|  |  |  | | | | Diseases | |  | Cord Blood Harvesting and Storage |
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| | Umbilical cord blood contains quite high numbers of stem cells from the baby. There is currently interest in the use of these for transplantation. As the immune cells have not been exposed to the outside world it is hoped that the risk of rejection and of a complication called Graft versus Host Disease will be much less. Careful studies have demonstrated that there is no risk to the new-born infant from having the cord blood collected.
Harvesting of cord blood stem cells does not harm the baby and potentially provides a great benefit from a resource which is otherwise wasted. For these reasons it is hoped to establish banks of frozen cord blood donations. This would be a major contribution to solving the problems of finding matched stem cells for patients.
It is not recommended by most experts in the field that families consider banking cord blood for future use by the donor - sometimes called directed banking. Facilities to do so are offered by several commercial organizations - an example is the UK Cord Blood Bank. They offer the following rationale:
"...Saving umbilical cord blood stem cells is one way of guaranteeing that you have an exact cell match for your baby -- it may also provide a match for other close family members. Any sibling or family member who is a close match to the donor has the opportunity to use banked cord blood stem cells as treatment against disease".
The major arguments against this approach relate to the extremely small chance of a child developing a condition which might require a stem cell transplant, the important consideration that in the most common indications for such treatment there are sound reasons why a child would be ill-advised to receive their own cord blood, and the fact that a sibling has only a one-in-four chance of being a match, with other family members having an even smaller probability. There are several centres in Britain which are currently collecting donated cord bloods. Any mother who is having a baby in one of the centres where cord bloods are being collected will be approached to ask for permission to harvest the cord. It is not possible for mothers to offer their cords if they live in other regions as the cord blood smust be procesed very promptly after delivery and this must be done by a specialist technician. It is not possible to simply save the placenta and cord and have the stem cells recovered at a later date.
 | Comment from Leukaemia Research on commercial storage |
The Leukaemia Research Fund does not advocate commercial storage of cord blood in the anticipation of future use of stem cells either for future therapy of the donor child or in anticipation of use for another family member. This advice is based on the probability of use of such stored cord blood cells and on sound biological reasons why use of a child's own stem cells may be less than ideal. The sole exception to this advice is when an existing child in the family has a disease which may require a transplant as part of treatment. In this case, it is usually possible to arrange for collection within the NHS system.
| NHS cord blood banks centres currently collecting donor cord bloods in UK |
Although antenatal patients may offer to donate for unrelated transplantation, the option of altruistic cord blood banking for the National Blood Service banks is, for logistic reasons, currently undertaken only at the following hospitals: Northwick Park Hospital in Harrow, Barnet General Hospital, The Luton and Dunstable Hospital, and the Mater Infirmorum Hospital in Belfast.
Northwick Park Hospital
Watford Road, Harrow HA1 3UJ
Barnet General Hospital
Wellhouse Lane, Barnet EN5 3DJ
The Luton and Dunstable Hospital
Lewsley Road, Luton LU4 0DZ
Mater Infirmorum Hospital
47 - 51 Crumlin Road, Belfast BT14 6AB
The National Blood Service has a section of its website devoted to this topic. Although intended for healthcare professionals, access to this section is not restricted.
| Royal College of Obstetricians and Gynaecologists |
Cord Blood Report
Low chance of use
"One bank in the USA has to date issued only two units out of 10 000 stored, although this figure may rise with time. "
"Its utility is less clear now that improvements in chemotherapy mean that transplantation in childhood leukaemia is used less frequently...."
Own stem cells not always best
"....beneficial graft versus leukaemia effects are achieved by use of haploidentical peripheral blood T cell-depleted stem cells."
[graft versus leukaemia is a beneficial result of donor immune cells attacking and destroying residual leukaemia cells - it is not seen when a patient receives his/her own stored cells.]
| Web links to articles discussing this topic |
Whose Cord Blood is it Anyway?
By Jeffrey P. Kahn, Ph.D., M.P.H., Director, Center for Bioethics, University of Minnesota
A discussion of the eithical considerations between "personal" and "community" banking
Cord blood: Preserving a lifeline
Tuesday, May 19, 1998 By Mary Niederberger
A feature article from the Pittsburgh Post Gazette newspaper
Parents warned over baby blood banking
Sunday, 18 November, 2001 - BBC News web site
A report linked to the launch of the Royal College of Obstetricians and Gynaecologists report
Umbilical cord blood
March of Dimes web site
Fact sheet prepared by the March of Dimes - a US charity dedicated to improving the health of babies and children
AAP ENCOURAGES PUBLIC CORD BLOOD BANKING
American Academy of Pediatrics
"The American Academy of Pediatrics (AAP) encourages families to donate their newborn’s cord blood, which is normally discarded at birth, to cord blood banks (if accessible in their area) for use by other individuals in need. Storing cord blood at private banks for later personal or family use as a general “insurance policy” is discouraged."
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