Inm-9: Global Approach toward Banking Cord Blood Stem Cells

Umbilical cord blood is the baby's blood left over in the umbilical cord and placenta after a baby is delivered and the cord is cut. Cord blood has all of the features of regular blood, but it is also a rich source of hematopoietic stem cells. Hematopoietic stem cells are unspecialized cells that produce all blood cells. These include: • Platelets, which are needed for blood clotting • Red blood cells, which transport oxygen to the cells • White blood cells, which help fight diseases These stem cells are similar to those found in bone marrow. In addition, cord blood is immunologically tolerant and can be transplanted without full HLA matching, increasing access to transplantation for patients lacking matched adult donors. The full potential of cord blood is currently unknown. Cord blood contains rare stem and progenitor cells for tissues that are different from the blood. Researchers are investigating the possibility that cord blood cells could be used to repair damaged tissues including those in the heart, brain and pancreas. In recent years, umbilical cord blood, which contains a rich source of hematopoietic stem and progenitor cells, has been used successfully as an alternative allogeneic donor source to treat a variety of pediatric, genetic, hematologic, immunologic, and oncologic disorders. Because there is diminished risk of graft-versus-host disease after transplantation of cord stem cells using matched related donors, the use of less-than-completely matched HLA cord blood stem cells may incur less risk of graft-versus-host disease than mismatched cells from either a related or unrelated “walking” donor, although this remains to be proven. Gene-therapy research involving modification of autologous cord blood stem cells for the treatment of childhood genetic disorders, although experimental at the present time, may prove to be of value. These scientific advances have resulted in the establishment of not-for-profit and for-profit cord blood-banking programs for allogenic and autologous cord blood transplantation.Many issues confront institutions that wish to establish or participate in such programs. Parents often seek information from their physicians about this new biotechnology option. This document is intended to provide information to guide physicians in responding to parents’ questions about cord blood donation, banking, the types as well as quality of cord blood banks. Provided also are recommendations about appropriate ethical and operational standards, including informed consent policies, financial disclosures, and conflict-of-interest policies for physicians, institutions, and organizations that operate or have a relationship with cord blood-banking programs Today, expectant parents may choose to have the blood remaining in their baby’s umbilical cord and placenta (cord blood) collected and stored with either a Public Cord Blood Bank or a Private Cord Blood Bank, to donate it for research, or simply have it discarded as medical waste. there are hundreds of cord blood banks, serving both the public and family clients, around the world. Since the first cord blood transplant 25 years ago, more than 30,000 have been performed worldwide. The biggest cord blood banks have hundreds of thousands of units in inventory, and many banks rely on automated equipment to facilitate stem cell separation and storage. The FACT-NetCord accreditation is end-to-end, covering every aspect of cord blood handling from the moment of collection at birth, through the laboratory where the cord blood is processed to store stem cells, and to end with patient care at hospitals where the cord blood is used for therapy. FACT is the Foundation for the Accreditation of Cellular Therapy, formed by medical doctors who perform stem cell transplants. Since 2004 they have partnered with the International NetCord Foundation, a consortium of the world's leading public cord blood banks.