NHS maternity units should not encourage commercial banking of umbilical cord blood, argues a senior doctor in this week's BMJ.
Instead, women should be encouraged to donate altruistically to public blood banks.
Umbilical cord blood is rich in stem cells that can be used to treat diseases such as childhood leukaemia. Bone marrow is used for this purpose, but cord blood is cheaper and easier to obtain and less likely to trigger a harmful immune response or rejection in the recipient.
For these reasons interest has been growing in banking cord blood as insurance against future disease, but this has worrying implications for NHS services and little chance of benefit, says Dr Leroy Edozien, a Consultant Obstetrician and Gynaecologist at St Mary's Hospital, Manchester.
Cord blood banks generally fall into two groups. Public banks collect cord blood which has been altruistically donated. The blood is used to treat unrelated recipients or is collected from families with a known genetic disease that is treatable by blood stem cell transplantation.
Since 1996, the NHS has been banking donated cord blood through designated public banks run by the National Blood Service and there is universal approval of the storage of this blood.
In contrast, commercial (private) banks operate collection and storage of a baby's cord blood for later use by that person or their siblings should they develop an illness. This 'just-in-case' collection has been criticised by numerous medical bodies and is not recommended.
Scientific arguments against commercial cord blood banking include the chances of the blood being used are very small, the alternatives such as bone marrow, and the speculative claims about how cord blood could be used to treat disease.
But, whatever the scientific merits or demerits, commercial blood banking also raises serious resource, legal, and ethical issues for NHS maternity units, warns the author.
Taking the arguments for and against into consideration, the balance is tilted strongly against NHS trusts collecting cord blood for commercial banking. It should therefore be NHS policy not to facilitate umbilical cord blood collection by its staff, he concludes.
Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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