Is cord blood worth saving for public or private banking?

which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Cord blood (CB) contains hematopoietic stem cells that can both reproduce themselves and turn into mature blood cells. Everyone agrees that CB cells can be lifesaving in patients with various malignant or non-malignant hema-tologic diseases, immune deficiencies and genetic diseases. Besides being a source of cells for hematopoietic stem cell transplantation (HSCT), CBs have been much used as a source of stem cells for research and for developing cell therapies [1, 2]. As a result CB that was once discarded after delivery is now often stored, and more than 30,000 patients worldwide have received banked CB for HSCT. Public CB banks were established in the 1990s, and over 600,000 units of CB are now stored in them; in addition private profit-driven CB banks have stored CB worldwide [3]. Although these various CB banking projects have saved the lives of many patients with refractory diseases, the use of banked CBs has become controversial, particularly in the case of private CB banks. Although over 30% of banked CBs have been used for HSCT in Japan, in most other countries only 3-4% of banked public CBs have been utilized, and the figure in Korea is 1.3% to the end of 2013. While recognizing the need to increase the rate of use of public CBs, most people agree with banking donated CBs. In Korea, several steps have been taken to increase the use of banked public CBs. First, an inspection system for quality control of CBs and CB banks has been established under the "Cord Blood Management and Research " Act, and entrusted to volunteers and transplant physicians. Second, governmental insurance coverage to reduce the cost of CB products promises to decrease the financial burden of patients from 4,000-6,000USD to 100-200USD. Third, a clinical guidebook is to be introduced shortly to help transplant physicians access CB transplan-tation. We anticipate that these efforts will encourage donation as well as the use of CB. So far, most CBs stored in public and private CB banks have been used for HSCT. However, from the private CB banks' point of view, there are too few documented cases of children receiving their own banked CB for HSCT, because physicians are reluctant to use autologous CB. The reasons are the following; 1) The graft-versus-leukemia effect in which the donor's immune system acts …