Cord blood bank

From Freepedia

Both private and public cord blood banks have developed since in the mid- to late 1990s in response to the success of umbilical cord blood transplants in treating diseases of the blood and immune systems, such as Fanconi's anemia and Leukemia. Cord blood, once seen as waste to be discarded after a birth, is now viewed as a precious resource. Since the first successful cord blood transplant was performed on a child with Fanconi’s anemia in 1988, more than 2000 patients have been treated with this procedure. Cord blood contains hematopoietic stem cells, progenitor cells that can form red blood cells, white blood cells and platelets and can be used to treat many diseases of the blood and immune systems.

Public banks, established by medical centers, accept donations for use by anyone in need. Once the blood is donated, it loses all identifying information after a short period of initial testing, so that families will not be able to retrieve their blood later. Private banking allows families to preserve their blood for their own use. For-profit private banks charge a fee of around $2000 to preserve a newborn’s cord blood for possible use by the family later.

Contents

The collection process

Whether a mother chooses to donate cord blood or store it for private use, the initial collection process is the same and poses no danger to mother or baby. The placenta is delivered and then placed in a sterile supporting structure with the umbilical cord hanging through the support. The cord blood is collected by gravity drainage yielding an average of 99 mL and is then cryopreserved. Before the blood is stored for later use, it undergoes viral testing, including tests for HIV and Hepatitis B and C and tissue typing (to determine HLA type).

Liklihood of use

"According to research in the Journal of Pediatric Hematology/Oncology (1997, 19:3, 183-187), the odds that a child will need to use his or her own stem cells by age twenty-one for current treatments are about 1:2,700, and the odds that a family member would need to use those cells are about 1:1,400." source

Benefits

Cord blood is currently used to treat approximately 75 genetic diseases, cancers, and blood disorders. For a list, see cord blood.

Problems

Public bank problems

Cord blood Banking is still in its developmental stages and there are issues in both private and public banking that need to be resolved before it will become a widely established practice. The main concern of cord blood banking, private or public, is that the long-term viability of cryogenically frozen cord blood has yet to be firmly established. The primary concern with public banking is how to ensure the safety of the cord blood. Because of privacy concerns, it is agreed by most ethical review boards that blood donated to a public bank cannot be permanently linked to the donor. Although cord blood that is donated goes through a series of tests for potentially harmful genetic disorders and viruses, some genetic disorders such as congenital anemias or immunodeficiencies might not become apparent in the donor for months or years, by which time all identifying information has long been removed. Because the recipient of the blood could also develop these disorders, this is an important concern. The larger obstacle facing public banks is that the costs required to maintain them has prevented more than a handful from opening. Because public banks do not charge storage fees, many medical centers do not have the funds required to establish and maintain them.

Private bank problems

Private cord blood banking also poses problems. Children who develop an immunological disorder often are unable to use their own cord blood for transplant because the blood also contains the same genetic defect. The cost of private banking also prevents it from being an option available to all families. Private cord blood banks have often been criticized for preying upon the insecurity of new parents, on the grounds that currently the chances of a child needing his or her own cord blood are exceedingly small, whereas storage fees at private banks are typically very high. Accordingly, for all but the wealthiest parents, it would be wiser to save the money against unforseen healthcare costs than to spend it on expensive private cord blood storage fees.

Concerns about premature clamping

Concerns have been raised that the current interest in cord blood can raise the amount of blood that is seen as 'unused' by the birth process, thus decreasing the amount of blood that is infused into the child as part of the birth process. The pulsation of the cord pushes blood into the child, and the ideal situation is for the cord to cease pulsation prior to clamping the cord. With the demand for cord blood increasing, the possibility that the cord could be clamped prematurely to preserve even more 'extra' cord blood is a strong outcome. This action could have detrimental affects on the child's future development. See the websites: www.cordclamping.com [1] and www.gentlebirth.org [2].

Sources

  • Cairo, Mitchell S. and John E. Wagner, "Placental and/or Umbilical Cord Blood: An Alternative Source of Hematopoietic Stem Cells for Transplantation," The Journal of The American Society of Hematology 90:4665-4678 (1997)
  • Kline, Ronald M., "Whose Blood is it, Anyway?", Scientific American 284: 42-49 (April 2001)
  • Kline, Ronald M., and Salvatore Bertolone, "Umbilical Cord Blood Transplantation: Providing a Donor for Everyone Needing a Bone Marrow Transplant?", Southern Medical Journal 91: 821-827 (1999)

See also

External links

General

Public cord blood banks

Private cord blood banks

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