How to Choose a Cord Blood Bank
Collecting, processing, and banking stem cells is a highly specialized industry. When comparing different cord blood banks, remember that stem cell processing is not a service that should be decided by the lowest price or the closest location to you. Expertise, experience, and accreditation by third party inspectors are critical aspects to investigate with any cord blood bank.
Always keep in mind that you are making a decision to entrust your newborn's unique stem cells to a banking service. The most important thing is that the company (and your baby's cells) are there if you need them and that they are viable (usable). Cord blood stem cells are a miracle of nature that are only available once in a lifetime.
The four "must have" features you should look for in a cord blood bank:
Make certain that the bank you choose is Accredited by the American Association of Blood Banks for the specialized processing of stem cells.
General accreditation is not sufficient - the bank should be accredited for the specialized processing of hematopoietic stem cells. That means that the bank had their laboratory and administrative procedures reviewed, inspected, and validated and were found compliant with the guidelines established by AABB for the specialized processing of stem cells. Don't assume that a lab that handles sperm, ovum, or whole blood is qualified to process your stem cells.
Make sure that the laboratory and storage facility are owned by the bank.
Banks that contract the processing and storage to a third-party do not take responsibility for these critical steps, and you don't know
what will happen to your sample when the contract between the lab and the bank expires.
Ask to have the red blood cells removed from your cord blood before it's cryopreserved.
Although it may be more expensive, there are significant advantages to removing the red blood cells from your baby's cord blood sample. Transplant physicians prefer to use samples that have been red-cell depleted, which reduces the potential for A-B-O incompatibility. Red-cell depleted samples require less of a "cryo-protectant" called DMSO, which can cause serious side effects when the stem cells are used in transplant. The smaller the quantity of DMSO, the less problematic the side effects will be.
DON'T MISTAKE "VOLUME REDUCTION" for "RED-CELL DEPLETION"! It is possible to reduce some of the plasma and other cells in a sample to make it smaller, but this does not remove the majority of the red blood cells.
You'll want a bank that has processed a significant number of cord blood samples and has provided samples that have been successfully used in transplant.
Ask both of these questions. The number of cord blood samples processed and stored speaks to experience, which is obviously an important
factor when choosing a health care service provider. Would you prefer a surgeon who has performed 50 by-pass operations or 1,500?
It is also very important for the stem cell samples that are processed and cryopreserved to be acceptable to a transplant physician. Each sample should be handled as if it were going to be used in this fashion. If your stem cell sample is ever required for transplant, it will be rigorously tested for bacterial contamination, viruses, cell viability, and cell count before it will be accepted for use. Good viability and high cell count are the results of proper processing. Verify that samples have been provided for transplant, and request the name of the specific transplant centers. Most importantly, ask if they have ever had a sample rejected for use because of loss of cell viability, contamination, or low cell count.
Important considerations about cord blood banks:
Look for a bank that processes and stores only stem cells in dedicated facilities.
Some banks may store other human and nonhuman tissue. Sperm banks, blood banks, and hospitals perform a variety of processes for numerous applications, but most don't have dedicated facilities, equipment, or staff. That increases potential for cross-contamination or material error and may mean that the processing applied to your stem cells is based on the cost-effectiveness of materials, rather than procedures that will provide the highest yield of stem cells.
Make certain the bank performs "controlled-rate" freezing.
Controlled-rate freezing is performed with computerized equipment that lowers the temperature of the sample as safely as possible. This means that the temperature of your stem cell sample is slowly lowered over a period of hours, past the point of freezing, until it is ready to be put into liquid nitrogen for long-term storage. Rapid freezing or simply putting a sample into liquid nitrogen may damage the cells.
Choose a bank that has published data on their collection and processing methods.
This can help validate the integrity of the bank. Published data validates the process because the data must be carefully
reviewed by impartial scientific and medical peers and verified for accuracy prior to being published.
Questions to ask:
- How many samples has the bank stored?
- How many of their samples have been used in transplant?
- What percentage of the bank's clients work in the health care industry?
- Does the bank have affiliations with insurance companies and hospitals?
- Does the bank offer hospital or obstetrical caregiver education programs?
- Are programs available for disadvantaged families or families in medical need?
- Does the bank have a qualified and respected medical advisory board?
- Is the bank in a risky location in terms of hurricanes, earthquakes, or airport closures?
- Is the bank financially stable?
- Does the bank offer additional incentives? (Some have rebate programs or added services.)
- Is the collection kit sterile?