Cord blood banking is when cord blood is collected and stored for treating a disease
or illness.-Types of cord blood bank:
-Public banks:
If you give birth in one of three hospitals in the south east of England, you can donate
cord blood to a public bank, such as the NHS cord blood bank. There is also a small
NHS public bank in Belfast in Northern Ireland (See section Is there anything else I
should know?). Donation is voluntary and collection and storage are free of charge. A
public bank stores cord blood for use by anyone anywhere in the world, thus ensuring
fair access for all patients requiring stem cell transplantation. It is an alternative to a
volunteer bone marrow donor registry.
The RCOG supports public banking and donation to the NHS cord blood bank.
If there is a known genetic condition in your family or you already have a child with
leukaemia or blood-related disorder, your clinician may recommend that you consider
banking your baby’s cord blood. Your clinician may be able to arrange for cord blood to
be collected and stored in the NHS cord blood bank for future use by your family. You
should also discuss this with the doctor looking after the person in your family who is ill.
-Private (commercial) banks:
People can store cord blood with a private bank in the hope that, in the future, cord
stem cells may be useful, should a member of their own family develop a disease
treatable by stem cell therapy.
The chances of your child ever needing to use his or her own cord blood are extremely
small, so there is no guarantee that the cord blood will ever be needed. Nevertheless,
you may feel this is worthwhile, like an insurance policy.
There is a fee for collection and long-term storage of up to £1,500. Depending on
circumstances, some private banks may store cord blood free of charge for certain
families where there is a known genetic condition.
If you have not banked with a private bank and your child develops a blood-related
disorder, immune system disorder or metabolic storage disorder in the future, then
you still have other options. These are:
- ● Cord blood from a public bank in the UK or internationally.
- ● Use of other sources of therapy such as bone marrow transplants. There is a worldwide collaboration with international bone marrow registries to find suitable matches for patients who require a bone marrow transplant.
- ● Treatment from a sibling who matches a family member who can give bone marrow.
to you at your antenatal booking appointment. This information may not be given
routinely, so you may need to ask if you would like to find out more.
The RCOG remains unconvinced about the benefit of storing cord blood with a private bank for families who have no known medical reason to do so.
-How is cord blood collected safely?
-The cord blood must be collected safely. It is important that:
- ● A trained technician who is not involved in your or your baby’s care collects the cord blood. It is important that neither your obstetrician nor your midwife should be distracted from looking after you and your baby during and immediately after childbirth.
- ● There should be no alteration in your ‘usual management’ of labour, such as the delivery of the placenta or clamping of the cord. Some evidence indicates that immediate cord clamping may be harmful to babies. However, delaying cord clamping can prevent a successful cord blood collection.
- ● Cord blood should be collected after the placenta has been delivered in a clean environment using methods and facilities, which meet the required regulations including the EU Tissue and Cells Directive.
-Cord blood collection may not be advisable or possible if:
- ● The baby is premature.
- ● You have a multiple pregnancy.
- ● The cord around the neck needs to be cut early to deliver the baby.
- ● You are delivered by emergency caesarian section.
- ● You are being prescribed certain medication.
- ● You or the father of the baby have tested positive for a transmissible infection(s).
-Making an informed decision:
If you are considering private banking you should discuss this with your doctor or
midwife. You may wish to consider the following points:
- ● Not all hospitals allow collection by private banks. You should ask about the private banking policy at your hospital during your antenatal booking appointment. Once you have made a decision about banking, you should let your doctor or midwife know.
- ● You may find that your midwife or obstetrician has been advised by their the professional organisation not to collect blood for a private bank.
- ● There are a number of uncertainties surrounding cord blood storage. For instance, who owns the cord blood legally? What are your rights if the facility storing the cord blood breaks down and the cord blood becomes unusable?
- ● Private banks are run by private companies. If you decide to bank through a private company, you will enter into a contract between yourself and the company. It is your responsibility to check that you are happy with all the terms and conditions of the contract. Some private companies make additional charges to screen for bacterial diseases.
- ● Since April 2006, all UK cord blood banks come under the EU Directive on tissue Cells 2004/23/EC and are required to be licensed by the Human Tissue authority (HTA). Cord blood should be collected and banked in accordance with this. If you choose to use a private bank, it is your responsibility to check that the private bank is approved and follows correct procedures.
-Some questions to ask are as follows:
- ● Is the bank accredited/licensed for storage of cord blood?
- ● If it is a UK bank, has it been licensed by the Human Tissue Authority (HTA)?
- ● Does the bank follow proper collection procedures?
- ● What happens if no stem cells are collected?
- ● Does the bank follow best practice testing regimens?
- ● Does the bank follow best practice sample storage?
- ● Where is the cord blood stored?
- ● Is the transportation to the storage facility checked to ensure the blood is kept appropriately?
- ● When is the stored cord blood no longer useful?
- ● What happens to the cord blood when it is no longer needed?
- ● Who is responsible for screening the blood to ensure that HIV/hepatitis positive cord blood is stored separately?
- ● Could my child or any of my children use the cord blood, if I am not around?
- ● What will happen to my cord blood, if the bank is no longer functioning in the future?
-Useful additional information:
A Parent’s Guide to Cord Blood Banks:
"www.cordbloodbank.com"
The Society of Obstetrician and Gynaecologists of Canada patient information leaflet:
"www.sogc.org/health/pdf/cord-bloodfinal_e.pdf"
The Anthony Nolan Trust is a charity that recruits and registers bone marrow donors:
"www.anthonynolan.org.uk"
-Is there anything else I should know?
- ● The commercial company advertising itself as the UK Cord Blood Bank is not the same as the NHS Cord Blood Bank.
- ● The hospitals that routinely collect cord blood for storage in a public bank are Northwick Park Hospital in Middlesex, Barnet Hospital in Hertfordshire, the Luton and Dunstable Hospital NHS Trust in Luton and the Mater Hospital Trust in Belfast.
Just like we didn't envision the powers of PCs thirty years ago, we may not be seeing all the uses of cord blood yet.
Dr. LeeAnn Jensen
No comments:
Post a Comment