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BMJ. Feb 3, 2007; 334(7587): 229.
PMCID: PMC1790966

World's first public-private cord blood bank launched in United Kingdom

Obstetricians and midwives are calling for discussions on the logistics of collecting umbilical cord blood for banking, after the launch of the world's first dual private and public cord blood stem cell bank in the United Kingdom.

The Virgin Health Bank will provide parents with the facility to store their child's umbilical cord blood in two portions—one as a private sample for the sole use of the child and his or her family and the second as a public sample, available free of charge to anyone requiring stem cell transplantation.

It is expected that around 80% of each sample will be placed in the public bank and 20% held in the private bank, although this will depend on the individual cord blood sample, stem cell expansion and whether cells meet the regulatory requirements for the international transplantation registry.

Storage of umbilical cord blood has been growing in popularity over the past few years, with private banks being established in several countries. Umbilical cord blood is rich in stem cells, which can be used to treat patients with abnormal haematopoietic cell lines, childhood leukaemia, and a range of immune and metabolic diseases. Cord blood is cheaper and easier to obtain than bone marrow and less likely to be rejected by the recipient.

The Royal College of Obstetricians and Gynaecologists welcomed the public nature and the international accessibility of the Virgin Health Bank. However, it warned in a statement: “Our prime concern remains the process of collection of the cord blood and the health of mother and baby. It is imperative that the collection should not in any way compromise the attention of the carers to the delivery, and ideally the sample should be collected by a trained third party once the placenta has been delivered.”

It added: “Further dialogue with the profession and involved maternity units is essential.”

Maggie Blott, a consultant obstetrician at University College Hospital London, said: “In practice, collecting cord blood is fairly straightforward. But I would hate to think that people might be concentrating on collecting cord blood and take their eye off the mother and baby.”

The Royal College of Midwives warned that accountability was a key issue. Sue Jacob, a midwife and student services adviser with the college, said: “A midwife is accountable to the mother and her baby. Anything that detracts from that would not be helpful.”

She said that when a woman has given birth, the midwife's primary concern must be to ensure her health and that of her baby, to ensure that bonding takes place, and to safely manage the third stage of labour.

The College reported that preliminary findings of a survey of maternity units in the UK showed that most NHS trusts do not have policies on the collection of cord blood. A spokesperson for the college said midwives were reporting difficulties with commercial cord blood banks, feeling under pressure from women who had paid commercial banks for storage to collect cord blood after delivery.

Virgin Health Bank has appointed a team of local advisers who will work with healthcare professionals involved in maternity services. Andrew Davis, chief executive of the company, acknowledged that discussions so far had indicated that maternity units varied in their attitude to the collection of cord blood samples.

The Virgin Health Bank service will cost £1500 (€2250, $2950), or £1600 if customers pay by instalments. This will include transport of the cord blood to the Virgin Health Bank facility and processing and storage of cells.

Sir Richard Branson, owner of the Virgin Group, said that any future profits from the Virgin Health Bank to the Virgin Group or to himself will be donated to charities “that are helping to fully realise the potential of cord blood stem cells,” including supporting the Anthony Nolan Trust in its plans for a new, ethnically diverse, cord blood stem cell public bank.

Sir Richard said that he became interested in the idea of banking stem cells several years ago after discussions with the director of the National Blood Service, in which it emerged that although the NHS was trying to collect umbilical cord blood samples, it lacked the resources to collect large numbers, so many potentially useful cells were being thrown away.

He offered to provide £3m to increase cord blood collection and storage, but the NHS said it was unable to accept money for a specific initiative.

Stephen Proctor, professor of haematological oncology at the University of Newcastle upon Tyne, said that the UK was falling behind other parts of the world in embracing cord stem cell technology for adults: “Anything which raises awareness and adoption of the use of cord stem cells will be incredibly valuable.” He added: “In my experience in transplantation, cord blood stem cells can offer some major benefits to a wide range of patients.”

More than 7000 patients have now been treated with cord blood stem cells transplantations in over 150 countries. The vast majority of these cases have been allogeneic (cells donated from another person). Professor Proctor predicted that thousands of people could benefit from increased access to stem cells for transplantation.

“I am enthusiastic about any programme that makes cord blood collection more widespread and available for general use,” he said, but added that he was not keen on private banks where cells are available only for the child whose cord blood has been donated, as these cells are hardly ever used.

Professor Proctor noted that bone marrow transplants are very difficult in patients older than 50 with blood cancers. “Cord cells offer a fantastic opportunity because of the naivety of the cells and the lack of complication associated with their transplantation. Results from cord cell transplants indicate that outcomes have comparable efficacy to use of bone marrow or PBSC [peripheral blood stem cells], even when cells are not fully matched to the recipient,” he reported.

Notes

See “NHS maternity units should not encourage commercial banking of umbilical cord blood” at www.bmj.com/cgi/content/full/333/7572/801


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