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Cord blood as a stem cell source: how it works and who it suits | CION Cancer Clinics
A cord blood transplant uses stem cells saved from a baby's umbilical cord and placenta. These young cells need a looser tissue match than an adult donor, and frozen units are ready quickly. The trade-off is fewer cells, so blood counts recover more slowly, and one unit may not be enough for a larger adult. This page explains the uses, the limits and how parents can donate cord blood. At CION Cancer Clinics, our haematology team assesses whether a transplant or CAR-T fits your situation and coordinates care with qualified centres.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- What is a cord blood transplant?
- How does cord blood compare with an adult donor?
- Should you donate or store your baby's cord blood?
- What happens when you donate cord blood at birth?
- What do parents often hear about cord blood that is not quite right?
- Who is cord blood less suited to, and what can this page not tell you?
- Common questions about cord blood transplants
The short answer
What is a cord blood transplant?
A cord blood transplant uses stem cells collected from the umbilical cord and placenta just after a baby is born. Those cells are frozen in a cord blood bank and can later rebuild the blood and immune system of a patient who has no suitable adult donor.
Why cord blood is useful
Cord blood cells are young and less likely to react against the patient's body. That means a cord blood unit does not need to match the patient as closely as an adult donor does. For patients whose tissue type is rare, or who come from communities that are under-represented on registries, this can open a door that would otherwise stay shut. Frozen units are also ready to use, with no donor to trace and check.
The main drawback
A single cord holds far fewer stem cells than an adult donation. Fewer cells mean the new blood counts take longer to recover, and the patient stays at risk of infection for longer. For a larger adult, one unit may not be enough, and some centres use two units together.
If you are an expectant parent, this page also explains how donating your baby's cord blood to a public bank works.Side by side
How does cord blood compare with an adult donor?
Cord blood
Adult donor
Can work with a looser match, often 4/6 to 6/6 on the markers checked
Usually needs a close match, such as 10/10 or 9/10, or a planned half match
Frozen and ready once a unit is found
Donor must be contacted, checked and scheduled
Fewer cells, so counts recover more slowly
More cells, so counts usually recover faster
Cannot go back for more cells from the same donor
Donor can sometimes give more cells later
Not sure whether this applies to you?
Ask an oncologistFor expectant parents
Should you donate or store your baby's cord blood?
You may be offered two very different things around the time of birth. They are easy to confuse.
Donating to a public bank
You give the cord blood free of charge. It is typed, tested and listed so any matching patient can use it. You do not keep rights to it, and it may be discarded if it holds too few cells to be useful.
What you usually agree to
- A consent form, often before labour
- A blood sample from the mother
- Questions about family health
Paying a private bank
You pay to store the cord blood for your own family. The chance that your own child will ever use it is very small. A child with a blood cancer usually cannot use their own cord blood, because it may carry the same fault.
Indian and international guidance has cautioned against marketing private storage for uses that are not proven.Directed family banking
If an older child already has a condition a transplant could treat, such as thalassaemia, doctors may advise saving a new baby's cord blood for that sibling. This is a medical decision made with the treating team.
The pathway
What happens when you donate cord blood at birth?
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Ask early in pregnancy
Only some hospitals work with a public bank. Ask your obstetrician in the later months whether your delivery hospital collects cord blood for donation.
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Consent and health questions
You sign a consent form and answer questions about your health, travel and family history. A blood sample is taken from you to check for infections.
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Your baby is born as normal
Delivery is not changed. After the cord is clamped and cut, the blood left in the cord and placenta is drained into a sterile bag. Nothing is taken from your baby.
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Testing and freezing
The bank counts the cells, types the tissue and tests for infection. Units with enough cells are frozen and listed. Others may be used for research or discarded, as your consent form explains.
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Commonly believed
What do parents often hear about cord blood that is not quite right?
"Storing cord blood protects my child from cancer."
Storage does not prevent any illness. And if your child developed a blood cancer, doctors would usually avoid using their own cord blood, because the same fault may already be present in it.
"Collecting cord blood takes blood away from my baby."
