Abstract
Objective
To review current evidence regarding umbilical cord blood counselling, collection,
and banking and to provide guidelines for Canadian health care professionals regarding
patient education, informed consent, procedural aspects, and options for cord blood
banking in Canada
Options
Selective or routine collection and banking of umbilical cord blood for future stem
cell transplantation for autologous (self) or allogeneic (related or unrelated) treatment
of malignant and nonmalignant disorders in children and adults Cord blood can be collected
using in utero or ex utero techniques.
Outcomes
Umbilical cord blood counselling, collection, and banking, education of health care
professionals, indications for cord blood collection, shortand long-term risk and
benefits, maternal and perinatal morbidity, parental satisfaction, and health care
costs
Evidence
Published literature was retrieved through searches of Medline and PubMed beginning
in September 2013 using appropriate controlled MeSH vocabulary (fetal blood, pregnancy,
transplantation, ethics) and key words (umbilical cord blood, banking, collection,
pregnancy, transplantation, ethics, public, private). Results were restricted to systematic
reviews, randomized control trials/controlled clinical trials, and observational studies.
There were no date limits, but results were limited to English or French language
materials Searches were updated on a regular basis and incorporated in the guideline
to September 2014. Grey (unpublished) literature was identified through searching
the websites of health technology assessment and health technology-related agencies,
clinical practice guideline collections, and national and international medical specialty
societies.
Values
The quality of evidence in this document was rated using the criteria described in
the Report of the Canadian Task Force on Preventive Health Care (Table 1).
Benefits, Harms, and Costs
Umbilical cord blood is a readily available source of hematopoetic stem cells used
with increasing frequency as an alternative to bone marrow or peripheral stem cell
transplantation to treat malignant and non-malignant conditions in children and adults
There is minimal harm to the mother or newborn provided that priority is given to
maternal/newborn safety during childbirth management. Recipients of umbilical cord
stem cells may experience graft-versus-host disease, transfer of infection or genetic
abnormalities, or therapeutic failure The financial burden on the health system for
public cord blood banking and on families for private cord blood banking is considerable.
Key Words
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Article Info
Publication History
No. 328, September 2015 (Replaces #156, March 2005)
Footnotes
This document reflects emerging clinical and scientific advances on the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Local institutions can dictate amendments to these opinions. They should be well documented if modified at the local level. None of these contents may be reproduced in any form without prior written permission of the SOGC.
This clinical practice guideline has been prepared by the Cord Blood Banking Working Group, reviewed by the Clinical Practice – Obstetrics, Maternal Fetal Medicine, Family Physician Advisory, and Aboriginal Health Initiative Committees, and approved by the Executive and Board of the Society of Obstetricians and Gynaecologists of Canada.
Disclosure statements have been received from all contributors.
Identification
Copyright
© 2015 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.
