Blood Products
As biological products, blood and blood products carry an inherent risk of infectious agents. While the FDA is responsible for enforcing regulations to keep the U.S. blood supply safe, it is the blood and pharmaceutical industry that is ultimately responsible for the safety of individual blood products. Unfortunately, there have been cases of contamination and infections through the blood supply. During the 1980s, approximately 9,000 U.S. hemophiliacs (45% of the hemophiliac population) were infected with HIV through the use of contaminated clotting factor. And in 2008, the FDA recalled several thousand does of the anticoagulant Heparin due to contamination. Because of improvements in donor screening procedures and the use of new tests, the blood supply is safer today, but threats still exist such as Creutzfeldt-Jakob Disease (CJD) and New Variant Creutzfeldt-Jakob Disease (nvCJD), hepatitis B, HIV, smallpox, severe acute respiratory syndrome (SARS), and other contaminants.
Cord Blood Banking
Among the many decisions facing expectant parents is whether or not to save the blood harvested from the umbilical cord, and whether to do so at a private bank or donate it to a public bank. Although the decision may seem to be an insignificant one that has only remote implications, it is one that could save a life: either a family member's or another's.
Umbilical cord blood is rich in Hematopoietic Stem Cells (HSCs) – the blood cells concentrated in the bone marrow that make all other blood cells (red and white blood cells, and platelets). HSC transplants are used to treat leukemia and other blood and immune system disorders. Laboratory research also indicates that HSCs may offer therapeutic treatment of maladies affecting other types of cells, including bone and muscle. HSC transplants usually require a bone marrow transplant, and it is well known that some patients face daunting odds when seeking a marrow donor who matches the patient’s human leukocyte-associated antigens (commonly known as the HLA-type). Unlike adult bone marrow, however, cord blood is immunologically immature and less likely to be rejected by the recipient than bone marrow HSCs donated by an adult. The first use of cord blood HSC occurred in the early 1990s, and since then the harvesting and use of these cells has grown quickly, commonly in children suffering from blood cancers and other blood disorders. Parents interested in saving the cord blood cells can contact a private bank, which will provide a collection kit. The cord blood cells are collected at the time of delivery by the obstetrician during a quick and painless process. The cells are then frozen and preserved until they are needed, though hopefully that day never comes. Apart from the initial collection and storage initiation fee, which varies from bank to bank, there are annual storage fees of approximately $100. Like any contract, before entering into an agreement with a private bank parents should read the terms of the agreement carefully, especially portions discussing ownership rights of the cells, and their disposal or subsequent use by the bank if the parents terminate the contract at a later date. Alternatively, parents can decide to donate the cord blood to a public bank. Unlike cells retained by a family in the event one of its members needs an HSC transplant, public cord blood donations are more thoroughly regulated as a matter of public health. This poses some additional obligations on parents, and may explain why most are deterred from public cord blood donation. Nevertheless, for those that do want to donate the cord blood it constitutes a valuable contribution to public health, at a minimum of inconvenience. Alerts
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