Transcription:

Warner Huh, MD (Host): Hello, everyone. This is Dr. Warner Huh, the Chair of Obstetrics and Gynecology at the University of Alabama at Birmingham. So, again, I'd like to welcome you to this monthly episode of Women's Health with Dr. Huh. And today, we're going to talk about something that most of the public knows little or nothing about, which is cord blood donation. And, actually, ironically, it's Cord Blood Donation Awareness Month. So it's an ideal time for us to discuss and bring up this topic.

And so with me today are two awesome guests, Dr. Brian Casey, who is a professor in the Department of Obstetrics and Gynecology. He's also the Division Director of Maternal-Fetal Medicine and the Vice Chair of Obstetrics here at UAB. And also, with us today is Luis Hernandez who's the Director of Cellular Therapies for LifeSouth Community Blood Centers. And one of his many responsibilities, I'm sure, is to oversee all aspects of the cord blood program from collection to distribution.

So, welcome, Dr. Casey and Mr. Hernandez.

Dr. Brian Casey: Thank you, Dr. Huh.

Luis Hernandez: Thank you.

Warner Huh, MD (Host): Okay. So let's talk about cord blood collection. And I guess I mentioned earlier, this is like the ideal time to do this podcast, given that it's Cord Blood Awareness Month. So Dr. Casey, can you tell me a little bit about what exactly is cord blood collection and how this is collected for our listeners?

Dr. Brian Casey: So, umbilical cord blood that we collect is typically the blood that is left in the cord and the placenta after the cord is clamped and cut, and the baby's either handed off to the pediatricians or Placed on the mother's chest for skin to skin. It's typically blood that is disposed as medical waste. However, it is an important resource for stem cells that can help us out in curing several diseases. We typically, as I say, collect it, the providers collect it at the time of delivery.

Warner Huh, MD (Host): And so maybe, Mr. Hernandez, you can tell us what exactly is the cord blood to be used for and how is the banking actually done?

Luis Hernandez: We partner with several hospitals such as UAB, different collectors to collect the cord blood. We receive it at our processing facility. Basically, we remove the RBCs, plasma waste and just leave basically the layer that we refer to as buffy coat, which is all the hemopoietic stem cells that are left. We then cryopreserve those units and we list them on the National Registry for Transplant Centers to be looking for a match. The cord blood is used, like Dr. Casey said, to treat various diseases such as leukemias, lymphomas or other disorders with the blood or immune system.

Warner Huh, MD (Host): And so I think it's important for the listeners to know why there's increased awareness around cord blood collection and its benefits. So I thought maybe, Dr. Casey, you just could comment a little bit on that.

Dr. Brian Casey: Yeah. Thanks, Dr. Huh. Cord blood collection is a relatively young science. We've only been doing it for the last 40 years or so. And it's important that we understand that it is a resource. The stem cells that you can get from cord blood are a resource that can be used to help individuals not necessarily related to the mom or the baby after banking. So, like I said, it's important to bring awareness that we have this incredible resource that isn't often used or captured. And so, this month of July is really important for us to bring it to future moms or new moms that this is something that is an opportunity for them to help others with cord blood that would otherwise be really kind of thrown away as medical waste.

Warner Huh, MD (Host): So aside from the actual process of collecting the cord blood, spinning it down, storing it, putting on a registry, so wondering if one of you could comment on what research is being done around cord blood, including here at UAB and worldwide.

Dr. Brian Casey: Luis, I'll take that one first and just sort of comment on the research that's being done here at UAB. We've had multiple collaborative scientists looking at cord blood in the study of Epstein-Barr virus and in HIV-related cancers, as well as sickle cell anemia. And as Luis, I think, will probably talk about is one of the benefits of donating blood if it's not acceptable for banking, is it can be used for other research throughout the country and the world, frankly. So Luis, you want to jump in and add some more to that?

Luis Hernandez: Absolutely. Yeah. We've provided units for research. One of the most recent clinical trials that we participated in was called the CoBIS trial, which was seeing how cord blood could be used to treat patients with strokes. That's an ongoing clinical trial with Duke University. But I think there's many different trials ongoing, and I think there's a great resource called Parent's Guide to Cord blood where you can find various information of all the clinical trials that are occurring around the world.

Warner Huh, MD (Host): And my understanding is that UAB and LifeSouth have essentially created a partnership in terms of promoting and advocating cord blood collection. And I was just curious if one of you can comment on how exactly are you promoting collection? How are you making this aware to patients and their partners and, you know, educating just the general obstetrical community about this?

