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Cord blood donation surges as hospitals launch public collection programs

Norbert von der Groeben/Stanford School of Medicine

Amalia Kessler holds her 4-month-old son, Ari, while her husband, Adam Talcott, holds their daughter, Stella, 3. Kessler tried to donate Stella's umbilical cord blood, but was told no public program was available. Thanks in part to her efforts, a public program was begun at the Lucille Packard Children's Hospital at Stanford University, where Kessler was the first donor after Ari's birth in September.

When Amalia Kessler was pregnant with her first child, Stella, in 2008, she knew she didn’t want to waste the baby’s valuable umbilical cord blood, which can be a life-saving source of stem cells used to treat cancer and other diseases.

Private donation was out, despite the barrage of glossy brochures from companies that target expectant parents. 

“I came to the conclusion that there was very little chance that the child I was pregnant with, or any future child, could benefit from any blood that I could bank,” said Kessler, 38, a law professor at Stanford University.

But when she tried to donate the cord blood to a public bank for wider use, Kessler was surprised to learn there was no nearby place that could salvage it. “I called all around,” she recalled.

Three years later, it was a different story. When Kessler delivered her son, Ari, last September, she became the first donor in a brand-new cord blood collection program operated by the Lucille Packard Children’s Hospital at Stanford University.

“It felt very good,” said Kessler. “All I did was complain.”

In fact, Kessler’s insistence was part of the impetus for the Packard project, one of a growing number of hospital cord blood collection programs nationwide. The programs, which are free to parents, collect cord blood immediately after birth for listing on the National Be The Match Registry operated by the National Marrow Donor Program network.

Some 200 hospitals now supply 20 U.S. public cord blood banks that are part of the NMDP network, according to Mary Halet, manager for cord blood operations at the agency’s cord blood coordinating center.

Last year, the NMDP helped supply nearly 1,200 transplants from cord blood units, up from 1,000 in 2009, for a total of 6,000 since the program began in 2000. Overall, the number of available cord blood units climbed 14 percent in 2011, with greater increases expected as more hospitals sign on.

“This is a good cause,” explained Dr. Rajni Agarwal, a bone marrow transplant specialist at Packard. “When you talk about a product that is going to be discarded and could be used in saving someone’s life, there’s a very good response.”

All told, the banks provide access to some 165,000 cord blood units in the U.S. for people with life-threatening conditions, including leukemia and immune system and metabolism disorders. Counting international partners, the agency has access to some 425,000 cord blood units worldwide.

Since it formally began in January, the Stanford hospital has banked 15 to 20 units, but expects that figure to grow rapidly from a  maternity unit that sees 5,000 births a year, Agarwal said.

In a market where nearly all cord blood – some 97 percent – is discarded as medical waste, public donation is gaining ground. There is sharp competition from private banks, which typically charge $2,000 to collect the cord blood and additional monthly fees to store it for the family’s future personal use.

Private banks have said they offer parents both individual options and peace of mind.

Medical experts such as the American Academy of Pediatrics have come out against private banking unless parents had an older child with cancer or a genetic disease that could benefit from a sibling’s donation. AAP experts estimate that the chances are only about 1 in 2,700 that a child will need his or her own cord blood to treat disease in the future.

Instead, the AAP has encouraged public banking as a way to increase access to stem-cell therapy. Cord blood does not need to match as closely as bone marrow or other stems cells derived from blood, so it’s a good choice for patients with uncommon tissue types who don’t have a closely matched donor available.

At the Packard hospital, obstetricians have been charged with collecting cord blood. At other places, specific technicians might retrieve the donations. All public donations must be strictly screened and have enough cells to make up a usable dose, at least 200,000 nucleated cells, Agarwal said. Smaller donations may be used for research or are discarded.

New parents who want to donate their babies’ cord blood should check with their local hospital to see if it’s possible.

In Amalia Kessler’s case, she’s glad she spoke up -- and sparked a change that will help others.

“The amazing thing, of course, is it doesn’t cost anybody anything,” she said. “They would throw this stuff out.”

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