Cord Blood Donation for Research
The blood and tissue from a baby’s umbilical cord is a rich source of stem cells which could be used for a number of potential stem cell treatments. There are a plethora of research trials which have already investigated the use of cord blood stem cells for treatment of a variety of disorders such as anaemia, blood cancers, cerebral palsy, and for reinfusion in neonatal hypoxic-ischaemic encephalopathy. The cord blood stem cells may then be used for immediate treatment of the neonate, or put into storage for use at a later date by themselves or a closely matched recipient. In March 2011 the state of Connecticut rolled out legislation to set up a public cord blood collection program as there is only one, private, cord blood bank currently available to state residents. The public cord blood bank would be connected to the national registry and many other states look set to follow a similar path, with some, such as New Jersey, already having such facilities available.
The stem cells in cord blood are relatively immature, making the matching of donors to those in need of a transplant considerably easier than the current convention of bone marrow transplantation. This use of tissue previously considered as medical waste, for the most part, also represents a non-invasive source of stem cells for both treatment and research purposes. There are few ethical considerations around the use of such material and many new parents are taking steps to have the cord blood collected and stored following their baby’s birth. In most cases this is a privately arranged procedure with the stem cells then stored for personal use at a later date. It is possible however to donate the cord blood to a public stem cell bank and in the UK this has now become the only option for parents who use the public health care system as legislation was put in place recently preventing the private collection and storage of cord blood in National Health Service (NHS) hospitals. There have been arguments against the new legislation, claiming that it increases the inequality and injustice in the healthcare system, although the NHS themselves say that the donor will still have access to cord blood, should they need it, but are also helping increase the potential for treating other patients.
The National Marrow Donor Program
Parents who donate cord blood to a public bank may also be aiding research as the stem cells may be used in clinical trials investigating potential new stem cell therapies. The National Marrow Donor Program (NMDP) in the US is building a cord blood bank in order to increase the potential for patients to receive life-saving stem cell transplants. However, not all cord blood is able to be used in such transplants, usually in cases where too little blood was harvested at the time of birth. In such cases the cord blood is likely to be used instead for research purposes in order to improve future transplants for patients. In a small number of cases the cord blood may not be stored due to complications in the mother’s medical profile, signs of infection or contamination of the blood, or due to the harvested material having suffered through poor storage of collection facilities. The NMDP states that around half of the cord blood units collected are not used in transplantation mainly due to the samples having too few blood-forming stem cells present. Those samples that are viable are stored and labelled in order to be added to the donor registry and made available for transplants and research on cord blood stem cells.
In the majority of cases the patients will remain unaware of the actual end use of the cord blood they have donated, but it may be possible to uncover specific clinical trials looking for cord blood donations. One study currently recruiting participants in Detroit is looking at the relationship between delivery information, maternal and gestational history, and the yield of stem cells from donated cord blood in African American donors (NCT00717535). This is just one way that donating cord blood may aid research into stem cell therapies as the findings from such studies could affect the protocols for collecting cord blood and allow parents to develop healthy habits related to stem cell activity both prior to pregnancy and during gestation.
Those who are from racial and ethnic minorities are particularly encouraged to donate cord blood as patients from minority groups often have difficulty finding matched bone marrow donors. Around 40% of those in minority racial and ethnic groups receiving a transplant are treated with cord blood as this does not need to be so closely matched. The NMDP is hoping to attract cord blood donations from under-represented groups such as Black and African Americans, American Indians and Native Alaskans, Asians, Native Hawaiians and other Pacific Islanders, and Hispanic and Latino donors. This also provides increased opportunities to study diseases that disproportionately affect minority groups, such as sickle cell anaemia, and thalassemia.
When to Register for Cord Blood Donation
Most cord blood banks ask that you register by the 34th week of pregnancy in order to make sure that there is someone available at the time of delivery to harvest cord blood correctly and to rule out and possible complications preventing you from donating cord blood. There is a list of participating hospitals on the NMDP website as not all hospitals are currently able to implement cord blood donation due to a lack of funding; this may influence your decision over where to have your baby if you feel particularly strongly about donating cord blood. If you are having twins then it may not be possible to donate cord blood as the tissue types may be mixed which can cause transplant complications. Even if your chosen hospital does not participate in the national program for cord blood collection it may still collect cord blood for research purposes, particularly where the hospital is a university of teaching hospital. It is important to find out about such research early in order to ensure that the relevant staff are on hand at the time of delivery if you have chosen to donate cord blood.
Video: Cord blood bank moving forward
