By Anthony Oliva, PhD
Updated September 2, 2026
Families researching stem cell banking find two different categories of service. The better known is traditional cord blood banking, and it helps to know what stem cell banking involves before comparing the two.
The second isolates the stem cells, expands them to a documented count, and defines how they are retrieved.
The difference is not how the sample is stored. It is whether the cells can be used when they are needed.
Dr. Khoshal, who works in regenerative medicine, describes what he finds when families attempt to use material they stored years before. In traditional models, banks “take the umbilical cord tissue and they freeze it”, without anyone knowing “how many cells there are” and without “culture expansion” these cells may not be available in the future.
The difference shows up at three specific stages of the banking process.
What does stem cell expansion actually provide?
Storing tissue is not the same as having cells ready for use. A service that freezes umbilical cord tissue preserves the material. This does not store samples optimally, and it does not establish that the cells inside will be usable later.
Stem cell expansion is the process of isolating the stem cells from tissue and naturally multiplying them under controlled culture conditions to a documented and verifiable number.
A frozen sample alone answers none of the following. What is the exact count of viable stem cells stored there? Will those cells remain alive after years of freezing? And when you need them, how difficult will retrieval actually be? Those three questions map to count, viability and access, and each one depends on the others.
Count: the gap between raw tissue and research
Stem cell expansion differs significantly from freezing the entire tissue and leaving expansion as a future possibility. In that second model, the tissue is preserved whole and the stem cells inside are never isolated. Cord blood is typically tested for cell count and viability at processing, and those results appear on the storage certificate. Cord tissue frozen whole produces no equivalent figure, because the Mesenchymal Stem Cells (MSCs) have not been separated from the tissue and cannot be counted until they are.
For Dr. Khoshal, the differentiator lies in the ability to “isolate what you are actually after, not just the entire tissue, but the stem cells”, focusing on “the component that you actually need, not just tissue en masse”. Then replicate those cells “to really high numbers”.
A review of 914 clinical trials with mesenchymal stem cells (MSCs) found a median intravenous dose of 100 million cells per patient per dose, with substantial variation across studies (Kabat et al., 2020). How many of those cells a family ends up with depends less on the tissue than on when the cells are isolated from it. In one comparison, isolating the MSCs from fresh cord tissue and then freezing them recovered on average 8.4 times more viable cells than freezing the tissue whole and isolating afterwards (Briddell et al., 2011).
That difference matters, because expansion done during banking is what turns an unknown sample into a documented one. When you isolate cells at the moment of collection and multiply them to higher numbers, you convert an unknown sample into a documented, verifiable asset. That number becomes something you can actually use.
Viability: verification at both endpoints
Count without viability offers incomplete information. A sample may contain millions of cells and still disappoint if those cells are not alive when you need them. The reverse is just as true: viability is a percentage, not a quantity. A result of 100% viability on one million cells is still one million cells. The two figures only mean something together.
Proper cryopreservation maintains cells alive through freezing in liquid nitrogen, which reduces all metabolic activity and preserves the state of cells over extended periods. The question that is rarely asked: when is viability verified? How long stem cells can be stored depends on whether the bank checks them at both points.
Assessing cells only at the entry point, when they arrive at the laboratory, offers information that something is alive at the beginning. Checking viability again at the exit point, when cells would be used, answers what actually matters.
Dr. Khoshal describes this dual approach: cells must maintain viability “not just on the front end when the tissue is first sent in, but on the back end when those cells are deployed back into the body”.
Access: what makes the difference
Access is the stage banks disclose least. When you attempt to recover stored cells, this is where promises encounter operational reality.
Dr. Khoshal reports that, in his own practice, when attempting to recover samples stored in traditional banks he frequently finds that access is possible only for “a very select few diagnoses that happen to be very uncommon”. This limitation is not incidental, it is systemic.
His advice to parents is straightforward: make “that phone call and see how easy it is to retrieve that placental tissue that you may have banked”. The experience, he says, reveals that it is “very, very challenging”.
The reason becomes clear when you examine the underlying science. A child’s own cord blood cannot be used against a genetic disease or a malignancy in that same child. For example, if that child later developed leukemia, their own banked cord blood would not be utilized and the child would have to use a donor sample. The HSCs naturally present in cord blood are also small in number and are a one-time use. This is why the cord tissue, and what happens to the cord blood or tissue during processing, is where the long-term value sits.
When count is documented and viability has been verified at both endpoints, retrieval becomes a defined operational process rather than an open question.
