ing for autologous use and use by family members. The money received from private banking activities can help to offset the costs of public banking activities at these facilities. Both public and private units are processed and stored at the same facility; however, as with fully private banks, the private units are the property of the donor’s family and are not available for general use. As with fully public banks, units that do not meet quality standards may be used for quality improvement or research. If a family decides that it no longer wishes to maintain ownership of a unit, it is conceivable that the unit would then become available to the public for unrelated transplantation to patients unrelated to the family or for research, if the family consents.

Some cord blood companies exist on a for-profit basis by obtaining unrelated units, expanding them, and making the same unit available to multiple recipients. However, this very small field was one that the committee chose not to focus on.

As an expectant mother’s primary source of information about banking options is her obstetrician, it is very important that obstetricians fully understand the different options available, and be able to effectively convey that information to the mothers. Further, as the obstetricians are not reimbursed by the public banking system the way they are with many private banks, it is also important that they fully “buy in” to the advantages of the public system.

STATUS OF CURRENT BANKS: RESULTS OF A SURVEY

The committee identified 40 cord blood banks in the United States (see Appendix C). Based on the responses (both full and partial) of 21 of those 40 banks to a survey that the IOM committee distributed in the summer of 2004, the committee found that 9 banks store both public and private units, 8 store only public units, and 4 store only private units. However, among those banks that store both types of units, most banks predominantly stored public units, with small private programs on the site.

The committee’s survey asked banks to indicate their accreditation status (e.g., American Association of Blood Banks [AABB] and Foundation for the Accreditation of Cellular Therapy [FACT]), although the committee could not always verify this information when it consulted with the agencies providing accreditation to confirm the information. Slightly more responding banks (n = 11) self-reported AABB accreditation than FACT accreditation (n = 6). Only LifeCord indicated that it is accredited by both AABB and FACT. One bank indicated pending FACT accreditation, and two other banks responded that they will be or are in the process of accreditation. Four of the banks also indicated accreditation by the National Marrow Donor Program, which is not considered an accrediting agency. Thus,



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