bullet1 $30,000 paid for stem cells Harvesting Baby's Placenta Blood for stem cells in Sydney Australia Children's Hospital.

$30,000 Paid for Stem Cells to the collector or to the stem cell blood bank that clones or gathers similar cells together. to quote:

"The cost of obtaining a unit of cord blood from an overseas bank exceeds $30,000."


    Harvesting of Babies at the Syndey children's Hospital, Australia,  was stated to be:  $30,000 for one unit  of cord blood from an oversea's cord blood bank.  Now Australia is harvesting their "own" babies.  Concerns of Donna Young, Natural Birth Education.

Reference of this Url is:  www.lotusbirth.com/doc/FEB2003Lotusbirth-444.htm

http://www.sch.edu.au/articles.asp?type=3&doc=13

September 1999  

   

The use of Cord Blood for Bone Marrow Stem Cell Transplants   

Interview with Professor Marcus Vowels by Sue Quayle   

 

Introduction


This month (september) marks the 6-year anniversary of the first successful cord blood transfusion from an unrelated donor. The director of the Ronald McDonald House Charities Cord Blood Bank and head of the bone marrow transplant program at the Sydney Children's Hospital in Randwick, Professor Marcus Vowels, spoke with Sue Quayle about developments in the use of cord blood for bone marrow stem cell transplants.


A quirk of nature which manufactures a profusion of bone marrow stem cells during late pregnancy has led to cord blood transplants becoming an established therapy for people with bone marrow disease who cannot find a suitable bone marrow donor.


The discovery that cord blood is rich in bone marrow stem cells from 34 weeks' gestation was made in Indianapolis in the early 1980s. But it was not until after the first transplant from a related donor in 1988 that doctors could confirm there were enough cells to engraft a child.


The subsequent discovery that cord marrow cells were less likely than bone marrow to attack the patient led to the first unrelated cord blood transplant in 1993.


Despite skepticism in the medical community that a transplant from an unrelated donor would work, the bone marrow stem cells engrafted and functioned. Since then, about 1500 transplants from unrelated donors of cord blood have been performed around the world.


The SCH performed its first successful unrelated cord blood transplant in November 1995 and their fourth child to have a successful transplant was recently discharged from hospital. So far, 25 transplants have been performed in Australian and New Zealand. All the patients were children and half of them are still alive. The risk of recurrence of leukaemia extends for three to four years after transplant, and like bone marrow transplants, the first one has the greatest chance of success.


The successful engraftment rate of cord blood transplants compares favourably with bone marrow: 90% and 93% respectively. Cord blood transplants also have several advantages:


* Tissue compatibility requirements are more flexible for cord blood transplants than for bone marrow so the chances of finding a compatible donor are higher.


* About half of the people who need a transplant cannot find a bone marrow match among family members or the 5.5 million registered unrelated bone marrow donors. If cord blood banks operated at optimum capacity, they could provide suitable donations for 95% of people searching.


* Because there is more flexibility when choosing a cord blood donation, the bank does not need to be as large as a bone marrow registry.


* Cord blood has a negligible risk of transmitting infection compared to bone marrow. About 70% of adult bone marrow donors have been exposed to cytomegalovirus which remains in marrow cells for life. Recipients of infected marrow may die if the virus becomes active after transplant.


* Cord blood is available for transfusion immediately, compared with a bone marrow donation which takes an average of four months to obtain from the start of the search to transplant.


* Cord blood can be frozen for up to about 20 years and sits 'on the shelf' ready for use.


* Bone marrow collection subjects donors to the risks associated with anaesthetics.

    •  Cord blood collection carries no risk to the donor. ????  

    • (Comment by Donna Young...the baby is deprived from 20 to 50 percent total blood volume. Often the donation has been take without informed consent.

  • A single 100ml donation of cord blood (3. 4 ouncs of blood) contains the same quantity of stem cells as 10 litres of blood from adults.


 However, only about 20% of cord blood transplants have been done in adults due to a prior concern that there may not be enough stem cells to engraft a fully grown adult. But enough transplants have now been undertaken to show that 100ml of cord blood does supply an adequate amount for adult transplants.


Developments during the last 12 months may further improve the outlook for adult transplants: the addition of growth factors to a unit of cord blood has been shown to increase the number of stem cells by up to 10 times. Although the technology is in its infancy, expansion of stem cells with growth factors promises increased applicability and use of cord blood.

  • Cord blood may be collected either before or after the placenta is expelled. Collection while the placenta is still in the uterus yields slightly more volume due to uterine contractions but this is method not always convenient in a busy delivery room.

  • At the Royal Women's Hospital (RWH) in Sydney the expelled placenta and cord are placed in a retort stand and drained by gravity.

  • Ideally, cord blood should be collected by specially trained staff who are responsible for all aspects of collection, including obtaining consent.

  • Experience has shown that trained collection staff generally obtain maximum volumes with few instances of contamination. Collection by labour ward staff is also an option and although enthusiastic for the task, they often have less time and additional responsibilities in the period immediately after birth.

