Public versus Private Cord Blood Banks: A Comparison
Impressive progress is being made in the use of stem cell transplants to regenerate human tissue and treat a host of medical conditions. Umbilical cord blood and umbilical cord tissue are excellent sources of stem cells, and consequently many expectant parents decide to have it cryopreserved and stored at a cord blood bank following the birth of their child. Currently there are two types of cord blood banks available to provide this service – public cord blood banks and private cord blood banks. While both offer the same basic service (process, freeze, and store cord blood), there are significant differences between the two. Parents should be aware of these differences so that they can choose the cord blood bank that best meets their current medical and financial situation, along with their expectations of what stem cell therapies will be able offer their child in the future.
A public cord blood bank cryopreserves and stores cord blood so that it will be available to anyone who needs it. Parents donate their child’s cord blood, so it is not stored for their child’s exclusive use. There is no guarantee that the cord blood stem cells will be available should their child or a family member need to use it. As a matter of fact, there is no guarantee that a public cord blood bank will even store an individual’s cord blood. Donations are screened to ensure they contain enough stem cells. If a donation does not meet the minimum requirement, it is discarded. More than half of all donations to public cord blood banks are discarded for failure to meet the minimum required stem cell count. Public cord blood banks will only cryopreserve and store umbilical cord blood. They do not store umbilical cord tissue or placental tissue. Public cord blood banking is free. No fees are charged for processing and storage of cord blood.
A private cord blood bank cryopreserves and stores cord blood exclusively for use by the individual donor and immediate family. The individual who supplied the cord blood owns the cord blood, and so is guaranteed that the cord blood will be available in the future should they or a family member need it. A private cord blood bank does not require cord blood specimens meet a minimum cell count. Low count specimens are stored too. Private cord blood banks usually only discard cord blood specimens at the owner’s request. Many private banks will also process, cryopreserve and store umbilical cord tissue and placental tissue. Since they offer ownership of specimens, private cord blood banks charge a fee for specimen processing and storage.
So, should you donate your child’s cord blood to a public cord blood bank or own your child’s cord blood and possibly cord tissue at a private bank – which is the smarter choice? The answer lies primarily in whether you are storing for stem cell therapies available today or whether you are storing for therapies that may be available ten or so years from now.
The case for public cord blood banks – the here and now.
Having a large pool of cord blood specimens available for the general public is more important than individual access to one’s own cord blood. Currently all of the approved standard stem cell therapies use hematopoietic (blood and immune cell forming) stem cells. These are the stem cells found in cord blood and bone marrow. Cord blood, unlike bone marrow, is much easier to match for transplant so having access to your own is not that critical. Donating cord blood to a public cord blood bank helps sick patients find a matching donor. Many of the diseases currently being treated with stem cell therapies are genetically based. A patient being treated for a genetically based disorder cannot use his own cord blood stem cells as these cells carry the genetic defect. Donor stem cells would need to be used in the stem cell based treatment. Right now, the minimum stem cell count in a specimen matters. Specimens that do not meet the minimum count threshold for a particular stem cell therapy cannot be used for that therapy. Lastly, public cord blood banks are free. There is no fee charged for processing, cryopreservation, and storage of cord blood specimens.
The case for private cord blood banks – the future is almost here.
Unlike public banks, many private cord blood banks will store umbilical cord tissue in addition to cord blood. Umbilical cord tissue contains a different type of stem cell than is found in umbilical cord blood. These stem cells are called mesenchymal stem cells (MSCs), and they develop into connective tissue like bone, cartilage, muscle, and fat. They also develop into nerve tissue. Although there are no standard stem cell therapies using MSCs, they have been successfully used to repair cartilage, bone, and improve heart and liver functioning. MSCs are currently being used in clinical studies aimed at treating spinal cord and brain injuries. In these scenarios where treatment is aimed at repairing damaged tissue, having access to your own stem cells could be critical, especially since the incidence of rejection is much higher with non-blood cells. The MSCs found in umbilical cord tissue also have the ability to develop into a wider range of specialized cells than those from other sources in older patients. Another “up and coming” stem cell application that supports private cord blood banks is the process of transforming a somatic (tissue specific) stem cell into an embryonic (pluripotent) stem cell. The stem cells found in umbilical cord blood and umbilical cord tissue are somatic stem cells, so can only develop into a limited range of cells. Umbilical cord blood stem cells can only develop into blood and immune cells. Umbilical cord tissue stem cells can only develop into connective tissue cells. Pluripotent stem cells, on the other hand, can develop into all the different cell types found in the human body. If it becomes possible to use induced pluripotent stem cells to treat medical disorders, having access to your own cord blood and cord tissue stem cells could be critical in scenarios where tissue rejection is an issue. Back in the “here and now”, private cord blood banking guarantees access to stem cells that could be used to treat a sibling with a medical condition that is treatable with an existing stem cell therapy. As a matter of fact, it is recommended for families with a medical history of one of the many diseases currently treated with cord blood and bone marrow transplants.
There really isn’t a right choice in terms of opting for a public or a private cord blood bank. Parents need to assess their individual family medical history and financial situation, along with their expectations of what emerging stem cell therapies could potentially offer ten or twenty years from now, and make the choice that best meets their needs. Regenerative medicine and stem cell based medical treatments are a reality, and new medical applications are made yearly. Do your research and pick the cord blood bank that works best for your family’s individual situation.