Analysis And Comment Controversy

NHS maternity units should not encourage commercial banking of umbilical cord blood

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.38950.628519.68 (Published 12 October 2006) Cite this as: BMJ 2006;333:801
  1. Leroy C Edozien (Leroy.Edozien@cmmc.nhs.uk), consultant obstetrician and gynaecologist1
  1. 1 St Mary's Hospital, Manchester M13 0JH
  • Accepted 28 July 2006

Storing cord blood at birth as insurance against future disease may sound like a good idea to parents, but it has worrying implications for NHS services and little chance of benefit

Increasing numbers of women in maternity units across the United Kingdom are requesting collection of umbilical cord blood at delivery to enable storage of stem cells for possible autologous transfusion in the future. Such commercial banking of cord blood has important implications for National Health Service maternity units. The debate on whether commercial cord blood banking should be encouraged has mostly been limited to the scientific merits, but risk management, medicolegal, and ethical issues also need considering.

Growth of blood banking

Umbilical cord blood is rich in stem cells that can be used to treat patients with abnormal haematopoietic cell lines, childhood leukaemia, or metabolic diseases.1 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.2

For these reasons interest has been growing in banking cord blood. The collected sample is commercially processed and stored for possible autologous transfusion in the future, a practice commonly referred to as biological insurance.

Media hype about the potential of stem cell transplantation3 and marketing by the commercial cord blood banks are likely to increase requests for blood collection at delivery. These banks advertise on the internet, distribute literature in antenatal clinics, and directly approach doctors and midwives.

A booklet distributed by one of the commercial banks tells potential clients that, “The cure for many life threatening diseases is dependent on the transplantation of stem cells.”4 It speaks of “unimaginable possibilities” and states: “Potentially [stem cell] research should provide answers to curing diseases such as diabetes, breast cancer, ovarian or testicular cancer, melanoma, …

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