As described above, the collection, processing, and banking of CB for immediate or future clinical use can be reproducibly performed with the proper methodology. It is important that all procedures used in the banking endeavor pass regulatory scrutiny. Regulatory compliance may increase operational costs but is essential in providing the assurance to clients and the treating physician that the cord blood unit is collected, processed, and cryopreserved under proper conditions, ensuring that the quality of the CB unit will be unchanged during long-term storage.

CB is being used with increasing frequency in hematopoietic stem cell transplants [64] facilitated in part by the establishment of large repositories of CB collected and cryopreserved for future use. CB donation to public banks has been integral to the over 30,000 estimated worldwide unrelated allogeneic cord blood transplants [9] while private (family) banks provide storage of cord blood for related allogeneic autologous use. Efforts are being made to extend the use of CB in HSC transplants including double cord blood transplants and expansion technologies which aim to overcome cell dose limitations in adult recipients [9].

Although many individuals over the past 20 years have elected to collect and bank cord blood for its potential use in the treatment of hematopoietic cancers and genetic blood and immune disorders, more and more, individuals are now taking advantage of the ability to bank cord blood for uses that are only now being realized or have yet to be discovered. Primarily, these stem cell applications are in tissue engineering and regenerative medicine. Regenerative medicine has the potential to treat many of the most common diseases by replacing or repairing malfunctioning tissues and organs. Because regenerative medicine focuses on functional restoration of damaged tissues, not just the abatement or moderation of symptoms, this field has the potential to cut healthcare costs significantly. However, in order for the promise of regenerative medicine to be realized, it is necessary to identify optimal stem cell sources for particular disease states, and make efforts to inform the lay and medical communities as to their options.

Already the therapeutic potential of CB stem cells to treat patients with neurologic and orthopedic issues, autoimmune diseases, and those suffering from the side effects of transplantation is being evaluated in clinical trials (Personal Communication from CBR and [65, 66]; see Table 24.1). Other trials will surely rapidly follow, including therapies for the eye, joints, and wound healing. In the next decade there will likely be additional uses that are not yet anticipated. The key to these advances is thought to lie in the paracrine effects of CB stem cells, and their ability to be used in many cases under the practice of medicine, since it appears in many instances that it is possible to merely infuse the stem cells directly without timely and costly in vitro culture and differentiation. That is why, in my opinion, CB stem cells are likely to become the preferred source of stem cells for many regenerative medicine applications, now and in the future.