If you're considering storing or donating your child's umbilical cord blood you'll want to know your options. This article can help you make a decision ...

Your baby's cord blood can be collected and stored privately for future personal use by you and your family, or stored by the public cord blood bank network for future use by anyone in Australia or around the world needing a transplant.

Public cord blood banking

In Australia there is a network of public cord blood banks that collect cord blood in a number of hospitals around the country. This blood is then made available to anyone in Australia or around the world needing a cord blood stem cell transplant. If you are giving birth at one of the public cord blood bank collection hospitals and are eligible then you can opt to donate your baby's cord blood. Donating your baby's cord blood to a public cord blood bank is free.

Private cord blood banking

In Australia you can also choose to store your baby's cord blood privately, ensuring it is immediately available for future use by your family. There are lots of different reasons that expectant parents may wish to consider private banking including situations where there is already a history of disease in the family or where they are having a baby of mixed ethnicity (traditionally it has been more difficult to find matched donors in the public banks for such children).

More recently, with emerging regenerative therapies, families are choosing to bank their children's cord blood to be able to take advantage of any scientific discoveries in the future. Private cord blood collections can take place in most hospitals around the country but there is a fee charged for the collection and storage.

The probability of using autologous cord blood

Australian parents deciding to store cord blood must choose between public or private cord blood banks. It is therefore important to understand the differences between the two blood banks in order to make a completely informed decision.

As part of the decision process, it may also be useful to consider some interesting figures concerning the probability of using autologous cord blood, ie the patient's own cord blood stem cells.

Historically, cord blood has only been used for stem cell transplants (transplant medicine) and as a consequence there has been a perception that the probability of autologous use is extremely low.

Going forward, emerging therapies (regenerative medicine) may see cord blood being used to repair diseased or damaged tissues in a range of other conditions and now the probability of using cord blood to repair a damaged heart or nerve cells is probably far greater than the likelihood of needing cord blood for stem cell transplants.

Although it is difficult to estimate the likelihood of using stem cells, published studies have estimated the chance of needing a stem cell transplant from any source (ie cord blood, bone marrow) to be:

• The chance of a child (ages 0 to 21) needing a therapy using his or her own stem cells are currently about 1 in 2,700 [1].
• The chance of an individual needing stem cells (either their own or from someone else) for transplantation over the course of their lifetime, is estimated to be about 1 in 217 (ages 0-70) [2].   
  

Importantly, these estimates do not include future therapies that may be developed, so the probability of using cord blood is likely to increase.

1. Johnson F. Placental blood transplantation and autologous banking-caveat emptor.
J Pediatr Hematol Oncol. 1997;19(3):183-6.
2. Nietfeld JJ, Pasquini MC, Logan BR, Verter F, Horowitz MM. Lifetime probabilities
of hematopoietic stem cell transplantation in the U.S. Biol Blood Marrow Transplant.
Mar 2008;14(3):316-322.