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    Banking on Umbilical Cord Blood

    Big Hope for Cord Blood

    Better Safe Than Sorry? continued...

    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 it's needed.

    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 patient identifiers.

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