Why timing at birth matters
There is a biological foundation for banking at birth. The stem cells from a newborn’s cord tissue proliferate faster than those from adult sources. Colony-forming efficiency is roughly 800 colonies per million nucleated cells, against 36 for bone marrow, and doubling times run between 21 and 45 hours (Arutyunyan et al., 2016).
They start from a biologically younger baseline for the expansion described above. Dr. Khoshal notes that there are distinct advantages: the cells are “much younger” and “much more active” at that moment.
Birth represents a unique biological window. The day 1 cells can only be collected at that specific point, one time, because this opportunity does not repeat. Parents also have a narrower window of time to decide on banking and to perform cell extraction. Collecting at birth also means the sample is available from the first months of life onward. A collection made later would in practice wait until adulthood, because obtaining cells from a child would involve a procedure under general anesthesia.
Younger cells and a collection window that does not repeat are the reason banking is done at birth rather than later.
Choosing a bank: what separates storage from real access
If count, viability, and real access determine true value, the choice of bank becomes a decision about process.
Dr. Khoshal summarizes: work with a bank that has done this “hundreds, if not thousands of times” and that has a documented process for “how those cells are stored, how those cells are replicated, how they are preserved during transport back to the clinic”.
In practice, five questions separate storage from actual use. Is the cell count documented? Is viability verified at entry and at exit? Does stem cell expansion occur during banking or remain a future possibility? Is the laboratory registered with the FDA and operating under cGTP? How does access to cells function operationally when needed?
These five answers tell you more than a price list does, because they define what the price is buying.
If you are ready to explore what makes sense for your family, review our newborn banking plans or contact us to discuss your situation.
Choose a stem cell bank that expands and documents the cells
Count, viability and access are what separate a stored sample from usable cells. If you already know what you are looking for, you can enroll in newborn stem cell banking directly, no call required.
Want the numbers for your own situation first? Contact us and we can walk through count, viability, and access, or call or text a stem cell educator at (469) 809-5806.
Frequently asked questions
Is cord tissue banking worth it?
It depends on what is being purchased. If the service simply freezes the tissue, you have a sample whose future utility remains uncertain. If the service isolates, expands to a documented number, verifies viability at both points, and maintains real access, you have a documented, verified sample.
How long can stem cells be preserved?
When properly maintained in cryopreservation at extremely low temperatures, cells can be preserved for many years without a fixed “expiration date” while the cold chain remains intact. What varies between banks is whether viability is verified also at the access point.
Do frozen stem cells maintain viability?
Yes, provided cryopreservation is performed and maintained appropriately. The critical point is verification. A bank that documents viability at entry and exit gives you more information than one that freezes and does not check again.
What should I ask a bank about retrieving the cells later?
Ask who is allowed to request the cells, what documentation is required, how long retrieval takes, how the cells are shipped, and whether viability and live cell count are confirmed again before release. A bank that can answer those five questions concretely has a retrieval process. One that cannot may only offer storage.
References
Kabat M, Bobkov I, Kumar S, Grumet M. Trends in mesenchymal stem cell clinical trials 2004–2018: is efficacy optimal in a narrow dose range? Stem Cells Transl Med. 2020;9(1):17–27. doi:10.1002/sctm.19-0202
American College of Obstetricians and Gynecologists. Umbilical cord blood banking. Committee Opinion No. 771. Obstet Gynecol. 2019;133(3):e249–e253.
Shearer WT, et al. Cord blood banking for potential future transplantation. American Academy of Pediatrics Policy Statement. Pediatrics. 2017;140(5):e20172695.
Briddell R, Litkenhaus F, Foertsch G, et al. Recovery of viable MSCs isolated from fresh umbilical cord tissue, measured after cryopreservation, is on average 8-fold higher when compared to recovery of viable MSCs isolated from previously cryopreserved umbilical cord tissue. Blood. 2011;118(21):4398. doi:10.1182/blood.V118.21.4398.4398
Arutyunyan I, Elchaninov A, Makarov A, Fatkhudinov T. Umbilical cord as prospective source for mesenchymal stem cell-based therapy. Stem Cells Int. 2016;2016:6901286. doi:10.1155/2016/6901286
This blog is for educational purposes only and does not constitute medical advice. It does not make any express or implied claims about the effectiveness, safety, or suitability of any procedure or therapy mentioned. VitalCells does not provide medical treatment. All procedures are performed by licensed, independent physicians. Always consult your own physician before making any health-related decision.