Donations of cord blood help save lives

Marisa Olmstead kisses the hand of her 19-month-old son, Connor. She donated his cord blood to a public bank. There is no cost to donate, and the blood can help treat diseases such as leukemia. Jeff Widener • The Honolulu Advertiser

Hawai‘i Cord Blood Bank To donate cord blood: Mother needs to be at least 18 years old, in good health and having a normal pregnancy. Cost: No cost to donor family Information: 983-BANK or visit www.hcbb.org

Just before giving birth to her son more than a year ago, Marisa Olmstead took a tour of Kapi‘olani Medical Center for Women & Children, hoping to learn more about the hospital where she would have her first child.

But Olmstead learned about something unexpected: cord blood.

She discovered that blood from the umbilical cords of newborns, typically tossed out after delivery, can be stored and used for bone-marrow transplant patients who cannot find matching donors.

Studies have shown the success of using umbilical cord stem cells to treat diseases such as leukemia, lymphoma, various anemias and genetic disorders. The stored blood by the Hawai‘i Cord Blood Bank is available to any patient who needs it, from anywhere in the world.

The simplicity of such a procedure - one that causes no pain for the mother or child - and the fact it could save a life made her decision to donate her son’s cord blood easy. Not to mention there’s no cost to donate to the public blood bank.

"I thought it was a great idea," said the 37-year-old full-time mom and part-time travel agent from Waipi‘o Gentry. "I just didn’t know it existed."

Struggling to find donors

That seems to be the Hawai‘i Cord Blood Bank’s biggest problem. Because so few people are aware of cord blood donation, the public blood bank is struggling to find donors.

Started in July 1998, the independent, nonprofit community service organization within Kapi‘olani had hoped to attract more than 200 donors in its first year. Instead, it banked just 43 units.

"We thought this was such a great idea, and that if we built it, people would come," said Dr. Randal Wada, medical director at the Hawai‘i Cord Blood Bank and associate professor at the Cancer Research Center of Hawai‘i. "But we were wrong, wrong, wrong."

But with the bank’s expansion into other hospitals, including Queen’s Medical Center, Wahiawa General Hospital and Kaiser Permanente in the past two years, cord blood awareness - and donations - are growing. And with Tripler Army Medical Center joining the cause in March, education about cord blood could potentially reach thousands of parents, as hospitals delivering more than 90 percent of all O‘ahu births will be participating in the donation program.

The organization’s grassroots efforts to further professional and public awareness has paid off: Today, the bank has more than 250 units stored. So far, no one in Hawai‘i has needed a cord blood transplant.

"If people knew about it and how easy it is, they would donate without question," said Lori Kaneshige, a 33-year-old clinical nurse specialist at Kuakini Medical Center, who donated her daughter Rika’s cord blood a year ago. "Cord blood is something they would just throw away anyway, so why not donate it? You have the opportunity to help somebody else."

Mountain of paperwork

Nationally, there is a need for bone marrow and cord blood from donors of Asian and Pacific Islander and mixed ethnic groups, as they are the hardest for which to find matches.

With Hawai‘i’s multicultural community, finding donors in these ethnic groups has been easier for the Hawai‘i Cord Blood Bank, much easier than it has been for the federally financed public bank run by the National Institutes of Health.

About 97 percent of the blood stored from Hawai‘i families is from newborns in these ethnic groups. That’s about as many units the national program has collected in five years.

In the past 10 years, awareness has grown steadily, with studies and testimonials appearing in national media.

This is good news for the 30,000-plus patients nationwide - more than 4,000 in Hawai‘i alone - who are diagnosed each year with a disease that could be treated with a bone marrow transplant, according to the National Marrow Donor Program in Minneapolis. There have already been more than 1,500 transplants using cord blood, mostly for children. In Hawai‘i, there are four patients waiting for a match.

The most daunting part of donating cord blood is the paperwork, Wada said. The procedure itself is nothing more than a doctor taking a blood sample from the umbilical cord.

For every 1,000 people given applications, half don’t fill them out, he said.

"It’s a mountain of paperwork," he said.

A person has to be over 18 to donate bone marrow. And because these are newborns, the blood bank needs a thorough medical history from the parents.

"It’s tedious and it takes a long time," Wada said. "It’s so easy to see that and say, ‘I’ll do it later.’ Before you know it, you’re having contractions and you’re out the door. The packet is still under a few layers on the coffee table."

Wada, a pediatric oncologist, said that some parents are uncomfortable disclosing information or are opposed to having their newborn’s blood tested for genetic disorders.

"Parents don’t want to know about genetic diseases," he said, adding that knowing either stresses them out or affects their insurance. But it’s better to know than not know, he said.

"The disease can be cured by bone marrow transplants," he said. "But the catch is, in order for the transplant to cure the disease, it has to be done before the child gets sick."

Ignorance, in this case, is not bliss, he added.

Private vs. public banks

Another concern parents have is whether to donate their child’s cord blood to a public or private blood bank.

Privately operated cord blood banks have been the subject of criticism in recent years, as many experts don’t find them necessary.

"I think they take advantage of the fact that many of these parents are first-time parents and want to do the best thing for their child," Wada said. "No one has really talked to them in depth about private versus public banking. It’s a matter of education."

The American Academy of Pediatrics expressed "concern that families may be vulnerable to emotional marketing (from private blood banks) at the time of birth of a child and may look to their physicians for advice."

Usually when a child needs a bone marrow transplant, it has to come from someone else. Leukemia, for example, is a cancer of the bone marrow. "Why would you give those cells back to the patient?" Wada asked rhetorically. "You’d want somebody else’s blood. The only time you’d want to bank privately is if you’ve already had a child with leukemia and you’re going to have another child."

Current estimates place the chances of a child needing to use his or her own cord blood sample at somewhere between 1 in 1,000 and 1 in 200,000.

"The odds of needing a marrow transplant is seven times the chance of being hit by lightning," Wada added.

The Olmsteads chose public banking because they wanted to help people, not take out biological insurance for their child.

"Even if we needed it, it would still be available to him," said Olmstead, seven months pregnant with her second child and cord blood donor. "As donors, we wanted to do our part."

[back to top]