When is it OK to discard umbilical cord blood stem cells?
A transfusion medicine physician wonders if any colleague has had experience dealing with the disposal of umbilical cord blood stem cells that were collected and stored at a family’s request. Apparently the family has fallen into arrears in payment for the product's future storage. The inquiring physician knows that it is not uncommon to discard frozen autologous red cells for non-payment, however to dispose of umbilical cord stem cells is, in her opinion, a different situation, and a much more emotional issue. She is hesitant to throw the stem cells away, only to have the family upset later because their "life-line" was discarded.
The following responses were received.
- A colleague with experience in the storage of umbilical cord blood stem cells reports that the informed consent document that the mother/parents sign is the most important place to start. If the consent clearly states that the cord blood will be distroyed if not financially supported, the responding colleague is of the opinion that liability will be better controlled. He adds that in his experience, at least some cord blood companies are holding the autologous product in inventory for a year during which time they contact the mother/family (quarterly) and try to work out payments. After this type of "good faith" effort with several documented contacts, the responding colleague would destroy the product. He cautions that a different approach would be needed if the stem cell donor (i.e., the baby) eventually turns of "legal age".
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Ira A. Shulman, MD
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