Cord blood banking

Abstract

Cord blood (CB) is a unique product, rich in haemopoietic stem cells (HSC), that is currently used in the transplantation setting to restore haemopoiesis. It restores haemopoietic stem cell function in patients suffering from malignancies, bone marrow (BM) failure disorders and inherited metabolic and immunological disorders. Related and unrelated CB donations have been successfully transplanted in both the paediatric and adult settings. CB, previously considered a waste product, can be collected from both vaginal deliveries and caesarean sections, either in utero or ex utero, at no risk to the donor, processed to remove excess plasma and red cells, cryopreserved, tested, HLA-typed and stored to provide an 'off-the-shelf' product. CB has a lower risk of some important viral infections and a lower incidence and severity of acute and chronic graft versus host disease (GvHD) than BM. CB transplantation is under innovative development and international collaborative studies are investigating ways to improve transplant outcomes. Other uses for CB remain speculative and it is premature to speculate whether non-haemopoietic stem cells are present in cord blood in sufficient numbers for use against degenerative conditions, as is currently postulated by some commercial organisations. Cord blood banking in EU member countries is now regulated by an EU Directive, which provides a statutory basis for regulation safety to ensure efficacy. Compliance is required by 2006. It requires that all banking establishments are inspected and accredited by a Competent Authority. This includes public altruistic banking as well as directed banking activities.