A phased consent policy for cord blood donation

Vawter, Dorothy E.; Rogers‐Chrysler, Gayl; Clay, Mary; Pittelko, Larrie; Therkelsen, D J; Kim, Debora; McCullough, Jeffrey

doi:10.1046/j.1537-2995.2002.00227.x

Cited by 33 publications

(23 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…16 The phased consent approach is a 3-step process involving (1) targeting information about cord blood banking to pregnant women; (2) allowing early labor consent to the ex utero collection and temporary storage of cord blood; and (3) permitting postcollection consent to the permanent storage, donation, and testing of the cord blood. Mothers who were eligible for intralabor consent had to meet strict eligibility criteria including dilation less than 7 cm, age older than 18 years, more than 36 weeks gestation, and no use of narcotics.…”

Section: Recruitment and Consent Of Donorsmentioning

confidence: 99%

New trends in umbilical cord blood transplantation

Ballen

2005

Blood

144

107

View full text Add to dashboard Cite

Since the first report of a successful umbilical cord blood transplantation in 1988, there has been great interest in the use of cord blood as an alternative stem cell source to treat cancer and genetic diseases. More than 4000 cord blood transplantations have been performed worldwide. In this review, the scientific rationale for this therapy, as well as related preclinical studies, cord blood banking issues, and ethical concerns, will be addressed. Results of studies in both pediatric and adult transplantation will be discussed.

show abstract

Section: Recruitment and Consent Of Donorsmentioning

confidence: 99%

New trends in umbilical cord blood transplantation

Ballen

2005

Blood

144

107

View full text Add to dashboard Cite

show abstract

“…In contrast to other institutions and in accordance with the FACT guidelines, we do not perform any UCB sampling without consent before delivery. The sampling is performed with the placenta still in utero by the obstetrician who is also responsible for the delivery and cannot leave the delivery room to collect blood ex utero in a separate room [15,23]. Thus, the ex utero technique is not applicable, but to collect UCB first and ask for consent afterwards is unethical not only in our opinion [24].…”

Section: Discussionmentioning

confidence: 99%

Problems in Umbilical Cord Blood Collection

Troeger¹,

Meyer-Monard

Thewis

et al. 2007

Transfus Med Hemother

View full text Add to dashboard Cite

The goal of the Cord Blood Bank Basel is to provide umbilical cord blood (UCB) for allogeneic stem cell transplantations from unrelated donors. Our registry contains 1,044 units, 12 have been released for transplantation (1%). In the past collection mainly took place at the Women’s Hospital Basel, where only 10% of deliveries resulted in HLA-typed and frozen transplants. The aim of our study was to evaluate the high deferral rate. Materials and Methods: During a 4-week period we assessed every delivery at our hospital by a questionnaire on patient data, consent procedure, inclusion or exclusion criteria and reasons for performing or not performing UCB collection. Results: 164 women delivered at our institution (135 vaginal deliveries, 29 cesarean sections). Among these, 131 were eligible for autologous UCB donation, whereas 33 women had to be excluded due to their medical history (26), triplet delivery (1), post partum hemorrhage (1), congenital malformation (1) or chorioamnionitis (4). Of the eligible women, 17 refused donating UCB, and 29 women underwent a cesarean section. 11 women were admitted under painful contractions. 18 had to be rejected due to lack of laboratory facilities at the weekend. Finally, 43 UCB samples had been taken, 2 for private banking purposes (4.6%), 21 (48.8%) for the public bank, and 20 samples (46.5%) which had to be discarded due to a low cell count. Conclusions: Donor selection is efficiently performed before the collection process. The rate of donor deferral and UCB sample discard is high and comparable to other UCB banks. The yield of UCB transplants could be increased if UCB collection would be additionally performed during cesarean section and with increased laboratory facilities during the weekend.

show abstract

“…The issue of obtaining consent for collection of cord blood has been controversial in the field of cord blood transplantation (36,37). Historically, the cord blood was considered to be the property of the hospital in which the baby was born, to be used, if desired, without patients' express consent.…”

Section: Cord Blood Collectionmentioning

confidence: 99%

“…labor has been allowed and advocated by some (37). Despite efforts to recruit women during the third trimester of pregnancy and obtain their informed consent well before the onset of labor, many pregnant women in labor come to the hospital interested in cord blood donation but without having given prior consent.…”

Section: Cord Blood Collectionmentioning

confidence: 99%

“…As has been previously noted, justice requires the establishment of mechanisms to ensure that all participants have a fair opportunity to participate in umbilical cord blood banking and use (39). The few banks that obtain consent after admission to the hospital or following collection of bankable units have in fact had considerable success in banking units from otherwise underrepresented populations (37). The data highlight the fact that policy making regarding informed consent involves a balance of protecting the interests of donor families and the challenges of equitable recruitment.…”

Section: Cord Blood Collectionmentioning

confidence: 99%

See 1 more Smart Citation

Untying the Gordian knot: policies, practices, and ethical issues related to banking of umbilical cord blood

Kurtzberg

Lyerly

Sugarman

2005

Journal of Clinical Investigation

View full text Add to dashboard Cite

Since the first successful transplantation of umbilical cord blood in 1988, cord blood has become an important source of hematopoietic stem and progenitor cells for the treatment of blood and genetic disorders. Significant progress has been accompanied by challenges for scientists, ethicists, and health policy makers. With the recent recognition of the need for a national system for the collection, banking, distribution, and use of cord blood and the increasing focus on cord blood as an alternative to embryos as a source of tissue for regenerative medicine, cord blood has garnered significant attention. We review the development of cord blood banking and transplantation and then discuss the scientific and ethical issues influencing both established and investigational practices surrounding cord blood collection, banking, and use.In 1988, a 6-year-old boy from North Carolina with Fanconi anemia was transplanted in Paris with HLA-matched umbilical cord blood from his baby sister (1). Most scientists and physicians at the time were highly skeptical, doubting that a few ounces of cord blood contained sufficient stem and progenitor cells to rescue bone marrow after myeloablative therapy. However, this child engrafted without incident, fully reconstituting his blood, bone marrow, and immune system with donor cells. He remains well and durably engrafted with donor cells 17 years following the original transplant (J. Kurtzberg, personal communication). From experimentation to practice: development of cord blood transplantationOver the 5-6 years following the first cord blood transplant, approximately 60 additional transplants between HLA-matched siblings were performed worldwide. Reports of results to a volunteer registry (2) demonstrated that cord blood contained sufficient numbers of stem and progenitor cells to reconstitute the entire hematopoietic system of a child after myeloablative therapy and that the incidence of graft-versus-host disease (GVHD) was 10-fold lower than that seen after transplantation with HLA-matched bone marrow obtained from a sibling.At this time it was becoming apparent that the diversity of HLA alleles and antigens was vast and that it was never going to be possible to find fully matched related and unrelated adult donors for all patients in need of allogeneic transplantation therapy from then-available sources. The National Marrow Donor Foundation (NMDP) and other international registries successfully recruited, typed, and listed millions of volunteer unrelated adult donors, but only 25-50% of patients in need could locate sufficiently matched donors in a timely fashion. Donors for patients of minority ethnic backgrounds were even scarcer and more difficult to locate. To provide donors for all patients in need, transplant physicians needed to find a way to transplant partially mismatched grafts.

show abstract

A phased consent policy for cord blood donation

Cited by 33 publications

References 30 publications

New trends in umbilical cord blood transplantation

New trends in umbilical cord blood transplantation

Problems in Umbilical Cord Blood Collection

Untying the Gordian knot: policies, practices, and ethical issues related to banking of umbilical cord blood

Contact Info

Product

Resources

About