精华 脐带血需要不需要保存呢？
- 主题发起人 小地主
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- 2002-05-13
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What is Cord Blood?
Cord Blood is the blood that remains in the umbilical cord immediately after the birth of a baby. Many families today decide to bank their baby's cord blood. Cord blood is collected once the baby has been safely delivered, from what would otherwise be discarded in the remaining umbilical cord.
The collection of cord blood is quick, painless and has no side effects on the mother or the baby. Cord blood is special because it is a rich source of stem cells.
Cord Blood is the blood that remains in the umbilical cord immediately after the birth of a baby. Many families today decide to bank their baby's cord blood. Cord blood is collected once the baby has been safely delivered, from what would otherwise be discarded in the remaining umbilical cord.
The collection of cord blood is quick, painless and has no side effects on the mother or the baby. Cord blood is special because it is a rich source of stem cells.
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- 2002-05-13
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Why Should you store your baby's cord blood?
Thousands of families have decided to bank their baby's cord blood because it could be their once-in-a lifetime opportunity to secure their family's health.
Cord Blood is a rich source of stem cells. Recent advances in clinical research have uncovered various life-saving and regenerative applications for stem cells. Banking your baby's stem cells ensures that you will have your family's stem cells readily available as a life saving resource. New applications for stem cells are being discovered everyday.
Thousands of families have decided to bank their baby's cord blood because it could be their once-in-a lifetime opportunity to secure their family's health.
Cord Blood is a rich source of stem cells. Recent advances in clinical research have uncovered various life-saving and regenerative applications for stem cells. Banking your baby's stem cells ensures that you will have your family's stem cells readily available as a life saving resource. New applications for stem cells are being discovered everyday.
- 注册
- 2002-05-13
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Ethical Issues
in Banking of Umbilical Cord Blood (UCB)
Who owns privately banked UCB; the child or the parents?
For what genetic diseases should UCB be tested?
The number of possible tests vastly exceeds the amount of available blood; some subset must be selected.
Who is allowed access to the results of UCB testing for diseases?
Are cord blood banks responsible for notifying parents of mistaken paternal identity?
Should commercial cord blood banks be required to exercise truth-in-advertising when marketing their services to expectant families?
How can we ensure ethnic diversity in public cord blood registries?
This is similar to the issue of ethnic diversity in the NMDP (National Marrow Donor Program), except that UCB transplants do not have to be matched as precisely as adult bone marrow.
Should society seek to avoid economic discrimination in the private banking of cord blood?
Currently, when a family has a known potential need (ex: older sibling with a disease that could be treated by UCB transplant), medical insurers (including Medicaid) are covering the cost of private UCB banking.
A transplant recipient might need a booster infusion of donor stem cells or an infusion of donor leukocytes. Should there be a procedure for contacting the donor family with such requests?
Who keeps track of the donors to public registries, and for how long?
Suppose a donor to a public registry develops an unforeseen genetic disease later in life:
Who is responsible for informing the registry, and any transplant recipient?
Who is liable?
This list is based on the references:
Pelehach, L. 1996 Lab. Med. 27:588-599
Sugarman, J., Reisner, E. G., Kurtzberg, J. 1995 JAMA 274:1783-1785
Ethical aspects of banking placental blood for transplantation
Legal Issues
in Banking of Umbilical Cord Blood (UCB)
This summary is based on the article Annas, G.J. (5/13/1999) NEJM, vol.340 no.19 ,
"Waste and Longing -- The Legal Status of Placental-Blood Banking"
by a member of the Health Law Dept at the Boston University School of Public Health.
The legal treatment of bone marrow transplants has been based on the model of
organ donation .
Even though bone marrow is a renewable resource, its collection is invasive and poses risk to the donor. Although the privacy of donor and recipient are protected from each other, careful records are kept of the screening and testing process.
By contrast, the legal treatment of cord blood has been based on the model of
blood donation .
The collection of cord blood poses no risk to the mother or newborn, and was previously considered medical "waste". Consequently, public registries feel justified in banking cord blood anonymously, stripped of all source identity. There are fewer records about the source of a public cord blood unit than there would be about the source of an ordinary blood transfusion.
