Pennsylvania has state legislation around cord blood education that follows the Institute of Medicine guidelines and mandates/encourages physicians to educate expectant parents about ALL forms of cord blood banking. The Pennsylvania bill was enacted 3 April 2008 and became effective 2 June 2008.
- How does the Institute of Medicine influence cord blood education?
- Congress commissioned an Institute of Medicine study on the ideal structure of a national cord blood
program. Based on the IoM report, Congress passed the Stem Cell Therapeutic and Research Act of 2005 that was signed into law 20 Dec. 2005. The key language regarding education is the requirement: Information provided to the maternal donor regard(s) all of her medically appropriate cord blood options. ie: Education of expectant parents and Informed Consent of maternal donors should cover all options, not just donation.
- Who is able to donate cord blood?
In theory, any expectant mother who passes the medical screening is eligible to donate. In practice, the biggest hurdle faced by families who wish to donate is finding a bank to accept their donation. There are only about 200 hospitals in the US that collect cord blood donations from births, and most of them require you to register for donation weeks ahead of the birth. The handful of programs that accept mail-in donations are opening this opportunity to the rest of the American public.
- How much cord blood is needed for a transplant?
The crucial thing is not the volume of the cord blood collection, but the number of stem cells it contains. Transplant doctors develop recommendations based on the Total Nucleated Cell count, or TNC, because it is the easiest measure to reproduce between different labs. For treating cancer, the transplant dose should be at least 25 million TNC per kilogram of patient body weight (1 kilogram equals 2.2 pounds). The average cord blood collection holds 8.6 million TNC per mL. Thus, the optimal transplant dose requires harvesting:
1.3 mL of cord blood for every pound of patient weight, -or-
2.9 mL of cord blood for every kg of patient weight
However, as more transplant centers are adopting the practice of giving adult patients "double cord blood transplants" with two cord blood units, it is less critical for both units to have adequate cell dose.
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