Sharon O’Connor of Beauchamps Solicitors looks at the issues surrounding the harvesting of stems cells from umbilical cord blood and the legal situation in this country
Stem cells are ‘blank slate’ cells that are categorised by their potential to differentiate into other types of cells and are used in the treatment of many diseases, most commonly leukaemia. Embryonic stem cells are the most potent, since they must eventually become every type of cell in the body. These stems cells are derived from a four- or five-day-old human embryo that is in the blastocyst phase of development.
The embryos are usually extras that have been created in clinics where several eggs are fertilised in a test tube, but only one is implanted. It is no surprise that embryonic stems cells are ethically contentious and the decision of the European Court of Justice in October last year to ban patents for procedures in which human embryos are involved sparked an outcry throughout the stem-cell research community.
No legal framework
In Ireland, there is currently no legal framework governing stem-cell research, nor does it appear to be a high priority for the Government. However, it is possible for parents to preserve their child’s own stem cells at birth, by collecting them from the umbilical cord blood. Cord blood is normally discarded as waste after the birth.
However, it is the richest source of stem cells and affords parents a one-time opportunity to collect blood safely, following which it can be cryopreserved and stored in purpose-built containers.
Many parents consider this to be a form of biological insurance, as the stems cells can be used for both the baby’s own use (autologous) and family use, once there is adequate histocompatibility. Since the 1980s, when the procedure was developed, stem cells have been used in the treatment of many different cancers, immune deficiencies and genetic disorders.
Prior to this, these diseases were mainly treated by bone-marrow stem cell and peripheral-blood stem cell transplantation.
It has been stated that the consistency of stem cells from cord blood is 10 to 20 times greater than those provided by bone marrow and significantly higher than those provided by peripheral blood. Research conducted by the International Bone Marrow Transplantation Registry in 2004 estimated that since 1998, one-fifth of stem cell transplants performed for patients under 20 years were cord blood transplants.
Medicare Health & Living Ltd (in conjunction with Future Health Technologies Ltd) is the only regulated entity in this jurisdiction that provides stem-cell preservation.
According to the company’s Managing Director, Michael Doherty, Medicare has had to date approximately 2,000 clients since it first offered the service in 2002 and over half of these are healthcare professionals.
Regulation process
Regulation affords those interested in stem-cell preservation the peace of mind that the healthcare professional procuring your child’s cord blood has been properly trained. However, regulation has also made the process more expensive, since mandatory maternal blood tests are required within 30 days leading up to birth and a minimum of six months after, at a total cost of €330. This is in addition to the cost of the procedure itself — some €2,540 for one child or identical twins, and €4,410 for non-identical twins. This cost can be reduced by claiming it against your annual tax bill. Aviva also makes a contribution towards the procedure for its customers.
Those interested in the procedure should firstly engage with a midwife or obstetrician, as the co-operation of the maternity hospital is a prerequisite. Most public hospitals are resisting the practice.
Harvesting stems cells from umbilical cord blood is popular in many European countries where public and private banking services are available. Although the Health Service Executive has no plans to introduce a public cord bank service in Ireland, we would hope that stem-cell preservation could be made more affordable and more accessible to those wishing to avail of it.