August 8, 2008
Cord Blood Banking Issues and Dilemmas
Thousands of mothers are spending hard earned dollars to store umbilical cord blood they hope their kids will never use.
These women believe in the life-saving potential of stem cells found in umbilical cord blood - cells that prized for their ability to become any other cells in the body.
Stored cord blood is saving the lives of kids within their own families and, via donations, the lives of strangers. A donation of cord blood can knock lethal leukemia into remission.
People, whose families have a history of cancer can set aside their children’s cord blood for its future disease-fighting potential. Others will receive life saving stem cells from a public cord-blood bank, transplanted into their bodies.
Clinicians use stem cells from cord blood to treat up to 70 illnesses - from leukemia to lymphoma - and the cells have the potential to treat other conditions such as Alzheimer’s and diabetes.
Lured by the possibilities of stem-cell research, families are paying private companies to collect, freeze and store their babies’ cord blood.
It’s a type of “biological life insurance,” it may never be used, but it’s worth every penny of the collection and storage costs to those who need to use it.
Over 120,000 people have banked cord blood, but the question of whether it’s a good idea or not is still the subject of much debate. In the mean time private facilities are growing but governmental indecision and a consequent lack of funds has limited efforts to build a national system that could simplify the storage process for both public donors and recipients.
Cord-blood stem cells are often confused with the stem cells taken from human embryos. Embryonic stem cells have the ability to become any of more than 200 different cells in the human body. Because the use of this type of stem cell involves embryos research using them has been limited by the Bush administration.
Cord-blood stem cells are different, they have a limited capacity to become other cells, but they can be used to great effect in many transplant operations.
Despite the great potential of cord blood cells, and that collecting cord blood is a simple procedure, some 95% of the umbilical cords from American births are discarded every year, so says research from the National Marrow Donor Program, a nonprofit registry for bone marrow and cord-blood patients and donors.
Blood from only 1 or 2% of umbilical cords is stored in private banks. Approximately 77,000 units of cord blood are distributed among the country’s 18 public banks.
Critics of private cord blood banking say that behind the push to bank cord blood privately are companies that prey upon the fears of new parents. Advertisements for private blood banking services regularly appear in doctors’ offices and glossy parenting magazines.
Critics suggest that private banking is very costly and helps only affluent families. Also, private cord blood banking detracts from efforts to create a national network of free cord blood banks.
Supporters say that private cord blood banks fill a need.
“All insurance is based on fear or risk aversion, but it’s really about your desire to protect the things you love the most from the things you cannot control,” says Steve Grant, V.P of communications for Cord Blood Registry, a large California-based private cord blood banking facility.
Many doctors believe that only families with histories of severe disease or inherited disorders such as leukemia should privately bank blood.They point out that the oddes of an individual within a family needing cord blood therapy is very small.
Curt Civin, professor of oncology and pediatrics at Johns Hopkins University School of Medicine’s Sidney Kimmel Comprehensive Cancer Center reports that the chances that the average baby will ever need to use its banked blood are about one in 2,500.
Joseph Wiley, chair of the department of pediatrics a Baltimore’s Sinai hospital, suggests strongly that blood banking is not necessary “If a family is collecting it as biological life insurance, the data suggests strongly that it is not needed.”
It is, according to many doctors, more effective to donate cord blood to a public bank. To date, no national registry for cord blood exists, cost is one of the reasons.
Estimates suggest that it takes about $2 million to build a new public bank. Some public facilities, strapped even for operating funds, have even turned away cord-blood donors because it is too expensive for them to accept new donations.
When a new mother decides to bank or donate her child’s umbilical cord blood she first must choose a bank, then she completes the facility’s consent form and health history. The cord blood is collected within minutes of the birth.
The collection process is simple and takes around 10 minutes. After the baby is born, the umbilical cord is clamped. Doctors use a syringe to extract the blood from the umbilical cord and placenta. Three to five ounces of blood are drawn and stored in vials or plastic bags. Sometimes, the amount collected is too small to be viable for storage, in such cases, the mother may give consent to using the blood for research.



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