We understand there are a lot of questions concerning umbilical cord blood banking and we want to ensure that you get straight and honest answers to your questions. That is why we have compiled a short list of some of the most common questions we are asked taken from the Anthony Nolan Trust guidance – which is a well known and respected organisation and therefore considered reliable information, which hopefully will answer some if not all of your questions. For more information, please visit http://www.anthonynolan.org/ or other known informed sites, such as http://www.nhsbt.nhs.uk/cordblood/faq/
What is cord blood?
It’s the blood that remains in your placenta and umbilical cord. After you give birth, your umbilical cord is clamped. With the placenta, it’s normally thrown away as clinical waste. As it’s rich in stem cells, saving more cord blood means saving more lives.
What are stem cells?
When a stem cell divides, each new cell can either remain a stem cell or specialise into another type of cell, such as a muscle, skin or red blood cell. These can divide to replenish other damaged cells, and in doing so, can act as a repair system for the body. Cord blood
contains hematopoietic stem cells. These are capable of making new red and white
blood cells, and platelets which are needed to help clot blood. Cord blood also
contains mesanchymal stem cells which can repair body tissue.
Why is cord blood important?
The stem cells found in cord blood can be used to treat a wide variety of diseases including leukaemia, sickle cell anaemia and other life threatening conditions. These stem cells can
be given to patients in a process called cord blood transplantation as an alternative to bone marrow transplants. They have the advantage of being immediately available when required and the more we collect the more lives we can save! We can’t do this without your help. We especially need donations from ethnic minority communities which will allow us to help more patients who share the same ethnic background.
Why do organisations need to collect cord blood?
The Anthony Nolan trust, for example plan to collect 15,000 cord blood units to their dedicated cord bank over the next five years. This will complement a UK public bank of 50,000 cord units that can be used for lifesaving stem cell transplants. A public bank of this size would allow the UK to meet over 80% of UK transplant requests. Then the NHS wouldn’t have to import cord blood from banks overseas, which cost much more.
How do I register my interest in donating my cord blood?
At present, you can only donate cord blood at King’s College Hospital in London, and the Leicester Royal Infirmary and Leicester General Hospital. There will be more collection centres opening in the near future but at the moment they are the only options. You can ONLY donate if you are booked for ante natal care at either of these three hospitals. To register to donate mail us at cordblood@anthonynolan.org and they will contact you with further information or call us on 0303 303 0303 to discuss the process further.
What happens after I have completed the registration form?
We will contact you to discuss your collection and arrange for a full consent.
Why do you require my consent BEFORE the birth of my baby?
Without your pre-consent we are unable to collect your cord blood following the birth of your baby. Legally, we need your full consent, preferably before your baby’s birth or shortly after birth to allow us to bank your cord blood. Consent involves a full explanation of what we do with your cord blood and a few short questions regarding your medical history. All of your details are treated in full medical confidence. If you have any additional questions regarding your cord donation please consult your GP or midwife.
Am I eligible to donate my cord blood?
Most mothers are able to donate their cord blood but we will need to ask a few questions about your lifestyle and medical history, to confirm that the donation would be safe for any patient.
Can I donate if I have a caesarean (c-section)?
Yes, in both elective and emergency caesarean deliveries we are usually able to collect your cord blood.
Where can I donate my cord blood?
At present you may only donate your cord blood if you are having your baby in the maternity unit at King’s College Hospital in SE London or Leicester Royal Infirmary and Leicester General Hospital. The Anthony Nolan Trust shortly be opening other collection units in a wider selection of hospitals so that we can offer this service to more expectant
mums.
How is my cord blood collected?
Once your baby has been born, the umbilical cord is clamped and cut. Currently Anthony Nolan only conducts ex-utero collections, in accordance with Royal College of Obstetricians and Gynaecologists advice, so once the cord has been cut and the placenta
delivered they will be passed to one of our trained healthcare professionals who work on the maternity ward. This dedicated collector will collect the blood contained in the placenta and umbilical cord, using a special needle which is connected to a sterile collection bag. This procedure takes only a few minutes in a separate place away from the delivery room.
Who can lawfully collect (procure) cord blood and what are the consequences of unlawful procurement?
In the UK, procurement of human tissues and cells which may be used for treatment (including cord blood) must occur on Human Tissue Authority (HTA)-licensed premises or under a third party agreement (TPA). In the latter case:
- The individual doing the collection must be procuring cord blood on behalf of
an HTA-licensed establishment; andthe TPA must meet the requirements set out in
the HTA’s Guide to quality and safety assurance of human tissues and cells for
patient treatments - The individual doing the collection must be a healthcare professional who has
(a) completed training to the approval of the Designated Individual named on a
cord blood establishment’s HTA licence, and (b) has entered into an individual
third party agreement with an HTA licensed cord blood establishment; orby a
healthcare professional who has (a) completed training to the approval of the
Designated Individual named on a cord blood establishment’s HTA licence, and (b)
is working for a hospital who holds a third party agreement with an HTA-licensed
establishment. - Training ensures that the person collecting the cord blood is competent to
undertake cord blood collection. Training will ensure that the risk of physical
harm to the mother and child during the cord blood collection is minimised; and,
that processes are followed to reduce the possibility of the cord blood being
contaminated during collection. - The patient’s partner may only collect cord blood if they themselves are a
registered healthcare professional who has been specifically trained in cord
blood collection.
Procurement that does not meet the conditions laid out above is unlawful and can result in action being taken against both the individual and hospital by the HTA under Human Tissue (Quality and Safety for Human Application) Regulations 2007.
