Saving the leftovers: models for banking cord blood stem cells.

ABSTRACT: Each year there are over four million live births in the United States. Each birth produces umbilical cord blood stem cells, which are usually discarded. The author argues that rather than discarding the umbilical cord, this valuable resource of cord blood should be banked and used for research and therapeutic purposes. Umbilical cord blood could provide a solution to the critical need to find matching donors for hematopoietic transplants in patients who have no matching bone marrow donors. Creating a system of universal donation to a public bank will greatly increase the number of donors and therefore, the number of matches for patients. Such a system will facilitate the development and use of new technologies and transplant procedures, while providing an opportunity for treatment to individuals who would otherwise not be able to find suitable donors. I. Introduction: The Benefits and Challenges of Banking Cord Blood Stem Cells The use of embryonic stem cells is a highly publicized, politically charged topic, which implicates many ethical, legal, and moral issues. (1) Cord blood stem cells, however, have not received the same level of media attention. Cord blood stem cells are extracted from the umbilical cord and exhibit many of the same therapeutic qualities as embryonic stem cells but present fewer ethical problems. The purposes of this Article are: (1) to distinguish between cord blood stem cells and embryonic stem cells for non-scientists; (2) to highlight the opportunities that exist to collect more cord blood stem cells; (3) to propose consent models for their collection; and (4) to provide guidance for future legislation. Often, cord blood stem cell publicity relates to private cord blood banking, which is a very individualistic approach to banking and focuses mainly on using banked cells for a family member. (2) Public banking, on the other hand, is based on a population approach and focuses on the use of banked cells to treat any patient whose tissue might match. (3) This Article emphasizes the utility of cord blood stem cells as a therapeutic and research resource, suggests a framework for obtaining consent to collect the cells, and drafts suggested guidelines for legislation. Thus, this Article lays the groundwork for creating a comprehensive program that will benefit many Americans--namely the establishment of a national, public biobank for both research and transplantation purposes. Each year there are over four million live births in the United States. (4) Each birth produces umbilical cord blood stem cells, which hospitals usually throw away. This Article argues that rather than discarding the umbilical cord, the valuable resource of the cord blood should be banked and used for research and therapeutic purposes. Throughout the world, models for biobanking biological and genetic materials already exist that take into consideration many of the ethical, legal, and social concerns. (5) Clear, established processes for collecting cells are used by the numerous existing biobanks; therefore, by incorporating existing banking and collection strategies, researchers and medical professionals could use cord blood stem cells for transplantation in ways that benefit populations often underrepresented in traditional donor registries. Establishing a framework that banks can follow to obtain many more patients' consent to cord blood donation could facilitate the collection of larger numbers of usable samples. This may not be as difficult as it might initially seem, as avenues are already in place to collect cord blood stem cells. One program currently collecting and banking cord blood cells is the New York Blood Center's National Cord Blood Donor Program. (6) This is a public bank of umbilical cord blood established in 1992. (7) The purpose of this program is to investigate the uses of cord blood as a possible substitute for bone marrow, one of the currently available sources of stem cells for medical therapies. …