The Royal College of Obstetricians and Gynaecologists (RCOG) has updated its advice on umbilical cord blood banking and storage. RCOG had published advice for obstetricians, midwives and other healthcare practitioners on these issues in 2001, but new legislation, such as the Human Tissue Act and the EU Tissue and Cells Directive, have introduced changes. In addition, more women have been asking whether they should store their baby’s cord blood after birth. In light of these changing circumstances, the RCOG felt it was timely to update their advice.
RCOG has confirmed their opinion that there is no compelling reason for low risk families to bank their baby’s umbilical cord blood. Transplanting haemopoietic stem cells from umbilical cord blood is often a viable alternative to a bone marrow transplant. Currently, families at a high risk, for example of passing a genetic condition to their child, can bank cord blood for the future use of a family member at an established public sector cord blood bank, such as the NHS Cord Blood Bank or the Anthony Nolan Trust. These public banks also will take donations not directed for use by a particular family and provide material for transplants as required. But increasingly private companies have approached families to bank their baby’s cord blood ‘just in case’ there is a need in the future. Companies market their services in GP surgeries, antenatal clinics and directly to the public and people are uncertain whether or not to take advantage of this service. The RCOG notes that “the interest generated by the potential of [umbilical cord blood], and parental guilt for not storing their child’s stem cells, is a potent driver to commercial storage.” In response, the RCOG has recommended that only families at high-risk consider storing cord blood, as there is little evidence that low-risk families will ultimately benefit from the practice.
The RCOG also recommends that each Trust and hospital develop its own policy regarding prenatal requests for cord blood storage. The process of collecting the cord blood can have an impact on how the birth is managed and Trusts and hospitals need to ensure the family is aware of the institution’s policy. Finally, the RCOG advises that the NHS consider improving the funding for the collection and banking of unrelated cord blood and directed donations for families with genetic disorders, “…in order to provide a broad coverage and equitable access for those in need of the benefits that stem cell transplantation can achieve now, and those that may be available in the future.”