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US public cord blood banking practices: recruitment, donation, and the timing of consent

Authors

  • Sherri M. Broder,

    Corresponding author
    1. From the Department of Bioethics and Center for Genetic Research Ethics and Law, Case Western Reserve University School of Medicine, Cleveland, Ohio.
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  • Roselle S. Ponsaran,

    1. From the Department of Bioethics and Center for Genetic Research Ethics and Law, Case Western Reserve University School of Medicine, Cleveland, Ohio.
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  • Aaron J. Goldenberg

    1. From the Department of Bioethics and Center for Genetic Research Ethics and Law, Case Western Reserve University School of Medicine, Cleveland, Ohio.
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  • This work was funded by Grant P50HG003390 from the National Human Genome Research Institute. The content is solely the responsibility of the authors and does not represent the official views of the National Human Genome Research Institute or National Institutes of Health.

Sherri Broder, PhD, Department of Bioethics, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106; e-mail sxb115@case.edu or smbroder@earthlink.net.

Abstract

BACKGROUND: Cord blood has moved rapidly from an experimental stem cell source to an accepted and important source of hematopoietic stem cells. There has been no comprehensive assessment of US public cord blood banking practices since the Institute of Medicine study in 2005.

STUDY DESIGN AND METHODS: Of 34 US public cord blood banks identified, 16 participated in our qualitative survey of public cord blood banking practices. Participants took part in in-depth telephone interviews in which they were asked structured and open-ended questions regarding recruitment, donation, and the informed consent process at these banks.

RESULTS: Thirteen of 16 participants reported a variably high percentage of women who consented to public cord blood donation. Fifteen banks offered donor registration at the time of hospital admission for labor and delivery. Seven obtained full informed consent and medical history during early labor and eight conducted some form of phased consent and/or phased medical screening and history. Nine participants identified initial selection of the collection site location as the chief mode by which they recruited minority donors.

CONCLUSION: Since 2005, more public banks offer cord blood donor registration at the time of admission for labor and delivery. That and the targeted location of cord blood collection sites are the main methods used to increase access to donation and HLA diversity of banked units. Currently, the ability to collect and process donations, rather than donor willingness, is the major barrier to public cord blood banking.

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