Anthony Nolan only uses specifically trained midwifes and dedicated collectors to collect cord blood from donating mothers.
Will donating cord blood affect my baby or me?
Donating cord blood does not interfere in the birth of your baby and it is a risk free
procedure. The safe delivery of your baby takes priority over all other considerations. We use dedicated staff so that your midwife is free to concentrate on taking care of you and your baby both during and after delivery.
What happens after you have collected my cord blood?
One of our staff will visit you before you leave the hospital to take a small blood sample from you (not your baby). They’ll ask some routine medical history questions and also to take you through the full consent form if you have only provided pre-consent, prior to your labour. Within 48 hours, your cord blood donation will be collected by courier to be delivered to our dedicated cord blood bank, the Anthony Nolan Cell Therapy Centre, in Nottingham. There we will process it. If there are sufficient stem cells, it will be frozen and stored until it is required for a clinical transplant. If there are insufficient cells
for clinical use, it will either be disposed of using standard medical procedures or we’ll process it to use in vital research.
What tests are performed on the blood samples taken from me?
Following your donation we need to take a blood sample from you (not your baby). In the same way that blood from blood donors is checked for any infections, we must check the cord blood is safe for transplantation. In the unlikely event that any test proves positive, we will pass the information to your doctor who will offer appropriate advice.
What tests are performed on my cord blood?
We’ll do virology and bacteriology tests to make sure it’s safe to be transplanted into
any patient. We also carry out haemotology tests to establish the number of stem
cells your cord blood has, which will decide whether it is more suitable for clinical transplant use or research. We match donors and patients by their tissue-type (HLA) so we’ll also run tests to find out your tissue type.
Is my personal information, including my test results, kept confidential?
Yes. We’ll store your information on our cord donor database, where it will be given a reference code. We’ll then refer to this code when reporting to other institutions such as transplant centres, without identifying either you or your baby.
Does it cost me any money?
No, there is no cost to you to donate your cord blood to our public bank.
Do I get paid?
No, we operate our cord blood bank as a public bank because we want to help any patient who needs a cord blood stem cell transplant. We do not offer any payment to mothers for donating their cord blood.
Is all cord blood collected and stored?
We can’t guarantee that your cord blood will be collected and stored. This may be because
either an accredited person may not be available to conduct the collection or other situation arises during the labour such as:
- Your temperature is raised and an infection has been identified
- Your membranes rupture prematurely
- The amount may be insufficient
- Mechanical failure with the equipment used
- Other medical issues
How long is my cord blood stored for?
We’ll store it until we need it for a transplant or research. We freeze the cord blood units
and store them in special cyrogenic tanks at temperatures of approximately -190°C. This means we can store them indefinitely.
When would my cord blood be used for research purposes?
Your cord would only be used in ethically approved research if there are insufficient stem cells to enable us to use it for clinical transplant use.
Would my cord blood be available to my own family should it be needed
in the future?
We operate our cord blood bank as a public resource and do not store cord blood for private use. In the unlikely event that in the future, a member of your family requires a cord blood donation, a search will be made of public registers. It’s possible that this could be the one that you donated to us, however, it may have already been used for another patient.
How does this differ to private banking of my cord blood?
We run our cord blood bank as a public bank to help any patient who needs a stem cell transplant. There is no cost to you to donate your cord blood to this programme. There are a number of commercial cord blood banks that charge a fee to collect and store your baby’s cord blood for private family use only. If you wish to use one of these companies you need to contact them directly to make your own arrangements for your baby’s cord blood to be
collected.
I am expecting twins, can I donate?
Yes you can still donate.
What diseases can cord blood treat?
Your cord blood could treat the same diseases currently being treated by bone marrow stem cells from an adult donor. These stem cell transplants are traditionally associated
with leukaemia, but are now considered as treatment for a variety of diseases. These include:
- Leukaemia
- Immune-deficiency illnesses, including Aplastic Anaemia and Severe Combined
Immunodeficiency (SCID) - Blood cell production disorders, including multiple myeloma and lymphona
- Haematological malignancies, including Thalassaemia Major
- Congenital metabolic disorders including Hurlers/Hunters Syndrome and Duncans
Syndrome
Would my cord blood be made available worldwide?
Yes. We are dedicated to providing a stem cell donation for any patient in need anywhere
in the world. We are linked through the Worldwide Marrow Donor Association to adult registers and public cord blood banks across the globe. We both provide stem cells to transplant centres overseas, and import stem cells and cord blood units from overseas for patients in the UK.
What happens to the cord blood when its not collected by Anthony Nolan collection staff?
Unfortunately we cannot always guarantee that a member of our collecting staff will be available to conduct the collection of your cord blood. If this happens, the umbilical cord and the placenta will be disposed of using standard NHS maternity procedures.
Is a cord blood collection always successful?
Not all collections are successful. This can be due to insufficient blood in the cord,
clotting problems or failure with the equipment used to do the collection. None of these issues has any impact on you or your baby.
Why does the Anthony Nolan Cord Blood Bank collect cord blood units at a limited number of hospitals?
We don’t receive any direct government funding, so there are financial limits to the number of collection units that we can fund. As such, we’ve adopted a policy to establish collection units at major maternity units, which enjoy both a high birth rate and a diverse population. This helps us to collect a wide variety of tissue types, which means we can help a wider variety of people.
Can my baby be cloned using my donation?
No. Your cord blood donation will not be used in reproductive cloning. The Human Reproductive Cloning Act 2001 prohibits any attempt to create a child by reproductive cloning.
Where can I get more information?
The Human Tissue Authority (HTA) have cord blood collection FAQs for parents on their website.