regenerative so regenerative medicine is where we're using stem cells to repair inflammation in the body and what I'm most familiar with is right now under clinical trial and expanded access is the use of cord blood for the treatment of autism. It doesn't quote bladder cord tissue cord blood cord blood.

Okay, so cord blood right now at Duke is there is a clinical trial and There's also an expanded access, which I'll explain in a minute. And what what we know about stem cells or cord blood is that they have a homing mechanism. And that's the exact words that transplant physicians use. And they migrate to areas of inflammation in the body. And this is what we've learned over the past 33 years that we've been using cord blood stem cells. They they have a signal that they react to just like, for example, when you cut your finger, your body knows to send clotting factors. It's a natural signal. Similar way. cord blood work, the mechanism of action, they have a homing mechanism and your body's sending out a signal of inflammation. They we believe they migrate to those areas and reduce the inflammation through the cytokines. We're still learning about it. But we do see a decrease in inflammation in children with autism who have been in a clinical trial and we see improvement in their symptoms when they are dosed with a large enough dose of cord blood stem cells, their dose trends through a transfusion. So they through the peripheral blood, and they will migrate to that area of inflammation release cytokines. This is part of the new field of Regenerative Medicine. And it's a very, very exciting, it's also a word of caution when you do want to use stem cells for Regenerative Medicine, you want to do it under clinical trial. So that you know safety measures have been achieved.

In this case, are we talking about using the the child who has experienced this experiencing the symptoms of inflammation? We're talking about using their cord blood, not a donor, right. So when the regenerative therapies actually the safest transfusion for you know cellular therapies, using your own stem cells, you can't reject your own stem cells. So they prefer especially in children, the FDA to have the child's own cord blood for autism and I also want to bring up cerebral palsy. Several palsy is now in phase three, which means the safety has been established. We're moving into dosage a we're into a larger clinical trial. This is very, very exciting because I believe by phase five, it would become a standard invitation, which I believe that's where it will head the next few years.

How about childhood cancers? How, how is cord blood or cord tissue used in those cases? And how effective is it, again, vary and it's your standard indication. And it's, as I said, easier to match up. It does have a weight restriction, because obviously we can't go back and get, you know, more stem cells. We're getting stem cells from a newborn baby. So typically, in an average collection, we can treat up to about 140 pound recipient. Beyond that, then they will do what's called a dual cord blood transplant, or even a tri cord blood transplant which they'll match the genetic Related stem cells from a sibling to a donated unit to kind of amplify the unit. And then down the road usually typically 100 days later or one of those units will engraft. But it gets enough stem cells to actually start being grafted process.

So how many people today are actually collecting cord blood? Because it sounds like there's just so many reasons that people should be not enough in my opinion. I mean, this is a real public service what you're doing because many families go through an entire pregnancy and get no information on cord blood, which is just, you know, a real detriment to you know, the family because family, everybody eventually even if they think they don't have a family history of concern, eventually as we all age we do. So, I would say at this particular time, depending what area you live in, it seems to sit that the coast the East Coast and West Coast we see the highest incidence of cord blood being saved. But I would say on the, you know, it can go between 5% up to 20%, depending upon the areas that you live. There are 28 states that mandate cord blood education in pregnancy. So your state may be a state that is required to provide it. And you know, I applaud them for that it's so important because you cannot go back and get these cells. Typically, it is the provider that were there, your ask that they make sure that families get information, and it's usually between between 16 and 20 weeks.

So what's the likelihood of a match? So the likelihood of a match to a parent is 50% for perfect match, and then for sibling 25% for a perfect match, which again, is six on six to two markers. But what the transplant physicians are reporting to us is that partial matches are so successful in cord blood transplants that they are really asking us to remind families that even with a partial match, there is a very like good likelihood that we can use the cord blood. There is a 75. And this is crazy. But I think at last, I'll have to verify this for you. The last transplant, supposedly I went to this day, so there's a 75 to 100% chance of a partial partial match to a family member.

So let me let me make sure I understand this. So if a sibling is using his or her siblings blood, and it's not a perfect match, it can still be beneficial and they can still use it.

