That we can create life is a wonder of nature.  However it does not stop there.  We can go further and not just create life.  By giving birth we can also save the life of another child if we both choose and are given the opportunity.  This is because the blood circulating the newborn has a very high proportion of cells that regenerate all the cellular elements of blood and the immune system (stem cells).  This blood, called cord blood, is obtained easily from the placental cord after birth.

Up to now the classical way to obtain stem cells has been from bone marrow.  However, this requires the need for a healthy individual to undergo an otherwise unnecessary operation.  Therefore, since this first cord blood transplant in 1988, cord blood has been used as a successful alternative to bone marrow and over 1000 cord blood transplants have been performed worldwide. 

The enthusiasm for cord blood as a source of stem cells has brought about a commercial interest.  It is now possible to store babies’ placental blood in case the child needs a stem cell transplant later in life.  Commercial banks argue that cord blood stem cells can be stored before environmental damage occurs, making healthy, perfectly matched stored stem cells immediately available for use.   If you are a prospective parent you may be thinking that, if you had the money (it is not cheap to keep these cells frozen year after year) this could benefit your child.  But consider the following: -

The odds of a child getting a disease that would require a stem cell transplant are very low

It is not yet known how long cord blood cells can be frozen for and remain viable

There are not enough stem cells in a cord blood collection for an adult transplant.  Therefore the stored cells can only be used if the child develops disease. However, if a child develops cancer in its’ early years, his or her cord blood might contain diseased cells. 

This questions whether long term storage of cord blood cells in commercial banks is ethical since the need for a transplant of ones own cord blood diminishes with time.  Furthermore, by storing our own children’s blood in a private bank (which will probably never be used) we could be denying the survival of a child who could desperately need that blood. 

Commercial banks are then faced with the problem of what happens to the cord blood once the child is too old to receive it.  Do the parents still own the cord blood and if so should they continue to pay for long-term storage even though there is a very low possibility of the blood being useful?  Alternatively would the blood get sold to a closely matched unrelated patient who could afford to buy it?

One of the greatest potential advantages of cord blood is that the level of matching required for a transplant may be lower than that needed for a bone marrow transplant.  Therefore cord blood is a good source of stem cells for people who do not have a relative to donate bone marrow.  Thus, it may be more ethical and financially viable for commercial banks to stop long term storage of cord blood from known individuals and concentrated on storing cord blood from unrelated sources, as the public banks currently do.  This would enable the commercial banks to have large numbers of stored cord blood with a wide range of genetic variation.  Having this wide variation would make it possible for these banks to get close genetic matching for paying patients.

However, to obtain cord blood the companies would have to pay the mothers for sample collection (in the same way that blood donations are currently paid for in the US).  One could imagine the scenario of low-income families having children just so they can sell the cord blood for commercial banking!  In addition storing a wide range of unrelated cord blood samples would put commercial companies in direct competition with public banks that obtain cord blood donations anonymously. 

Public bank cord blood donations are given freely by mothers who have given their consent for the blood to be stored and used to transplant children who desperately need a stem cell transplant and cannot find a good bone marrow match.  These public banks have been set up worldwide and provide stem cells for the whole population, not just those who can afford it.  But public banks are very expensive and rely on both government and charitable funding.  If commercial banks begin to store cord blood from unrelated donors and pay for that collection they could be removing an important source of cells from the public pool and public banks could be phased out.

Thus, by paying for the personal storage of our childrens’ cord blood, selling the cord blood or paying to obtain a cord blood for transplantation, we could be creating a future where the poor or benevolent are excluded from life saving treatments.We may be turning our children’s blood into a commercial property!