Collection happens after the cord is clamped and cut, from the part that would otherwise be thrown away. Your baby's care and the timing of cord clamping come first.
"Cord blood can treat almost any disease."
Its proven use is rebuilding blood and immune systems, mainly for blood cancers and some inherited blood and immune disorders. Claims about other conditions are largely unproven.
"Cord blood is always the preferred source because it matches easily."
Looser matching helps, but slower recovery of blood counts is a real trade-off. Many centres prefer an adult donor, full or half matched, when one is available.
Did you know
A cord blood unit is usually searched through the same networks as adult donors. When a transplant centre runs a search, it can see matching adult volunteers and banked cord blood units side by side.
Being straight with you
Who is cord blood less suited to, and what can this page not tell you?
Cord blood tends to suit children and smaller adults better, because the number of cells needed depends on body weight. For a larger adult, a single unit may hold too few cells, and a double-unit transplant or another donor type may be advised.
When the wait for counts matters
Because recovery is slower, cord blood may be less suitable for a patient who already has a serious infection or cannot safely spend longer with very low counts. The transplant team weighs this against the time it would take to find and prepare an adult donor.
What only the transplant centre can decide
This page cannot tell you which donor source is right for a particular patient. That depends on the illness, the patient's size and health, and the donors and units available. CION's haematology team does not perform transplants or bank cord blood. We review the case, discuss it at a tumour board and help families reach a qualified transplant centre, with questions to ask there.
Questions we are asked
Common questions about cord blood transplants
Is donating cord blood safe for me and my baby?
Collection is done after the baby is born and the cord is cut, so it does not touch your baby or change how you give birth. If anything unexpected happens during delivery, the team looks after you and your baby first, and the collection is simply skipped.
Can I donate cord blood after a caesarean delivery?
Often, yes. Many public banks collect after both vaginal and caesarean births. It depends on the hospital's arrangement with the bank and on what happens during the delivery. Ask the bank or your obstetrician before your due date.
Can my family get our donated cord blood back later?
Usually not. A publicly donated unit belongs to the bank and is listed for any matching patient. It may already have been used by someone else. If you want cord blood kept for a known family need, speak to your doctor about directed banking.
Does a cord blood transplant need a match at all?
Yes, but a looser one. Units are usually matched on fewer markers than adult donors, and more differences are accepted. The team also looks at how many cells the unit holds relative to the patient's weight, which matters as much as the match.
Why does recovery take longer with cord blood?
A cord holds far fewer stem cells than an adult donation, and those cells are less mature. They take longer to settle in the bone marrow and start making enough blood cells. During that time the patient needs extra protection from infection and may need more transfusions.
We are being offered private cord blood storage. Is it worth it?
For most families, the chance of ever using privately stored cord blood is very small. Ask the company exactly which conditions it has been used for, what happens if they close, and how renewal fees work. Talk to your paediatrician before signing.
Does cord blood carry a lower risk of graft-versus-host disease?
Graft-versus-host disease is when donor immune cells attack the patient's body. With cord blood it tends to be less severe than the degree of mismatch would suggest. It still happens, and the patient still takes medicines to calm the immune system after the transplant.
Who pays for a cord blood unit?
The patient's side pays a fee to obtain a unit through the transplant centre, which can be high, especially from banks abroad. Coverage under Aarogyasri, CGHS, ECHS, EHS, PM-JAY or insurance varies and rules change. Ask the centre for a written estimate first.
Your Haematologist
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Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- American Cancer Society — Stem cell transplant donors
- National Cancer Institute — Stem Cell Transplants in Cancer Treatment
- NHS — Stem cell and bone marrow transplants
- ICMR — Indian Council of Medical Research
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
HLA Matching Explained: What a 10/10 Match MeansHow adult donor matching is scoredHaploidentical Transplant: Using a Half-Matched DonorThe other option when no full match existsUnrelated Donor Registries in IndiaWhere adult volunteer donors are foundDonors, HLA Matching and Stem Cell CollectionEvery donor guide in one place
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Weighing up donor options for your family?
Tell us what the transplant team has said so far. Our haematology team will explain the options and help you reach a qualified centre. One helpline serves every CION centre.