This model becomes questionable now that cord blood is becoming very desirable as a source of stem cells for research, and is frequently sold for profit. If the cord blood is not waste, but has great value, then the collecting institution "has a fiduciary or trust obligation to inform the mother of the research itself, as well as the possible commercial applications of the research, and to obtain her consent to use the placental blood in this manner". I would add, also an obligation to make forecasts of the possible profits derived from these commercial applications, just like the "forward-looking statements" in a corporate prospectus.
Annas further states, "Permitting the storage company to sell the placental blood to others for therapeutic use, on the other hand, would create conflicts between the storage facility and both the donor (who benefits, if at all, only if the blood is retained in storage) and the recipient (who would want records kept of the donor even though the donors would not)."
Public versus Private Banking: must we choose?
Some people say private cord blood banking is unethical, because it deprives the public of access to this resource. That viewpoint is eloquently expressed in the column, "Whose Cord Blood is it Anyway?" , written by Dr. Jeffrey P. Kahn, Director of the U. Minnesota Center for Bioethics, for the CNN Interactive column, "EthicsMatters" .
As of summer 2003, so few parents in the United States have access to a public bank which is willing to store their donation, that the idea of altruistically giving the blood to society is a moot point. The only choice presented to most parents is between discarding the blood or saving it privately.
List of Relevent References:
Annas, GJ 1999 May 13; NEJM, 340(19):1521-24
"Waste and Longing -- The Legal Status of Placental-Blood Banking"
Burgio GR, & Locatelli F. 1997 Jun; Bone Marrow Transplant 19(12):1163-68
"Transplant of bone marrow and cord blood hematopoietic stem cells in pediatric practice, revisited according to the fundamental principles of bioethics."
Burgio GR, Gluckman E, Locatelli F. 2003 Lancet. 2003 Jan 18; 361(9353):250-2
"Ethical reappraisal of 15 years of cord-blood transplantation."
Pelehach, L. 1996 Lab. Med. 27:588-599
Sugarman, J, Kaalund V, Kodish E, Marshall MF, Reisner EG, Wilfond BS, Wolpe PR. 1997 Sep 17; JAMA. 278(11):938-43
"Ethical issues in umbilical cord blood banking"
Sugarman, J, Reisner, EG, Kurtzberg, J. 1995 Dec 13; JAMA 274(22):1783-1785
"Ethical aspects of banking placental blood for transplantation"
in Banking of Umbilical Cord Blood (UCB)
Who owns privately banked UCB; the child or the parents?
For what genetic diseases should UCB be tested?
The number of possible tests vastly exceeds the amount of available blood; some subset must be selected.
Who is allowed access to the results of UCB testing for diseases?
Are cord blood banks responsible for notifying parents of mistaken paternal identity?
Should commercial cord blood banks be required to exercise truth-in-advertising when marketing their services to expectant families?
How can we ensure ethnic diversity in public cord blood registries?
This is similar to the issue of ethnic diversity in the NMDP (National Marrow Donor Program), except that UCB transplants do not have to be matched as precisely as adult bone marrow.
Should society seek to avoid economic discrimination in the private banking of cord blood?
Currently, when a family has a known potential need (ex: older sibling with a disease that could be treated by UCB transplant), medical insurers (including Medicaid) are covering the cost of private UCB banking.
A transplant recipient might need a booster infusion of donor stem cells or an infusion of donor leukocytes. Should there be a procedure for contacting the donor family with such requests?
Who keeps track of the donors to public registries, and for how long?
Suppose a donor to a public registry develops an unforeseen genetic disease later in life:
Who is responsible for informing the registry, and any transplant recipient?
Who is liable?
This list is based on the references:
Pelehach, L. 1996 Lab. Med. 27:588-599
Sugarman, J., Reisner, E. G., Kurtzberg, J. 1995 JAMA 274:1783-1785
Ethical aspects of banking placental blood for transplantation
Legal Issues
in Banking of Umbilical Cord Blood (UCB)
This summary is based on the article Annas, G.J. (5/13/1999) NEJM, vol.340 no.19 ,
"Waste and Longing -- The Legal Status of Placental-Blood Banking"
by a member of the Health Law Dept at the Boston University School of Public Health.
The legal treatment of bone marrow transplants has been based on the model of
organ donation .
Even though bone marrow is a renewable resource, its collection is invasive and poses risk to the donor. Although the privacy of donor and recipient are protected from each other, careful records are kept of the screening and testing process.
By contrast, the legal treatment of cord blood has been based on the model of
blood donation .
