Firetop

Having spent more than seven years working with Nature - one of the world’s most prestigious science publishers, I’ve been aware for some time of the potential use of stem cells for the development of new medical treatments. With ‘Baby Peskett’ due in early July, my wife and I have been looking at some of the commercial services offering to store cord blood (the source of stem cells) for up to 25 years. The stumbling block is that the umbilical cord blood collection is not something many NHS hospitals will support; in our case East Surrey Hospital has just rejected our request. East Surrey will only collect blood if it is needed ‘for therapeutic reasons’ i.e. the treatment of an existing sibling.

The summarised response we received from East Surrey is ‘We’re unable to help’ due to a ‘decision by the National Health Service Litigation Authority (NHSLA)’. This decision (with supporting scientific paperwork) argues that NHS staff and hospitals are not insured to collect cord blood during the process of delivering a baby. Why a hospital is willing to take the legal risk in order to obtain cord blood for treating an existing sibling is a mystery though; the risks of doing so are surely no lower in that instance? One might also question the ethics of encouraging people not to store cord blood, but to instead use overseas services to conceive a ‘saviour baby’ to get at the required stem cells (although the ten month gestation period might be too long to save the life of another sibling).

The Royal College of Obstetricians and Gynaecologists’ scientific advisory committee paper we received is actually quite interesting, it took a while to get through (it’s quite intense) but the main arguments against stem cell collection from Cord Blood in the UK are:

1. There is already an NHS Cord Blood Bank (NCBB) of 7000 cord blood samples collected by the NCBB at Edgware, it is available for matching worldwide if required and is added to at random from time to time.
2. The NCBB is altruistic in basis- whilst the paper doesn’t suggest that commercial storage by families for their own use is wrong, it reads a little like the RCOG don’t think it’s right for people with cash to be in a better situation than anybody else.
3. Whilst research suggests that some cord blood cells could one day be developed into cartilage, fat cells, hepatic and cardiac cells, such research is at an early stage and the role of stem cells is speculative.
4. Interrupting the normal working practices (logistics) of midwives and doctors in a birth increases risk by diverting attention away from the health of mother and baby – thereby increasing the risk of haemorrhaging and other time sensitive procedures (including speedy maternal/infant contact etc.). There is no insurance cover as a result (which begs the question ‘How does the NCBB collect cord blood?’).
5. Cord blood collection is not easy to do, samples can easily be contaminated by untrained birth partners (despite what commercial companies claim), and only experienced trained staff should attempt the collection of cord blood. NHS staff are not trained to do so.
6. An individual’s chances of using cord blood for haematopoietic disorders before the age of 20 years is low; estimates vary from 1/2000026 to 1/2700.
7. Use of own cells may be inappropriate in conditions where the disease has a genetic origin anyway.
8. The European Group on Ethics in Science and New Technologies advised the EC that commercial cord blood storage seems unethical.

Interestingly what the RCOG do recommend at the end of their research paper is increased funding and support for the NHS Cord Blood Bank for benefit by the whole world. However, given the fact that stem cell research is ongoing they can’t see much point in arguing for increased funding right now. Having read the RCOG findings it does seem like there may be other alternatives anyway should we be facing a worst case scenario situation i.e. make another baby, and perhaps the commercial companies are exploiting parents’ desires to safeguard their offspring’s future.

Clearly my wife and I have little choice but to accept the service rejection from East Surrey Hospital for our own uses. It is worth noting however that Virgin’s Stem Cell Bank (who we were considering) is unlike most other commercial collection services – to quote Richard Branson “We will take an individual’s cord blood and we will divide it in two”…”part of it will go into a National Blood Centre that anybody can get access to. And the other half will be put aside for the child.”. Virgin seems to be addressing a major concern of the RCOG by providing free donation to the NCBB – surely a positive thing?

Interestingly the National Blood Service who operate the National Cord Blood Bank do themselves enable applications for making cord blood donations and provide full contact details online, this will be our next approach… if Baby Peskett can’t benefit I don’t see why somebody else can’t.

Technorati Tags: stem cells, cord blood, umbilical cord, national blood service, national cord blood bank, virgin health bank, richard branson, east surrey hospital, nhs,

Bookmark to: