Why Canada needs a national public umbilical cord blood bank

Canada's first national public blood bank for umbilical cord blood is set to begin taking donations today at an Ottawa hospital. Here's what's unique about umbilical cord blood and why harvesting it can be so important.

What is umbilical cord blood?

Umbilical cord blood is contained in the cord that attaches a newborn infant to the placenta. It is rich in stem cells, which have the ability to develop into many other types of cells, including bone marrow, red or white blood cells, platelets and immune cells.

Cord blood is collected within a few minutes of delivery after the cord has been clamped, either before the placenta is delivered or after. The blood is retrieved by inserting a needle into the umbilical cord and extracting around 40 to 50 millilitres of blood.

The donations are then sent to facilities in either Ottawa or Edmonton and tested for viruses and abnormalities. The stem cells are then extracted and cryopreserved at -196 degrees Celsius.

What illnesses can cord blood cells help to treat?

The stem cells in cord blood can be used to treat several diseases and disorders, including:

At any time, somewhere between 800 and 1,000 Canadian patients are in need of a stem cell transplant. Around half of these patients are unable to find a suitable match, and many die.

Stem cell research is continuing to develop and it's possible that one day, the cells will be able to be used in the treatment of many more diseases.

Are stem cells from cord blood better than stem cells from bone marrow?

Most stem cell transplants in Canada currently use cells harvested from bone marrow.

In order for a bone-marrow transplant to succeed, certain tissue proteins from the donor -- called human leukocyte antigens, or HLAs -- have to match perfectly match with the recipient. While family members can often donate bone marrow stem cells, around 70 per cent of patients in need of a stem cell transplant have to look outside their immediate families for a match.

As well, when stem cells from cord blood are used, the donor cells appear more likely to engraft with the recipient's blood system, even when there are partial HLA mismatches.

Donor cells from cord blood are also less likely to attack the recipient's tissues, which can lead to a potentially fatal condition known as graft vs. host disease (GVHD). This complication appears to occur less frequently with cord blood than with bone marrow, possibly because cord-blood cells are immature and may lack the ability to attack the recipient.

Finally, harvesting cord blood is painless for mother and child, whereas bone marrow transplants can be painful.

Where can I donate my baby's cord blood?

The plan for the National Public Cord Bank is to have five collection hospitals in four cities across the country. As of Sept. 30, 2013, donations are being accepted at the Ottawa Hospital General campus or the Ottawa Hospital Civic campus.

In mid-2014, collections will begin in Brampton, Ont., at the Brampton Civic Hospital. Donations will also be accepted at two yet-to-be announced hospitals in Edmonton and Vancouver. Collection kits will also be distributed to hospitals and birthing centres where there are high number of aboriginal births.

The eventual goal is to collect 18,000 cord blood units over six years.

The blood bank will be managed by Canadian Blood Services on behalf of the provinces and territories, except Quebec, which runs its own cord blood banking program through Héma-Quebec.

Healthy mothers over the age of 18 who reach 34 weeks or later in their pregnancy can consider donating their baby’s cord blood.

Any patient in Canada will be able to access the cord blood donations in the national bank. The samples will also be made available to patients in need around the world.

Can I still use private cord blood banks?

Parents can still bank their child's umbilical cord blood through private cord blood banks by paying a one-time fee for the blood collection, as well as annual storage fees.

Blood banked this way can only be used by the child who donated it, or a family member, whereas blood donated to the public bank can be used by anyone.

In 2005, the Society of Obstetricians and Gynecologists of Canada spoke out against private cord-blood banking, citing “limited indications and lack of scientific evidence to support the practice.”

It also noted that the odds that a child would ever need their own umbilical cord blood stem cells were very low.