The collection of cord blood poses no risk to the mother or newborn, and was previously considered medical "waste". Consequently, public registries feel justified in banking cord blood anonymously, stripped of all source identity. There are fewer records about the source of a public cord blood unit than there would be about the source of an ordinary blood transfusion.
This model becomes questionable now that cord blood is becoming very desirable as a source of stem cells for research, and is frequently sold for profit. If the cord blood is not waste, but has great value, then the collecting institution "has a fiduciary or trust obligation to inform the mother of the research itself, as well as the possible commercial applications of the research, and to obtain her consent to use the placental blood in this manner". I would add, also an obligation to make forecasts of the possible profits derived from these commercial applications, just like the "forward-looking statements" in a corporate prospectus.
Annas further states, "Permitting the storage company to sell the placental blood to others for therapeutic use, on the other hand, would create conflicts between the storage facility and both the donor (who benefits, if at all, only if the blood is retained in storage) and the recipient (who would want records kept of the donor even though the donors would not)."
Public versus Private Banking: must we choose?
Some people say private cord blood banking is unethical, because it deprives the public of access to this resource. That viewpoint is eloquently expressed in the column, "Whose Cord Blood is it Anyway?" , written by Dr. Jeffrey P. Kahn, Director of the U. Minnesota Center for Bioethics, for the CNN Interactive column, "EthicsMatters" .
As of summer 2003, so few parents in the United States have access to a public bank which is willing to store their donation, that the idea of altruistically giving the blood to society is a moot point. The only choice presented to most parents is between discarding the blood or saving it privately.
List of Relevent References:
Annas, GJ 1999 May 13; NEJM, 340(19):1521-24
"Waste and Longing -- The Legal Status of Placental-Blood Banking"
Burgio GR, & Locatelli F. 1997 Jun; Bone Marrow Transplant 19(12):1163-68
"Transplant of bone marrow and cord blood hematopoietic stem cells in pediatric practice, revisited according to the fundamental principles of bioethics."
Burgio GR, Gluckman E, Locatelli F. 2003 Lancet. 2003 Jan 18; 361(9353):250-2
"Ethical reappraisal of 15 years of cord-blood transplantation."
Pelehach, L. 1996 Lab. Med. 27:588-599
Sugarman, J, Kaalund V, Kodish E, Marshall MF, Reisner EG, Wilfond BS, Wolpe PR. 1997 Sep 17; JAMA. 278(11):938-43
"Ethical issues in umbilical cord blood banking"
Sugarman, J, Reisner, EG, Kurtzberg, J. 1995 Dec 13; JAMA 274(22):1783-1785
"Ethical aspects of banking placental blood for transplantation"
- 注册
- 2002-05-13
- 消息
- 5,887
- 荣誉分数
- 156
- 声望点数
- 173
Cord Blood Banking
A topic of growing populartiy among new parents is cord blood banking. The question many parents may ask is, “Do we need to bank the cord blood of our new child?”
Parents may be vulnerable to emotional marketing during pregnancy and labour, so seeking information as early as possible is important.
Cord blood is the blood that remains in the umbilical cord after a child’s birth. This blood is particularly rich in stem cells.
There are two ways to store cord blood. The first one is to donate the cord blood to a non-profit public bank. The blood will be accessible to anyone, and there is no guarantee that it will still be accessible by the donor if needed.
The second one is the use of a for-profit company that encourages parents to store cord blood from their child in case the child - or another member of the family - should need it. However, there is a 75% chance that the stored blood will not be compatible for other siblings.
There are many advantages to storing cord blood. First, the procedure is painless and “risk-free” for the baby and mother, contrary to bone marrow harvest - a painful experience that is more risky, usually involving general anesthesia and surgery.
Secondly, in case transplantation is needed, if the recipient is the donor, there is no risk of graft versus host diseases. These diseases appear when the donor cells begin to attack the recipient, with the most of severe of cases fatal to the recipient.
If the recipient is not the donor, but is closely matched, the tolerance is generally better with cord blood cells than cells obtained from bone marrow. The risk that the stem cells carry an infectious disease is lower, since the newborn donor was likely in contact with few pathogen agents. All gifts of cord blood are also screened for many types of blood pathogens to increase security within the samples.
Finally, there is a lot of research currently ongoing with stem cells, which could result in new applications for cord blood banking.