Yes, I mean, it would be up to me. Every case is different. Every physician, every hospital has different protocols, but it would be presented to them. Yes, it's not like it, it takes or it doesn't take. So if it's a perfect match, it's it's highly likely to be successful, be successful. And if it's not a perfect match, it still has a chance. Yeah, success. Absolutely. And is that saved blood used up? Is it a one time thing that's used up and then the family can use that blood again.

So it depends upon the size of the child. I would say for the cancers pretty much count, they're going to use all of the cord blood because you are rebooting the immune system. I mean, you, you start by preparing the recipient with chemotherapy and radiation to destroy all the cancer cells. They are starting off at ground zero, and then you're rebooting the immune system through the cord blood. So you do need as many cells as possible for the regenerative therapies like autism, cerebral palsy, they can use dosages, and we are now storing cord blood in a five chamber bag. So they have five individual dosages. And for example, we participated in a transfusion for speech, a proxy and they used her own cord blood that's called an autologous transplant. They took one dosage and five ml of the cord blood. She was dose I believe at two and then they're going to go Back when she's older and Rios again with another dosage and that's the real benefit now of having this five chamber bag is that we can address some of these regenitive therapies with multiple dosages. But I still tell people, if it's for the cancers, you know, count on I, you know, for now that they're going to take all the cord blood. As cell expansion continues to improve and we get better results. The day I hope comes that we will be able to continue to replicate these cells.

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Let's talk about some of the barriers to people storing cord blood, because for all the reasons that you have been talking about, it seems that this is something that probably everybody would want to do, or hopefully in the future, everybody has the opportunity to do. Clearly people are not getting enough education on it. But can you talk about some of the reasons that people might choose not to do this?

Well, obviously the first is financial. If you're doing family banking, and the the family banks have really stepped up and how provided a lot of programs for families to assist them whether it be extended payment plans out, you know over two years to a military programs, programs for the community medical need programs. If you have a child please with sickle cell and you're expecting please contact the contact us here and we'll help you to store your baby's cord blood. So there's a lot of medical need programs. The the issue of financial, you know needs is something we deal with on a daily basis and we do try on an individual basis to help every family that we can. The other main objection may be religious, even though the Catholic Church has embraced cord blood stem cells fully they do hold stem cell conference. And I hope I can get to at some time every two years on cord blood and bone marrow. So I want to make sure families that if you feel that question Catholic Church is post a cord blood that is not the fact. And many of the Catholic hospitals, you know, collect cord blood in the Vatican has really been great about educating scientists and clinicians on cord blood and bone marrow. So those are the two that I deal with. And then they're just some, some people that just feel like I don't have anything in my family that would warrant the need for this. And I just don't feel it's necessary and it makes me feel uncomfortable and and that's fine, too. But I always remind them in a very respectful way that you know, when I had my children 30 years ago, I did not know of my family's history, my parents were in their 50s and I had not a worry in the world and then obviously, as they got older, then my family history started to become more visible and I learned that we had a risk of Parkinson's and macular degeneration.

So on the topic of bearing Is what do we do for the people who want to do delayed cord clamping for the sake of their baby getting all of his or her blood from the placenta? That was my choice. And as an educator, that's something that I teach. Is there a happy medium here for those families?

There are definitely I, I believe in delayed cord clamping, I think it shows some of the same results we're seeing, you know, in autism, you know, improvement. One of the early studies showed improvement in social skills. The aka guidelines is 60 seconds. We have no problems with collecting cord blood. If you want to go up to two minutes, we typically can as well make stem cell recovery.

One point of clarification, I think the AKA guidelines are at least 60 seconds, right? Just not to imply that they suggest cutting off okay, but if we go for that minimum that they recommend, there might be the opportunity after that 60 seconds.

Absolutely. There should be in almost all cases unless A premature birth or multiples when we may not but we still say collect the cord but if we don't make cell count there's no financial obligation on the parent. So we want providers to collect send them in if cell count is not made we have a criteria that we have to meet as a fact credit bank as a bank credited by a BB and if not, then the families are notified what can be done for those who want the baby to get all of the blood until the cord stops pulsating completely Is there any option there so there's still  you know, it's gonna be up to your provider if there's she believes or he believes there's still blood in the in the cord, you still have the option of the cord tissue which is completely unaffected by delayed cord clamping and I have worked with Matt, many families who have just did a cord blood a cord tissue collection, and that's just a five to eight inch piece of the cord. typically done after the baby is born. It can be done while the placenta is in utero or after the placenta is expensive. That harbors the master structural cells extremely important and good to know though it also harbors a few of the hematapoetic as well. So as cell expansion, you know, continues to advance and maybe someday we'll be able to replicate some of the cells that are remaining in the court tissue as far as the hematapoetic .

