When Manpreet Kaler gave birth to Simer five years ago, she considered storing a unit of her daughter’s umbilical cord blood with a private company. But the initial cost and annual storage fees were simply too much.

Instead, the cord and placenta, which are rich in stem cells that can be transplanted to treat various diseases, were discarded as medical waste.

This year, while expecting son Amar, she learned of a new option: the National Public Cord Blood Bank, run by the not-for-profit Canadian Blood Services. The decision was simple.

The Kalers weren’t sold on the idea of privately storing cord blood for family use — because statistically the odds of someone actually needing it one day for personal use are slim. However, donating to the national public bank is free and not exclusive — it could save someone else’s life. Plus, Kaler was slated to give birth at Brampton Civic Hospital — one of five collection sites nationwide.

“There’s no loss in doing it — only gain,” says Kaler, reaching for now 8-month-old Amar as he tries to make a getaway on all fours. “If somebody else could use it, then why not? If we decided not to (donate) they would’ve just thrown it out.”

The 26-year-old is among a growing number of women donating cord blood to the country’s public bank, which has collection sites in Ottawa (there are two in the capital city) and Brampton, with two more scheduled to open in Edmonton and Vancouver in early 2015.

To date — the program has been operating in Ottawa since October of 2013 and in Brampton since July — about 2,600 units have been collected with more than 350 of those in Brampton.

Dr. Heidi Elmoazzen, director of the National Public Cord Blood Bank, believes those figures will increase as awareness about the program grows. The Canadian Blood Services has provided information kits to 260 doctors in cities with collection sites — 52 of them in Brampton — to share with expectant moms and give them enough time to consider the option.

So far, it’s been an “easy sell” to moms, she says.

“There’s really no risk to the mother or baby because all the collection takes place after the delivery of a healthy baby,” says Elmoazzen. “(The mothers) sort of feel like they’ve been able to, out of a happy occasion for them, potentially save somebody else’s life.”

Blood stem cells found in the umbilical cord blood — along with those found in bone marrow and peripheral blood from adult donors — can be used to treat more than 80 diseases and disorders, including leukemia, lymphoma, aplastic anemia and inherited immune system disorders.

A successful transplant requires that the patient’s and donor’s genetic markers be similar. What’s great about stem cells from cord blood is that it’s easier to make a match because these young and immature cells are more malleable and adaptable when transplanted, so the patient is less likely to reject them. Plus, because cord blood has been collected in advance, and stored, it’s ready for patient use.

At any given time, there are about 1,000 Canadians waiting for a stem cell transplant — but only half find a suitable match. The odds aren’t great, even though Canadian Blood Services has about 350,000 potential donors registered on the OneMatch Stem Cell and Marrow Network. It has also has access to 74 international stem cell registries with 24.3 million registrants and 49 cord blood banks worldwide containing about 621,500 units.

That’s why creating a public bank is important — it will, hopefully, increase the odds of finding a match for patients. And it will save the health-care system money because each time Canada buys a unit of cord blood from an international registry, it costs about $42,000.

Brampton mom Shelley Goulbourne credits a successful stem cell transplant with saving her 14-year-old son Kai, who was diagnosed at 9 years old with chronic myelogenous leukemia, a rare type of cancer affecting the blood.

Because ethnicity plays a crucial role in a stem cell match, Kai’s ancestry — a mix of black and Caucasian — made it more challenging. None of his family members were a match, but a close enough match was found in cord blood donated in Europe. Using international donors isn’t uncommon — in 2013, for instance, 61 Canadian patients received transplants from Canadian donors, while 277 patients received transplants from donors worldwide.

“I am truly, truly grateful,” says Goulbourne, noting that before the transplant, her son was so ill his kidneys almost failed. Nowadays, Kai is doing “wonderfully well” — he’s a regular teen, who enjoys school, plays basketball and hangs out with friends.

Seeing as Canada’s current donor database is about 70-per-cent Caucasian, it was important to create a national public cord blood bank that’s reflective of the diversity here, says Elmoazzen.

For this reason, collection sites were set up in hospitals in ethnically diverse communities with bustling maternity wards — more than 4,000 births each year. Brampton, for example, has a large South Asian population. The hospital in Edmonton serves a large aboriginal community, and the hospital in Vancouver has a large Asian population — all groups under-represented in the registry.

“We’re trying to get the best units to match our own Canadian patients,” says Elmoazzen. “The more people we can get on the OneMatch registry and the more moms we can get to donate to the bank, not just is it a cost savings, but we’re more likely to find a better match, especially for our hard-to-match ethnically diverse patients because we have a lot of ethnicities here in Canada that you don’t see in other parts of the world.”

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So far, about 50 per cent of Ottawa moms who have donated cord blood are ethnically diverse. And in Brampton, about 75 per cent are ethnically diverse — of those 46 per cent are Asian and South Asian and 10 per cent are black.

“We were absolutely thrilled to have the opportunity to partner with Canadian Blood Services,” says Joanne Flewwelling, executive vice-president of clinical services and chief nursing executive at William Osler Health System, which includes Brampton Civic Hospital. “We really are in an enviable position, with the diversity of our patient population and our community, to really help many patients who are in need of stem cell transplants.”

The non-profit organization South Asians for Life, which raises awareness within the South Asian community about stem cell donations to increase the number of OneMatch registrants, is also promoting cord blood donations at information events it holds in Brampton.

“In some regards, (cord blood) might be an easier sell because it’s medical waste that would otherwise be tossed,” says the organization’s medical director, Dr. Prateek Lala, who is also a pediatric fellow at the Hospital for Sick Children in Toronto. “There’s a general need to educate the public as a whole about the need for and ease with which cord blood stem cells can be collected.”

New mom Kaler, who is Punjabi, has also been educating her friends and family about cord blood donation and telling them about how surprisingly easy the process is. (Her baby was born in April, during the validation phase.)

Basically, a mom shows up at Brampton Civic Hospital with a permission form authorizing Canadian Blood Services staff to collect cord blood. Within the first five to seven minutes after delivery, the placenta and attached umbilical cord are whisked down the hallway to a collection room where a needle is inserted into the cord, draining about 100 mL of blood.

There are some moms who decline, even though they have no plans on private banking. Some aboriginal patients, for instance, decline because they have cultural practices that involve burying the placenta after birth. Yet, even in those cases, the cord blood can be withdrawn and the placenta returned to the mom, say staff.

All of the units collected in Brampton and Ottawa are shipped at room temperature to an Ottawa manufacturing facility, where it’s processed, tested, frozen and stored. Meanwhile, an Edmonton facility handles units from the western sites.

Not all donations are bankable. For instance, units that don’t have enough stem cells, were collected too late, or come from moms, or babies, with certain medical conditions are deemed unacceptable. (In Ottawa, mothers whose donations aren’t bankable can donate the cord blood for research.)

In Canada, the Canadian Blood Services isn’t the only organization running a public cord blood bank. Hema-Quebec manages a collection in Quebec and the charitable organization Victoria Angel Registry of Hope will pick up donor samples from about 35 different hospitals throughout southern Ontario.

There’s definitely one more donation that the Canadian Blood Services can count on — that is, if Kaler and her husband have baby No. 3.

“If I were to have another baby, I would do this again, for sure,” she says, “100 per cent.”

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