Banking on Umbilical Cord Blood
Big Hope for Cord Blood
Better Safe Than Sorry?
Harris, who has banked cord blood for his own children, says
that on the basis of current capabilities, the chances of a person needing stem
cells is in the range of 1 in 2,000.
Yet that is surely on the low end of estimates. In 1999, the
American Academy of Pediatrics (AAP) released a statement recommending private
banking of cord blood only when there is a family member with a current or
potential need to undergo a stem cell transplant.
"The range of estimates [for likelihood of using stored
stem cells] is from 1 in 1,000 to 1 in 200,000," according to the AAP
statement. "Given the difficulty in estimating the need for using one's own
cord blood cells for transplantation, private storage of cord blood as
biological insurance is unwise."
The AAP does recommend philanthropic donation of cord blood to
Yet as Harris points out, private companies will store cord
blood shipped from anywhere in the world, but public banking is accessible only
at hospitals and centers that provide the service.
Lilja says he never considered the option of using public banks
-- because he was unaware they existed.
While private banking companies have sprung up around the
country -- with a number going out of business in recent years -- public banks
have been slower to develop. There are currently just eight public cord blood
banks in the National Marrow Donor Program (NMDP) registry.
The NMDP web site lists some 17 centers around the country that
also accept cord blood donations but which are not members of the registry.
People who donate cord blood can, theoretically, retrieve their
own donation should they need it before the units have already been used for
transplantation, points out Vicki Slone, PhD, manager of the cord blood bank at
Children's Hospital of Orange County, Calif. And because donation is free, it
is liable to be a more accessible option for poorer families and those from
diverse ethnic backgrounds -- thereby increasing the pool of transplantable
stem cells for those groups, Slone says.
Questions of Ethics -- and Law
Although it's never been firmly established in a courtroom,
most legal experts consider cord blood to be the property of the baby -- and
the parents are guardians of this potentially lifesaving material. Upon
deciding to bank cord blood privately, some parents have drawn up legal
documents in which they designate that upon reaching age 18, the child can take
over guardianship of the cells.
Legal issues also arise with respect to the collection process.
In contracts with parents, private blood banks usually try to absolve
themselves from any responsibility if, for instance, the cord blood isn't
collected during the baby's delivery, or if the blood sample isn't usable when
There is also the question of who has access to the cord
blood's hidden information -- the diseases and genetic traits shared by both
infant and parents. Parents should find out what the bank's policy is in regard
to screening cord blood and ask whether all identifiers are stripped from the
blood samples in order to protect the donor's privacy. Many physicians will
advise their patients against donating cord blood to a blood bank that retains