So I have kind of a tough question. So is there is there an argument for the baby receiving all of those stem cells as opposed to saving them and storing them? So is there an argument for the baby getting the full perfusion from the placenta waiting, you know, the longer delayed cord clamping and getting all of that blood volume and what those stem cells do for the baby in their lifelong health, versus storing those stem cells for the potential treatment of an illness.

So I am Don't feel comfortable answering that, because I think that's going to be long term studies that we're going to see. I know for now, there are additional studies coming out on delayed cord clamping. The first study was on improving social skills. There's been some new studies that have been released, showing additional benefits. And there's a wonderful study from an actual nursing school. I think we're still learning. I don't think that the there's any real decisive content right now that says one or the other. So at this point, I just I can't answer it. I don't know. I think it's just too early. I think we have to see and learn more about the benefits of delayed cord clamping.

There's obviously the benefit of storing those cells for the potential use in siblings and parents. And I mean, I don't want families to feel they have to choose one or the other at this point. I don't think providers do either. It's an uncomfortable situation. I think you have to look very carefully. If you're pregnant at your family history, at your ethnicity, where this is going, I mean, you know, I've been in the field a long time, and I never thought when I first started in the late 1990s, that this would be, you know, beneficial to children with autism. So where it's gonna go up, and I think it's going to continue to advance every medical school today has a stem cell lab. A lot of research Donald's both in public and private are going into stem cell therapy. So I foresee that there's going to be a lot more indication, like I said, and in the time that I've done it, education and cord blood, it's gone from 30 indications to 80. But as again, on the delayed cord clamping, I think we just we're going to have to follow that and see what happens.

Can we talk a little bit more about saving the cord tissue because I don't really feel like I understand that yet. Can it serve in the same way that the blood does or it does it have different benefits? Are they mutually exclusive? of what's the difference between saving the blood and the tissue? And would anyone ever save both?

Most families today are saving both because it's two separate stem cells. One is the master blood, and one is the master structural. So the master blood does have at standard indications. As we were talking the blood disorders, metabolic disorders, inborn errors, it's being used in clinical trial for autism, cerebral palsy, the core tissue as the master structural is being used in clinical trial does not have any standard indication as of yet it is being used off label in the orthopedic community from the peripheral blood for bone and cartilage repair, please, you know, it's moving faster than probably, you know, the FDA would like very important to look at what's, what clinical trials are available now. The government has a registry of clinical trials.gov you can put in your diagnosis. Stem Cells cord blood and they don't give you an idea of what clinical trials are using the mesenchymal corporate stem cells.

Is that from the tissue?

Yes, mesenchymal is from the tissue. It's from the Wharton's jelly that surrounds the umbilical veins. It's the master structural and it currently has no known indication, no standard indication, and it indications it's currently in trial. Right. And it's currently used off label, which doesn't necessarily mean unlawfully, but it's just not FDA approved yet, for those trials is that it's still I don't know how to find points. But it's, you know, be it said it's not FDA approved for anything as a standard indication. But if a family saves that cord tissue, can it be used by them? Or is it under a clinical trial?

Yes, under a clinical trial?

Yes. Until such time that it becomes a standard indication, then it'll be available through all you know, through many, many venues and hospitals. This is most of the time. This is How new procedures are started off label clinical trial before they get FDA approved, this is a long term decision that lasts decades potential benefit to the family for decades and have great this is a rapidly changing field. Very, very dynamic. Very exciting. Yes. But is this at the core Titian? I tell families This is still in clinical trial for its indications for its uses. They are looking at combining the cord tissue with the cord blood for some of the cancers. It's new, it would depend on your facility it would depend on your transplant physician so you know there that is happening but this time it's still very new and it would really vary from hospital hospital.

Okay, everybody hold hold the phone.

This has been an intense conversation very intense, so much science.

