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Cord Blood Banking: Private vs. Public Options

24 September 2024

One of the dilemmas that parents have before the birth of their child may include the decision of whether to collect cord blood. After birth, the newborn’s umbilical cord and the placenta contain cord blood that contains stem cells and may be used in the future for treating and curing various diseases. The parents are free to choose whether to collect the cord blood, and can choose between banking in a public or private bank. A little bit about the differences:

Donating to a public blood bank

  • The blood unit is for use by the entire population.
  • The blood unit may also be used by the donor whenever necessary – on the condition that it is available for use.
  • Donating to a public cord blood bank means waiving any right over the blood unit.
  • Donating to a public cord blood bank does not involve payment, nor does it qualify for payment or any other benefit.

How to donate to a public bank

Every pregnant woman with a normal pregnancy can donate cord blood to a public blood bank. Today, the only public bank in Israel that takes cord blood donations is the blood bank at Sheba Medical Center, Tel Hashomer. Only expecting mothers who choose to give birth at Sheba can currently donate cord blood to the public bank, to which end they must contact the bank to get an explanation and directions on donating it.

Private cord bank collection

  • The unit is intended for personal or family use only.
  • This is a service that costs a few thousand shekels (in some HMOs the service is subsidized by supplementary insurance) and is for a limited period as defined in the contract.
  • You cannot transfer cord blood that has bee collected at a private bank to a public one.
  • For certain diseases, it is not recommended to use an autologous cord blood unit, because there is a chance of it containing the pathogen that caused the disease.
  • The blood unit may prove unsuitable for grafting when needed.

What should you check before choosing a private bank

Before making the decision, you should compare a number of important issues:

  • Background on the bank and its financial strength.
  • Does it have a permit from the Ministry of Health?
  • Details of the contract.
  • How is the blood collected?
  • What does the blood unit’s treatment include?
  • What happens if a unit is not suitable to be preserved?
  • How is your privacy protected?
  • Information about the costs.

Cord blood that is collected from the umbilical cord and placenta at the end of childbirth may be used in the future for treating various diseases, such as blood diseases and immune system diseases. The parents are free to choose whether to preserve cord blood and can choose between donating to a public blood bank or keeping it in a private blood bank.

Public versus private

Here are a few facts you should know to better understand the differences, advantages and disadvantage of donating cord blood to a public bank and keeping cord blood in a private one.

Donating to a public blood bank

  • A cord blood unit that has been donated to the public bank is intended for use by the entire population and may save lives – in cases a bone marrow transplant is necessary and no suitable donor is found (full tissue match), cord blood cells may be used instead of an ordinary bone marrow transplant.
  • A cord blood unit that has been donated to the public bank may be used by the donor when necessary – on the condition that the unit is available for use.
  • Donating to a public cord bank means waiving any right to the blood unit, including the right to receive information on its use.
  • Donating to a public cord blood bank does not require payment, but does not qualify for payment or any other benefit either.
  • Only approximately 40% of units collected for a public bank prove suitable for preservation. Units that do not meet the quality and safety requirements are disqualified, for example due to a low cell count that precludes a transplant or the presence of contaminants originating from the collection and processing work.
  • Many organizations in the world promote altruistic donations to public cord blood banks and object to preserving cord blood in private banks. These donations have saved the lives of thousands of people worldwide.

Private cord blood banking

  • Private cord blood banking is intended for future autologous use (by the donors themself) or use for close relatives (usually a sibling born to the same parents).
  • The units are not registered in the national and global databases and are not intended for use by the entire public. Checking for tissue matching of these units is not mandatory.
  • For certain diseases (such as certain types of leukemia), it is not recommended to use an autologous cord blood unit because there is a chance that it already contains the pathogen causing the disease.
  • Private cord blood banks offer preservation of blood units for other future uses that are not in use yet today or the efficacy of which is not yet sufficiently proven, such as: curing a range of diseases, (for example diabetes and heart disease), cerebral palsy and autism.
  • The blood unit kept in a private bank may prove unsuitable for a transplant when needed. However, some banks also keep cord blood units that do not meet the current requirements for bone marrow transplant for future use for other purposes (as stated in the previous section).
  • Cord blood preservation in a private bank is a service that costs thousands of NIS (in some HMOs the service is subsidized by supplementary insurance).
  • Preservation of the unit in a private bank is usually for a limited period defined in a contract.
  • Cord blood kept in a private bank cannot be transferred to a public one.

The process of donating to a public blood bank

Every pregnant woman whose pregnancy is normal can donate cord blood to a public blood bank. Today in Israel, the only public bank that takes cord blood donations is the blood bank at Sheba Medical Center, Tel Hashomer. Only expecting mothers who choose to give birth at Sheba can donate cord blood to the public bank today, and those interested in doing so must contact the bank (Hebrew) (there is no recommended time for doing so during pregnancy – you can contact it at any time) for an explanation and additional instructions. In special medical conditions, you can contact the public blood bank to check for eligibility for donating.

The process for donating cord blood includes:

  • Signing a form of consent.
  • Answering questions on your medical history.
  • A blood test to rule out infectious diseases.

In addition, when signing the agreement, you can choose to transfer a blood unit for a future clinical trial, if it proves unsuitable for freezing and preservation. This option is relevant only for a blood bank announced by the public blood bank’s medical director or a specialist hematologist as not meeting the bank’s criteria and being unsuitable for further preservation for stem cell transplant purposes.