Dr. Brian Casey: I can't say enough good things about LifeSouth. LifeSouth came to us a little bit over a year ago and wanted to engage UAB in perhaps offering cord blood donation to our patients delivering here at UAB. And after some negotiations of how we were going to do that, starting in February, we've been offering to all of our patients the opportunity to donate cord blood through LifeSouth for banking and if they elect to do so for research. And here at UAB, it has been an enormously collaborative experience between our nurses on the front line who are approaching patients when they come into labor and delivery for delivery. Our nurses and providers out in the outlying clinics, when they interact with patients providing them with information about the possibility of blood banking and the research staff here at UAB also helping us coordinate the collection of the blood and the processing of the blood and preparing it to send off LifeSouth. So it has been a really gratifying experience from my perspective to see the great collaborative effort between the folks here at UAB and LifeSouth.

Warner Huh, MD (Host): Mr. Hernandez, I don't know if you have any thoughts on your perspective on your side of the relationship.

Luis Hernandez: No. I mean, you couldn't ask for a better partner than UAB and I think Dr. Casey nailed it. It's really all of the staff there, the OB-GYN providers, the nurses, Dr. Casey himself, it's just been fantastic. And we try to provide marketing material information that can be handed out. We try to get in front of expecting mothers as much as possible before they arrive for delivery, but you can't take away the credit. It really is the UAB staff that is doing all the hard work. So we really appreciate it.

Dr. Brian Casey: That's awesome.

Warner Huh, MD (Host): So I have an additional question for the two of you. So I haven't practiced obstetrics in about 25 years, but when I was a resident many years ago, I remember collecting cord blood for patients and couples, and they paid a fee to store their cord blood to have it banked. I guess the question I have, is there a fee for patients to donate their cord blood on this program?

Luis Hernandez: There is no fee. That is the difference between public banking and family or private banking. So we're a public cord blood bank. Once the unit is donated, we basically list that on the national Registry and it's available for any patient in need around the world. Whereas family banking or private Banking, there is a cost that's associated to that. That unit can only be used within a related family member. Once you donate either public or private, you can't switch back and forth from the other. There is no cost to the patients. LifeSouth incurs all costs related to the donation.

Warner Huh, MD (Host): Okay, that's helpful because I think some of our listeners are maybe thinking about the exact same question. And again, for those of you listening, I think the difference is as Mr. Hernandez says, the distinction between a public registry and one that's private. And I think this kind of goes without saying, but I'm going to ask it, given that this blood is largely discarded as Dr. Casey said, it seems to me like we should make an effort to basically collect cord blood on all patients, even for a public registry. So do you see it ever becoming a time in which this becomes the standard of care, and we routinely collect cord blood with the patient's consent and put it on a registry or even a personal banking?

Dr. Brian Casey: I think I would love that. And I think probably Luis Hernandez would love that as well for LifeSouth. But currently, it is a blood specimen that is being donated. And so it is a consent process for patients. Patients have to be asked and consent to providing the specimen. And I think your question really underlines the importance of Cord Blood Awareness Month and why we're having this conversation today, is if we can increase the awareness for our patients like we're doing here at UAB at many other hospitals across Alabama and the country, I think we would all see much more utilization of cord blood for treating patients throughout the world.

Luis Hernandez: Absolutely. I completely agree with Dr. Casey. I think just making more and more people aware of the uses of cord blood. Whenever I speak about this, we don't actually compete with private banking. What we're competing with is the biohazard bin. This is being discarded at different facilities across the country. And it's a rich source that can help. The more units that are collected and processed and listed on the registry, the better the chances for everybody. And I think one of the important notes to make is diversity is huge. So the chances of somebody of a minority patient to find a match is a lot less than, for instance, a Caucasian. And I think closing the gap for everybody, including Caucasian patients in need, is really important.

Warner Huh, MD (Host): No, I appreciate both your comments and that's, again, for our listeners. I think this is a major takeaway point. And you know, I just think that this is a way to give back to the community. And I think that it's something that probably is underrecognized. And I think with the work that both Mr. Hernandez, as well as Dr. Casey are doing is huge. And I think for some of our pregnant listeners, or soon to be pregnant listeners, I would just hope that this is something that you all will strongly consider. I think it's a huge public service to the community.

So anyway, again, as always, I learned a tremendous amount doing these podcasts and this one is really no exception. And I personally want to thank Dr. Casey and Mr. Hernandez for updating us in cord blood collection and the importance of this at UAB and beyond, and to make our listeners aware of the unique relationship that we have with LifeSouth. And again, as always, please rate this podcast. And we welcome any comments, particularly on topics that you're interested in listening about.

And for more services about this cord blood program with LifeSouth or any of our obstetrical services and expertise and all clinical services that UAB provides, please check out uabmedicine.org. And until next time, hope you all have a great day. Please be safe, take care and peace out. Bye-bye.