Marian, what's what's the practical application? How does one collect the blood? What do I do if I if I'm expecting a baby? How do I have Where do I start. So we would like you to contact your core cord blood educator or your company of choice. Around 32 weeks because it's beneficial to have the kit with, you know, 60 days prior to the delivery in case you go deliver early, you would register typically by phone, it's very easy, it only takes a few minutes. A pre labeled kit with come directly to your home not to the providers office to your home because we will prepare labels according to the FDA for the cord blood bag for the cord blood core tissue cup, and then for the maternal bloods that are collected prior to the cord blood, it comes to your home, there will be a health history questionnaire that's extensive that will be archived with the cord blood so which is for your family, which is a wonderful benefit. And that will also include four factor credited cord blood banks, a travel history, so we want to know have you been to a Zika zone while you were pregnant or three years back or Ozone so there will be a health history form that will be completed if possible prior to the delivery sent back to the bank or it can go back with the kit. The kit is stored all kits are stored at between 39 and 86 degrees prior to delivery. You would bring it to the hospital, they would set it as soon as you get there, let them know you are collecting cord blood. And you should let your provider know at one of your visits that you're collecting cord blood and you collect you have a collection kit. They will set it up they will do a maternal blood draw first for the moms turn off. And that is because we are required by our accreditation bodies to do infectious disease testing at the time of delivery to make sure there's no infection. If there is we will let your provider know and we can still store the cord blood but it would be noted to the transplant physician that the mother had an infection at the time of the delivery. The maternal bloods can be collected prior To the delivery at the hospital This is usually done during the delivery journey, or right after you had the baby as long as it's within 72 hours of having your baby. Then, when your baby is born and we want you to follow your birth plan, the cord blood is collected after the cord is cut completely painless to the mother into the baby. Baby can be skin on skin can be with the nurses. But while the placenta is in utero, they will insert a needle that's connected to a blood bag into the umbilical vein and collect as much blood as possible typically a good collection which means that we have a high volume of blood, which correlates to a high volume of stem cells would take between two to five minutes and the provider can insert up to two times into the umbilical vein to maximize the collection as long as the umbilical cord is wiped with the antiseptic. For each insertion we want to keep contamination down as much as possible. Once the cord blood is collected, they will pack it up in the bag, the corporate your cord blood kit, the core tissue is typically cannot collected next and that is a five to eight inch piece of the chord. It can be anywhere in the chord because the mesenchymal the master structural cell is Harvard in the Harvard in the Ardennes jelly, which is this jelly gelatin substance that protects the umbilical vein. And it's actually contains more mesenchymal stem cells and what's in the cord blood itself for cord blood. Once that's all collected, the partner or husband whoever with you, whoever you designate will call your cord blood bank to schedule a medical carrier to come and pick up the cord blood we want that scheduled usually within two hours after having the baby and then that cord blood tissue stays with the parents not on the nursing station because there'll be other people collecting. We don't want it to get mixed up we want to direct handoff. So the cord blood collection kid stays with the family until the medical courier comes in, there'll be a direct handoff, then that courier will transport it to the laboratory will be processed and stored. Typically, depending on location within 48 hours of delivery,

Marion, how much does all of this typically cost? So the programs range from about $1,000 for collecting only the cord blood, depending upon your program and type of processing that you choose to about 17 1800 for cord blood using an advanced technology called prep a site which doubles the stem cell recovery so you have a range. The storage fees are 175 a year pretty much across the board to store it so the cost is in the first year and that includes you know, your credit collection kit, your medical courier we have to transport using a medical courier if you're using a cord blood that's using FedEx, I advise you not to go forward with that bank. If you do the cord blood and cord tissue arranges about 1800 and 2600 I would say pending on the program the quality of the program the storage fee, pretty much a standard at 350 a year starting when your baby turns one and you also mentioned affect accredited blood bank what is that so not all cord blood banks are factor accredited stands for the foundation and Accreditation of cellular therapy. It's an advanced accreditation that the top 10 cancer hospitals hold like MD Anderson Sloan Kettering and it means that we have higher requirements one of them being that we do have to collect five maternal bloods because as a factor credit bank, we store two maternal bloods with the cord blood Because if you go back if you go to transplant 10 years from now, this is a long term program. And the FDA says we're adding additional screening prior to transplant. We're making sure every mother's tested now for Zika. Prior to transplant, we'll be able to say no problem. We have two maternal bloods from the time of delivery. And I tell families in a very simple way, it's a complete with a factor credited cord blood bank, it's a complete tissue time capsule, you're getting the cord blood, you're getting the cord tissue, you're getting maternal bloods stored, and that has really resonated Well, the addition of the maternal bloods being stored with providers, they really see that as a very important part now of cord blood banking, because so many viruses and Trisha can speak more about this are asymptomatic at the time of birth.

