Cord Blood Preservation

Harvesting and preservation of cord blood are procedures that are done immediately after delivery, during which blood cells are collected from the umbilical cord and placenta. The blood cells may be used in the future for treating blood diseases and immune system diseases, and for donation, like bone marrow transplant. The decision on whether to preserve cord blood is a personal choice of the parents and is not mandatory.

What is cord blood

After delivery and detachment of the newborn from the umbilical cord, blood is left in the placental blood vessels and in some of the umbilical cord that remains attached to it. This blood is called cord blood.
Cord blood contains red blood cells, white blood cells, platelets and plasma and is also rich in stem cells of the blood system (hematopoietic stem cells), like bone marrow. The advantage of these stem cells lies in their ability to develop into different types of blood cells, which later divide and replicate and can renew the various blood cell populations as needed. In addition, their dividing ability is very rapid, so they are effective in rehabilitating the blood system and immune system.

Stem cells are the source of 3 types of blood cells:

• Red blood cells, which transport oxygen to the entire body.
• White blood cells, which constitute part of the immune system, involved in protecting the body against infectious diseases and foreign agents (bacteria, viruses, parasites, foreign particles and tumors).
• Platelets, which are involved in the hemostasis process (blood clotting).

Use of cord blood

Hematopoietic stem cells received from umbilical blood are used for treating blood diseases and immune system diseases (such as myeloma, leukemia, lymphoma and others) and may be a substitute for bone marrow donations. The cells are transplanted by transfusion and enter the bone marrow, where they divide and differentiate into mature, functioning and healthy blood cells.

Transplant of stem cell from cord blood has been performed since 1988 and shows positive results mainly in children, whose cord blood transplant success rates are similar to bone marrow transplant success rates. For adults there has also been success and constant improvement in cord blood transplant outcomes.

The cord blood harvesting process in the delivery room

Cord blood harvesting is done in the delivery room after the infant’s birth is complete, detaching the umbilical cord and before the placenta is expelled. The blood is collected into a sterile kit by a trained midwife or midhusband (an exception is Magen David Adom’s public cord blood bank, which has trained external harvesters according to the regulations enacted under the law – but currently this bank has discontinued harvesting new units).
The procedure does not endanger the mother or the newborn and involves no pain or discomfort.

The harvested unit will be transferred to a laboratory, where it will undergo testing for good condition and ruling out infections and stem cells will be separated from it. If all the test results are valid and the unit is found fit for preservation, it will be kept in a deep freeze.
Collection in private and public cord blood banks is done during all hours of day.

Optional ways to preserve cord blood

You can donate the harvested cord blood to the public blood bank for use by the general population, or preserve it in a private bank blood for future personal or family use. Today there is an active public blood bank only at Sheba Medical Center in Tel Hashomer, so only mothers giving birth at Sheba can choose the option of donating to the public bank. Magen David Adom used to operate a public cord bank that harvested units at 3-4 hospitals nationwide, but the harvesting of new units has been discontinued.

The private blood banks work today with approximately 30 hospitals nationwide.

In relation to donating to the public cord bank, it is important to note that when they sign a donation agreement, the parents can choose the option of transferring a blood unit for future clinical research – if it is found unsuitable for freezing and preservation. This option is only relevant to a blood unit found by the medical director of the public blood bank, its physicians or hematologists, to fail to meet the bank’s criteria and to be unsuitable for preservation for stem cell transplant.

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

Further information on the differences between cord blood preservation in a public bank and preservation in a private one

Regulation of cord blood banks in Israel

All cord blood banks in Israel, private and public alike, are regulated by of the Ministry of Health, which is also responsible for issuing operation permits for banks that meet the requirements of the law, the regulation and procedures on safety and quality issues.

Running a private or public cord blood bank for a person who has not received an operation permit and a valid confirmation of compliance with professional and statutory requirements from the Ministry of Health is prohibited.

If a private cord blood bank transfers cord blank units for preservation outside of Israel, the Ministry of Health permit refers only to the stages of treating the units that are performed in Israel. The Ministry of Health does not regulate cord blood banks and preservation sites outside of Israel.