  • Mothers who agree to donate cord blood must consent to HIV testing and grant permission for the blood to be banked and used.

  • This necessitates pre-HIV test counselling and obtaining a medical history to exclude possible sources of infection and inherent diseases.

  • The number of women prepared to donate cord blood overwhelmingly exceeds current collection capabilities.

  • Each year, the cord blood bank at the SCH receives hundreds of calls from women in urban and remote areas who would like the opportunity to provide their baby's life-giving cord blood to a needy person.

  • Unfortunately, collection services are only cost effective in large obstetric hospitals where collectors can obtain three to four donations per shift.

  • Only about 4% of women decline to donate their cord blood. This is usually due to cultural reasons, particularly among women from certain ethnic groups who traditionally take their placenta home.

  • However, their refusal has not affected supply.

  • Cord blood donations so far identically reflect Australia's ethic mix with more than 30% of donations from a non-Anglo-Saxon background. In contrast, bone marrow registries around the world, including Australia, tend to be dominated by volunteers from Anglo-Saxon backgrounds.

  • At the RWH about 1200 donations are banked from 4000 annual deliveries.

  •  Not all donations are suitable for banking as problems can occur during labour such as the mother becoming febrile or foetal distress. Other problems include a small volume of blood or a small cell count.

  • After collection, the blood is tested for infectious diseases and cultured to exclude contamination during collection. It is then tissue typed and the information is entered in an international database accessible from anywhere in the world.

  • About 40,000 cord blood donations are stored worldwide in banks in the US, UK, Belgium, the Netherlands, Germany, France, Spain and Italy.

  • The largest bank is in New York and contains 10,000 donations , which enables it to provide a suitable unit for 60% of people searching. It has been calculated that in a bank containing 20,000 donations, 95% of people needing a transfusion would be able to find a suitable matching unit of cord blood.

  • Asians are the only ethnic group not well represented in cord blood bank stores but plans are underway to establish banks in Hong Kong and Malaysia.

  • Australian cord blood banks have about 3500 donations . Of these, 2600 are stored at the SCH with most of the remainder (900 units) at the Royal Children's Hospital in Melbourne. Smaller numbers are banked at the Mater Hospital in Brisbane, the Adelaide Children's Hospital and the Red Cross in Melbourne.

  • It is important for Australia to develop adequate stores of cord blood (at least 20,000 units nationally) as our ethnic mix is creating a unique tissue type .
    •     For example, even if the planned cord blood bank in Hong Kong comes to fruition, it will only meet the needs of pure Chinese and not those of the increasing number of Australian-Chinese.

  • Cord blood banks in Australia also must cater for the unique tissue typing of Aborigines who have no bone marrow matches anywhere else in the world.

  • In the first half of 1998 when the cord blood bank at the SCH had only 1000 donations, there were five searches. In the second six months, 28 searches were done. The number of searches increased to 37 in the first six months of 1999, and in July alone there were 11 searches. Six cord blood units have been sent for transplant with another three reserved.

  • This experience shows that Australian cord blood services are recognised internationally.
    •      If future funding permits the numbers of donations to grow, the bank will increasingly be able to meet the needs of Australian children. As yet, only one cord blood transplant has been undertaken in Australia using a locally source donation .

  • The cost of obtaining a unit of cord blood from an overseas bank exceeds $30,000.

  • Because one bank cannot achieve the goal of 20,000 donations in a reasonable amount of time, cord blood banking in other major centres in Australia must be supported.

  • Applications have been made for government funding to assist these aims. In the meantime, private sources of funding are being used but these do not provide the means for expansion. Progress is almost at a standstill with some cord blood banks in other states unable to start cost-effective collections despite having the available technology.

  • The increasing demand around the world for units of cord blood shows that these types of transplants are increasingly gaining acceptance.
    • Cord blood transplants are no longer experimental .
    • They have well and truly passed the research stage and now satisfy a well-established service need.

  • With "guaranteed funding", cord blood banks would be able to meet the needs of almost all of the 50% of Australians who are unable to find a suitable match on bone marrow registries.
  

First published September 1999

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(Reference from Protect Babies http://www.123-baby-birth.com)   Search at Google this web site for the " No Policies " on equal protection to babies at from the various government officials who appointed representatives to protect the public on medical policies and practices; also the "No policies" of the various medical associations, societies, and colleges did not live up to no form of discrimination to women or the child of any kind.  It is believed they had a duty to have a policy of equal protection and security of person, regardless of:  age, mental or physical disadvantages ; race, color, social or marital status of the pregnant lady ; or belief or faith of the family, or genetic type of blood sought for by medical researchers, for stem cell matching, and use of white cells, mature red cells, platelets, enzymes, hormones, and plasma.


contact:   Donna Young, Mother and Grandmother

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References of research:   www.lotusbirth.com/doc/FEB2003Lotusbirth-110.htm

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  www.cordclamping.com

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