Sydney Cord Blood Bank - How to Search Cord Blood
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How to Search for Cord Blood
A cord blood transplant can be performed in Australia at Transplant Centres sited in major public hospitals.
The transplant doctor would submit a search request to the Australian Bone Marrow Donor Registry (ABMDR) to search for suitable bone marrow and /or cord blood units. The ABMDR then searches international databases and obtains a list of suitable donors. As well containing a list of available bone marrow donors, the list will include a selection of available cord blood units with their cell count and HLA type (HLA A,B and DR) and the level of HLA matching (tissue type matching), e.g. 4,5 or 6 out of 6 HLA matching (4/6,5/6 or 6/6). A response from ABMDR to the search request is usually obtained within a day of the application.
The transplant doctor selects one or more potentially suitable cord blood units for additional HLA typing.
Once all the information is available, the transplant doctor will reserve one or possibily two cord blood units. Arrangement is made for the transport of the cord blood unit(s) in a special shipper kept at or below -150°C to the Transplant Centre.
The search for a suitable cord blood will usually be completed within days to weeks depending upon the availability of matched units.
The SCBB has received over 1500 search inquiries and released over 300 CB units to patients in Australia and overseas (New Zealand, U.K, Belgium, Finland, France, Israel, Turkey, Canada, USA, South America, Hong Kong, Malaysia, and Singapore to name a few).
Alternatives to public donation
Sydney Cord Blood Bank is a public bank storing cord blood for use, anonymously, to anyone in need. The information provided below is information about other options that are not services provided by the Sydney Cord Blood Bank.
1. Designated Donation
This is a donation of cord blood for use where there is a family member with a disease such as leukaemia and who is in need of a bone marrow transplant. Arrangement for such donation and banking of the cord blood are made with the doctor treating the family member needing a transplant.
For such a designated donation, the following aspects are important:
- The tissue typing of the baby needs to be compatible with the family member for whom the cord blood would be used.
- Cord blood transplant is considered appropriate therapy by the physician treating your relative.
- Delivery may need to be planned, for example, by induction so that appropriate personnel can be available to collect the cord blood.
- The collected cord blood unit may be inadequate and may have to be supplemented by a bone marrow harvest from the baby.
Arrangements for the collection, processing and storage of the cord blood have to be made by the physician treating the family member. Processing and storage will normally be arranged at the laboratory of the Transplant Centre.
If the cord blood cannot be collected or is unsuitable for banking, all is not lost. If the donor and patient are tissue compatible, bone marrow can be collected instead from the donor when transplant is needed. If the donor is not compatible (70% chance), search can be made of the unrelated bone marrow donor registries and Cord Blood Banks. There are over 10 million unrelated bone marrow donors registered world wide and over 300,000 donations of cord blood stored (with over 19,000 in Australia). The likelihood of finding a suitable unrelated bone marrow donor is over 30% and of a suitable unrelated cord blood donation is over 90%.
2. Private Use Donation:
Some families consider collecting cord blood to keep for their own private use, either for the child who donated or for another family member in case there is ever a medical need. Private Donation involves a collection fee and an annual fee to store the umbilical cord blood. Private family cord blood banks are available throughout the country for anyone.
The facts your doctor would consider relevant to considering the potential benefit / use of privately stored cord blood are as follows:
- If the baby who provided the umbilical cord blood needs the transplant:
- The doctor will decide if a transplant using that person's own cells (an autologous transplant) is the best choice. Many diseases that are treated with transplant may already be present in the cord blood. For some diseases, a transplant using cells donated from a relative or unrelated donor (allogeneic transplant) is the best choice.
- If the sibling of the baby who provided the umbilical cord blood needs a transplant:
- The doctor would first test to see if the sibling matches the brother or sister who needs the transplant. Because tissue types are inherited from parents, there is a 25% chance that siblings will match each other. (For more details, see the patient information on HLA matching).
- If the siblings match: the doctor will decide between the stored cord blood or a bone marrow donation from the sibling; each has advantages and disadvantages.
- If the siblings do not match: the doctor will search a donor registry for an unrelated adult bone marrow donor or a cord blood unit that closely matches the patient.
- If your child's stored cord blood is the best choice, the doctor would check to be sure that the cord blood unit is large enough (has enough blood-forming cells) and is free from disease and infection. If these standards are not met, then the doctor will consider the other options above (see http://www.marrow.org for more information).
There is also the potential to grow stem cells into other tissues such as heart muscle and nerve cells and that these might be able to be used for treatment in later life. This research is being performed in experimental models. It has a long way to go before it has a potential application in humans, but the potential may well develop into a reality in the future.
A number of august bodies and authorities have commented on this issue, indicating that the value of storing cord blood for private use is questionable (at present). They include the American Academy of Pediatrics (www.aap.org) in Cord Blood Banking for potential future transplantation. Subject Review (RE9860) Pediatrics 1999;104:116-118; Professor Leonard Johnson ( Oregon Health Sciences University) in "Blood and Bone Marrow Transplant Newsletter" Issue #43, July 1998 (www.bmtinfonet.org/newsletters) and the British Royal College of Obstetricians and Gynaecologists (www.rcog.org.uk) in Umbilical Cord Blood banking: Scientific Advisory Committee Opinion Paper 2 (October 2001). In these and other reviews, it is estimated that the likelihood of using cord blood collected for private use ranges from 1 in 2,500 to over 1 in 200,000.
If your cord blood is donated to a public bank it is estimated that in 10 years time, the chance that your cord blood will still be in the bank is around 85%. If it is there and there is a need for you to use it, it could still be available.
Sydney Cord Blood Bank | What is Cord Blood | How to Donate Cord Blood | How to Search | Foundation