Another option, which is included in the health basket, is asking to preserve, in the public blood bank, a "specific donation" of cord blood for a patient in the family (usually a sibling born to the same parents). This service is offered to families in which there is a first degree relative with a known hemato-oncological diagnosis or other disease treatable by a bone marrow transplant. The unit will be preserved in the public cord blood bank, on the condition that the unit is found to match the patient for up to four years. To this end, it is necessary to contact the attending physician and HMO.

Important

Important

  • The decision on donating cord blood for public benefit is a personal decision of the parents, and must be made of their free will.
  • Refusal to sign will not affect your rights as an expecting mother or your medical care.
  • At any stage, it is possible to annul the decision to donate cord blood – before harvesting the unit and up to 24 hours afterward.

The process of preservation in a private blood bank

Israel has a number of private banks for preserving cord blood, currently working with approximately 30 hospitals in the country, and choosing among them may be confusing. If a decision has been made to preserve a unit in a private bank, you should know what you should check with the various companies offering the service and the rights parents have. To facilitate the process, here is vital information along with important recommendations on private cord blood banking:

Payments and refunds

  • Private cord cell banking is a service that costs several thousand of NIS, for a limited time as defined in the contract (usually for 20 years or 40 years). The price varies between banks, and sometimes it includes various surcharges, such as transplant insurance.
  • There are banks that permit choosing the manner of payment – installments or a single advance payment.
  • Some HMOs subsidize the service through supplementary insurance.
  • If a decision is made to waive the preservation of a blood unit because it has been found unsuitable for use, you will pay only for harvesting the unit and the tests. The payment for a unit that has not been preserved will not exceed 20% of the total predetermined price, or approximately 2,000 NIS, whichever is lower, according to the chosen transaction type. Where the payment has been made in advance, you will get a partial refund.

Conducting a market survey

Before deciding on a bank to preserve cord blood in, it is a very good idea to compare the different companies offering the service, including the bank’s background and financial resilience, whether it is approved by the Ministry of Health, details of the contract that you will sign, what the treatment of the blood unit includes, what happens if a lot is unsuitable for keeping, how the privacy of the family is protected and of course the costs.

To facilitate the choice, you can ask the following questions:

  • What are the criteria used to decide whether to allow cord bank to be kept in the bank? What factors affect the possibility of keeping cord blood at the specific bank?
  • In what week of pregnancy can you enroll in the service?
  • In the case of early delivery – what is the earliest week of pregnancy before which the unit cannot be harvested?
  • How is the cord blood actually harvested? Does the medical staff in the delivery room get equipment and special instructions for harvesting, or is an outside team that enters the delivery room responsible for harvesting the blood unit?
  • In addition to the cord blood unit, are blood samples also taken from the mother?
  • How are the blood units transferred from the hospital and where?
  • What happens if a unit is damaged in transit?
  • Are there special instructions for harvesting and conveying the blood unit during weekends?
  • In what conditions can the unit not be harvested after delivery?
  • What tests will be conducted on the blood units and will the parents be updated on the results?
  • Where and how is the cord blood unit kept?
  • Is the unit kept as a single unit or multiple separate ones (to ensure that if one of the units is damaged, for example due to a malfunction or natural disaster, another unit will be available)?
  • What happens if a unit is found unsuitable for preservation?

  • Does the bank have a valid permit from the Ministry of Health?
  • Does the bank have a valid agreement with the hospital at which the birth is scheduled?
  • How long has the company been working in cord blood preservation?
  • How many cord blood units are already being kept at the bank?
  • Does the bank also have a department dealing with harvesting for public preservation?
  • Who is the manager of the cord blood bank?
  • What confirmation of depositing the unit at the bank is given and how will it be given to the parents?
  • Does the bank ensure that the units will continue to be kept in the case of closure or bankruptcy of the bank?
  • Does the bank offer transplant insurance in addition to blood preservation?

  • What means does the bank take to safeguard customers’ privacy?
  • In the case of installments – can the payment change over time or is it fixed?
  • Under what conditions can you get a partial refund for a unit that is found unsuitable for preservation?
  • Is there a discount for preserving units of more than one newborn in the same birth or units of additional children in the future?

After a check and comparison not just on the matter of costs but also of all details of the agreement and the service provided by the private banks, you can make an educated decision on which bank to choose.

Parents’ rights

Another thing that is important to remember is that parents have rights in relation to private cord blood preservation, which you should know:

  • The decision on whether to preserve cord blood is a personal, free choice of the parents.
  • The parents are entitled to receive a clear, detailed explanation about the service, orally and in writing, from an authorized person as soon as possible.
  • The parents have a right to receive a copy of any form or agreement that has been signed with the bank.
  • After harvesting and depositing the unit, you can get a written deposit confirmation from the private bank containing information on the harvested and tested unit, results of tests done on it, the number of cells in the unit (alongside the bank’s minimum requirements) and the place in which the unit is kept.
  • If the cord blood unit harvested at delivery is found unsuitable for use, the parents have a right to choose whether to preserve it regardless.
  • The cord blood unit deposited at the bank for private preservation belongs to the newborn, and may be transferred for transplant only according to the instructions of the guardians (the parents up to the age of 18) or in the future after the newborn's approval (most units today are kept frozen for 20 years, and sometimes even 40 years).
  • A cord blood unit cannot be subjected to attachment or pledging.
  • The bank and all its staff are required to maintain confidentiality regarding any information or document containing customers’ personal information. Information may only be disclosed when required for performing the provisions of the Cord Blood Law, Supervision of Banks Law or by court order.