Absolutely. Any woman who wants to choose to store cord blood or cord tissue, are all providers. trained to do this can can any woman who wants to do this Just tell her provider that this is what I want to do and expect that it will be done correctly or is there a specific training that they need to do the writer goes through.

So for public banking and some of the fact accredited banks, yes, there's videos that that are sent out that they can watch. It's pretty much covered in residency, the residents are collecting cord blood, and there are educational tools available.

How long can the blood be stored for?

So we're out about 27 and a half years on studies showing storage is no storage and we see that viability is still 99%. No expiration date at this time is required on cord blood that's being stored by the FDA or accreditation bodies, the believe if it's stored at minus 196 centigrade it should last decades. We know that from other tissues that have been stored like sperm for example, what did you say the temperature of storage was? 39 to 86 degrees Fahrenheit. Oh,
okay. Okay. Hi, you said something completely different.

Well, there was something about making Celsius, there was something about like 199. So when we freeze the cells, we're freezing them at minus 196 centigrade, 196 centigrade, right? Negative, right? Minus one. Yeah, that would have hopped cellular activity without destroying the cells. So with corporate banking, ultimately, your provider will make the final decision at the time of delivery, if it's possible to do the cord blood collection. The you know, mother cups First, the baby comes first. So if there's a risk to either the mother or the baby or it's a complicated birth that your provider will have make the final decision as whether they want to collect or not. Are there any differences when there's a Syrian How does that work out? So Syrian is what happens quite a bit. And yes, we can collect on with this area and after the babies, you know, we moved So they basically use the cord blood bag and they insert it and they do it as fast as possible. I think it's very important if you're expecting to reach out to your provider and make sure they are giving you information on your options for preserving your baby's master stem cells. If they do not, and you do not get it from your childbirth educator, you need to reach out to your hospital. There's an excellent website called parents guide cord blood comm provides wonderful information. Dr. Fran birder manages that website. It's world renowned. It's very respected. Please go to that website to learn about cord blood. You can contact anybody here and this podcast will provide you with information. That's the first step make sure you're getting your information and getting it early. And secondly, if you are interested in doing cord blood and you have a financial concern for not doing it, make sure you mentioned that to your cord blood bank. There are many programs support programs extended pay programs. No person should be denied cord blood banking based on a financial reason we will help you we will work with you, we'll extend it out. If you're military please really, really strongly consider making your baby's cord blood. There are excellent support programs there for you and we want to see our military really taking advantage of these programs that are available for them. If you have a family history of any of these ad indications, blood disorders, metabolic inborn errors, solid tumors, you want to look at cord blood banking, you want to talk to your provider. If you are concerned about autoimmune diseases, Ms. Parkinson's, this is something that you want to review and look at. And if you are at high risk for premature birth, it is of utmost importance that you walk in with a cord blood kit. If you don't use a cord blood kit, you can return it at No cost, there is no financial responsibility to receive a cord blood kit and bring it with you into delivery. If you decide the time of delivery, you do not want to collect, just return the unopened kit to your cord blood bank, there is no charge. I want everyone to be able to walk in with a cord blood kit. And you can and if you say hey, you know what, let's not do it. You know, everything's fine, whatever, return the kit, unopened and there's no charge. So you know, peace of mind at least have that kit with you. So if there is a concern at the time of delivery, and I have had this, I've had to rush up to hospitals. I've had doctors use kids that I've started hospitals at the last minute because of a complicated birther issue. But if you do you have that kit with you because you cannot go back and get these cells once they're gone. Once they're discarded. That's it.

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About Cynthia Overgard

Cynthia is a published writer, advocate, childbirth educator and postpartum support specialist in prenatal/postpartum healthcare and has served thousands of clients since 2007. 

About Trisha Ludwig

Trisha is a Yale-educated Certified Nurse Midwife and International Board Certified Lactation Counselor. She has worked in women's health for more than 15 years.

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