Of course, there are also disadvantages to cord blood banking. There may not be a sufficient amount of cells available through this method to transplant to an adult patient. In this case, other more classical methods should be used.
There is a risk that physician with less ethical concerns could clamp the cord blood too early, which can yield more cord blood, but deprives the newborn from a placental blood transfusion, potentially setting up the later onset of anemia.
Another disadvantage of cord blood banking is that even if transplantation is needed, it doesn’t mean that the cells extracted from cord blood will be useful, particularly if the specific batch of blood has a weakness that will lead to a relapse.
There are also reports that a graft originating from cord blood could take longer to engraft.
Finally, there’s only one time in life where cord blood can be stored: at birth.
So should new parents bank cord blood?
The answer is a personal one. If money isn’t an issue, then this process can be seen as an insurance policy against future medical conditions. Generally, physicians will recommend storing cord blood if a family has a strong medical history for a particular disease.
Giving cord blood to a public bank could potentially save a life, using tissue which is usually discarded. But there is currently only one public cord blood bank in Canada, located in Alberta.
Special concern for storing cord blood may be given to ethnic or racial minorities, as locating a match for bone marrow transplant may be more difficult.
graft versus host diseases - diseases which appear after a transplant, when the donor cells begin to attack the recipient. Severe of cases fatal to the recipient.
pathogen - an agent that causes disease, especially a living micro-organism such as a bacterium or fungus.
anemia - definiciency of red blood cells.
A topic of growing populartiy among new parents is cord blood banking. The question many parents may ask is, “Do we need to bank the cord blood of our new child?”
Parents may be vulnerable to emotional marketing during pregnancy and labour, so seeking information as early as possible is important.
Cord blood is the blood that remains in the umbilical cord after a child’s birth. This blood is particularly rich in stem cells.
There are two ways to store cord blood. The first one is to donate the cord blood to a non-profit public bank. The blood will be accessible to anyone, and there is no guarantee that it will still be accessible by the donor if needed.
The second one is the use of a for-profit company that encourages parents to store cord blood from their child in case the child - or another member of the family - should need it. However, there is a 75% chance that the stored blood will not be compatible for other siblings.
There are many advantages to storing cord blood. First, the procedure is painless and “risk-free” for the baby and mother, contrary to bone marrow harvest - a painful experience that is more risky, usually involving general anesthesia and surgery.
Secondly, in case transplantation is needed, if the recipient is the donor, there is no risk of graft versus host diseases. These diseases appear when the donor cells begin to attack the recipient, with the most of severe of cases fatal to the recipient.
If the recipient is not the donor, but is closely matched, the tolerance is generally better with cord blood cells than cells obtained from bone marrow. The risk that the stem cells carry an infectious disease is lower, since the newborn donor was likely in contact with few pathogen agents. All gifts of cord blood are also screened for many types of blood pathogens to increase security within the samples.
Finally, there is a lot of research currently ongoing with stem cells, which could result in new applications for cord blood banking.
Of course, there are also disadvantages to cord blood banking. There may not be a sufficient amount of cells available through this method to transplant to an adult patient. In this case, other more classical methods should be used.
There is a risk that physician with less ethical concerns could clamp the cord blood too early, which can yield more cord blood, but deprives the newborn from a placental blood transfusion, potentially setting up the later onset of anemia.
Another disadvantage of cord blood banking is that even if transplantation is needed, it doesn’t mean that the cells extracted from cord blood will be useful, particularly if the specific batch of blood has a weakness that will lead to a relapse.
There are also reports that a graft originating from cord blood could take longer to engraft.
Finally, there’s only one time in life where cord blood can be stored: at birth.
So should new parents bank cord blood?
The answer is a personal one. If money isn’t an issue, then this process can be seen as an insurance policy against future medical conditions. Generally, physicians will recommend storing cord blood if a family has a strong medical history for a particular disease.
Giving cord blood to a public bank could potentially save a life, using tissue which is usually discarded. But there is currently only one public cord blood bank in Canada, located in Alberta.
Special concern for storing cord blood may be given to ethnic or racial minorities, as locating a match for bone marrow transplant may be more difficult.
graft versus host diseases - diseases which appear after a transplant, when the donor cells begin to attack the recipient. Severe of cases fatal to the recipient.
pathogen - an agent that causes disease, especially a living micro-organism such as a bacterium or fungus.
anemia - definiciency of red blood cells.
