Q1. What is cord blood?
A1. “Cord blood” is the blood that can be drawn from the umbilical cord of a baby after birth. Cord blood is a rich source of haematopoietic (blood-forming) stem cells. Similar to those found in bone marrow, these cells may be used to treat a variety of blood diseases. Cord blood is usually preserved by freezing technique for later use.

 
Q2. What is haemtopoietic stem cell?
A2. Haematopoietic stem cell is a primitive and undifferentiated cell that can replenish itself and develops into all types of blood cells, including white blood cells, red blood cells, and platelets. Apart from cord blood, haematopoietic stem cell is also found in the peripheral blood and bone marrow. Cord blood may offer a useful alternative to bone marrow transplants for some patients, as cord blood is easier to collect and can be stored frozen for future use.
 
Q3. How is cord blood used?
Many uses of haematopoietic stem cells in cord blood are still under clinical trials and their benefits are yet to be proven.
Haematopoietic stem cells in cord blood can be used to treat certain blood diseases such as leukaemia. As for other uses of stem cells, e.g. use in neurological injuries and diabetes, clinical trials are still underway and their benefits are yet to be proven. If you choose to receive those unproven therapies, you must be well aware of the risks involved and consult healthcare professionals regarding the efficacy of the therapies.
 
Q4. What are the risks involved in cord blood collection and banking?
A4. Cord blood may be damaged or contaminated during collection, transportation, processing and storage, hence should only be handled by trained and experienced professionals. Before deciding whether to store your baby’s cord blood, you should consult your doctor about the details of various risks involved.
 
Q5. Can my baby’s cord blood help a family member or a friend?
A5. Theoretically, cord blood would be able to help patients who have diseases that can be treated by haematopoietic stem cell transplant.
Quantity of cells in cord blood is small and their use is limited. Storage of cord blood for own “insurance” purpose is not encouraged.
However, the chance of getting perfectly matched cord blood from a sibling is 25% (the chance that parents are perfect matches is very low). The chance that other family members can be a perfect match is even lower. Moreover, the quantity of cells in cord blood may not be sufficient for use in patients with bigger body size, which further limits the therapeutic use of cord blood. Hence the storage of cord blood for own “insurance” purpose is not encouraged.
 
Q6. What are the options for cord blood banking in Hong Kong?
A6. For cord blood banking in Hong Kong, there are two main options:
Donate cord blood to the public cord blood bank: The public cord blood bank
Cord blood mixed with cryopreservant in a 25-ml freezing bag
(Photo courtesy of Hong Kong Red Cross Blood Transfusion Service)
collects donated cord blood for free and stores it anonymously for the treatment of people who have clinical needs. Other than using donated cord blood in transplant for patients in need, it may also be used in medical research. There is no guarantee that the cord blood donated will be used if any of the donor’s family members develops a disease and needs stem cell transplant. However, donation of cord blood may help others, especially those in clinical need. Public cord blood bank can also pool donated cord blood for the treatment of patients with bigger body size. At present, the only public cord blood bank in Hong Kong is managed by the Hospital Authority through the Hong Kong Red Cross Blood Transfusion Service. You can ask whether your birthing hospital participates in the public cord blood banking programme.

Donate cord blood may help others with clinical need while banking of cord blood for private use has limited use and is unlikely to help others.
Hire the services of a private blood bank: If you want to store cord blood for sole use of yourself or your family members, you can pay to use the storage service provided by a private cord blood bank. However, as mentioned above, the use of one’s own cord blood is very limited and unlikely to help others.
 
Q7. What is the cost to donate or store cord blood?
A7. There is no cost
Cord blood collected in a blood bag
(Photo courtesy of Hong Kong Red Cross Blood Transfusion Service)
for donating cord blood to the public bank, but the cord blood would be stored anonymously and the donor cannot decide on the usage or recipient of the donated cord blood. Private cord blood bank for personal use usually involves a storage fee, and the fee depends on the duration of storage. The doctor and hospital may also charge a fee for the collection and handling of cord blood. Please consult your doctor and birthing hospital regarding the collection procedures and cost.
 
Q8. Are there any existing ordinances in Hong Kong which regulate cord blood banks?
A8. Currently, there is no specific ordinance regulating the storage of cord blood in Hong Kong. However, the collection and use of cord blood are subjected to regulatory control of existing ordinances under different circumstances.

Cord blood is regarded as an “organ” under the Human Organ Transplant Ordinance (Cap. 465), which prohibits commercial dealings in human organs intended for transplant, restricts transplant of human organs between living persons, and regulates transplant of imported human organs. A person is guilty of an offence if he makes or receives any
Currently, there is no cord blood product registered as pharmaceutical product in Hong Kong.
payment for the supply of, or for an offer to supply an organ which is removed from a dead or living person.

On the other hand, if a cord blood product, e.g. haematopoietic stem cells derived from cord blood, falls within the definition of “pharmaceutical product” under the Pharmacy and Poisons Ordinance (Cap. 138), it must be registered in accordance with the requirements of the Ordinance before it can be supplied and used in Hong Kong. The person who manufactures or supplies the pharmaceutical product also needs to obtain appropriate licence under the Ordinance. Currently, there is no cord blood product registered as pharmaceutical product in Hong Kong.

In addition, healthcare professionals such as doctors, nurses or medical laboratory technologists should comply with relevant ordinances in Hong Kong, and the codes of practice or conduct of the respective professions in the collection, processing, storage and/or use of cord blood (including the provision of
Flow-cytometer – instrument for cell counting and detection of biomarkers
(Photo courtesy of Hong Kong Red Cross Blood Transfusion Service)
treatment or professional advice related to cord blood).

 
Q9. Does the operation of a cord blood bank need to meet certain standards?
A9. At present, international
Liquid nitrogen tank – for cryopreservation and storage of cord blood
(Photo courtesy of Hong Kong Red Cross Transfusion Service)
standards and good practice guidelines have been set targeting at the donation, collection, preservation, storage, processing and distribution of cord blood for cord blood banks to follow. Certain international accreditation bodies, e.g. AABB and Foundation for the Accreditation of Cellular Therapy (FACT), also provide audit and accreditation services for cord blood banks.
 
Q10. What are the advantages of choosing a cord blood bank that is accredited?
A10. Under the accreditation system, the accreditation body assesses the cord blood bank regarding
Cryopreservant dispenser
(Photo courtesy of Hong Kong Red Cross Blood Transfusion Service)
the quality and safety of collecting, processing, testing, storing, distributing and administering cellular and blood products. A cord blood bank is also required to maintain good performance at regular audits in order to retain the accreditation. If a cord blood bank is accredited, it means that its quality is assured to a certain degree. However, as accreditation is usually process-specific, you should check not only if the bank is accredited, but also if the relevant process(es) is(are) accredited when you choose a cord blood bank.