Shearer William T, Lubin Bertram H, Cairo Mitchell S, Notarangelo Luigi D
Pediatrics. 2017 Nov;140(5). doi: 10.1542/peds.2017-2695.
This policy statement is intended to provide information to guide pediatricians, obstetricians, and other medical specialists and health care providers in responding to parents' questions about cord blood donation and banking as well as the types (public versus private) and quality of cord blood banks. Cord blood is an excellent source of stem cells for hematopoietic stem cell transplantation in children with some fatal diseases. Cord blood transplantation offers another method of definitive therapy for infants, children, and adults with certain hematologic malignancies, hemoglobinopathies, severe forms of T-lymphocyte and other immunodeficiencies, and metabolic diseases. The development of universal screening for severe immunodeficiency assay in a growing number of states is likely to increase the number of cord blood transplants. Both public and private cord blood banks worldwide hold hundreds of thousands of cord blood units designated for the treatment of fatal or debilitating illnesses. The procurement, characterization, and cryopreservation of cord blood is free for families who choose public banking. However, the family cost for private banking is significant and not covered by insurance, and the unit may never be used. Quality-assessment reviews by several national and international accrediting bodies show private cord blood banks to be underused for treatment, less regulated for quality control, and more expensive for the family than public cord blood banks. There is an unquestionable need to study the use of cord blood banking to make new and important alternative means of reconstituting the hematopoietic blood system in patients with malignancies and blood disorders and possibly regenerating tissue systems in the future. Recommendations regarding appropriate ethical and operational standards (including informed consent policies, financial disclosures, and conflict-of-interest policies) are provided for physicians, institutions, and organizations that operate or have a relationship with cord blood banking programs. The information on all aspects of cord blood banking gathered in this policy statement will facilitate parental choice for public or private cord blood banking.
本政策声明旨在提供信息，指导儿科医生、产科医生及其他医学专家和医疗服务提供者，以回应家长关于脐带血捐献与储存以及脐带血库类型（公共库与私人库）和质量的问题。脐带血是患有某些致命疾病儿童进行造血干细胞移植的优质干细胞来源。脐带血移植为患有某些血液系统恶性肿瘤、血红蛋白病、严重形式的T淋巴细胞及其他免疫缺陷疾病和代谢疾病的婴儿、儿童及成人提供了另一种确定性治疗方法。越来越多的州开展了严重免疫缺陷检测的普遍筛查，这可能会增加脐带血移植的数量。全球范围内的公共和私人脐带血库都保存着数十万份用于治疗致命或使人衰弱疾病的脐带血单位。对于选择公共储存的家庭，脐带血的采集、特征鉴定和冷冻保存是免费的。然而，私人储存的家庭成本很高，且不在保险范围内，而且储存的脐带血单位可能永远不会被使用。几个国家和国际认证机构的质量评估审查表明，私人脐带血库在治疗中的使用率较低，质量控制监管较少，对家庭来说比公共脐带血库更昂贵。毫无疑问，有必要研究脐带血储存的用途，以便为患有恶性肿瘤和血液疾病的患者重建造血血液系统创造新的重要替代方法，并可能在未来再生组织系统。本政策声明为运营脐带血储存项目或与之有关系的医生、机构和组织提供了关于适当伦理和操作标准（包括知情同意政策、财务披露和利益冲突政策）的建议。本政策声明中收集的关于脐带血储存各方面的信息将有助于家长选择公共或私人脐带血储存。
