US public cord blood banking practices: recruitment, donation, and the timing of consent.
BACKGROUND
Cord blood has moved rapidly from an experimental stem cell source to an accepted and important source of hematopoietic stem cells. There has been no comprehensive assessment of US public cord blood banking practices since the Institute of Medicine study in 2005.


METHODS
Of 34 US public cord blood banks identified, 16 participated in our qualitative survey of public cord blood banking practices. Participants took part in in-depth telephone interviews in which they were asked structured and open-ended questions regarding recruitment, donation, and the informed consent process at these banks.


RESULTS
Thirteen of 16 participants reported a variably high percentage of women who consented to public cord blood donation. Fifteen banks offered donor registration at the time of hospital admission for labor and delivery. Seven obtained full informed consent and medical history during early labor and eight conducted some form of phased consent and/or phased medical screening and history. Nine participants identified initial selection of the collection site location as the chief mode by which they recruited minority donors.


CONCLUSIONS
Since 2005, more public banks offer cord blood donor registration at the time of admission for labor and delivery. That and the targeted location of cord blood collection sites are the main methods used to increase access to donation and HLA diversity of banked units. Currently, the ability to collect and process donations, rather than donor willingness, is the major barrier to public cord blood banking.
Department of Bioethics and Center for Genetic Research Ethics and Law, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA. sxb115@case.edu
Sherri M
SM
Broder
Roselle S
RS
Ponsaran
Aaron J
AJ
Goldenberg
D001771:Blood Banks / Q000706:statistics & numerical data*; D001782:Blood Donors / Q000706:statistics & numerical data*; D032962:Consent Forms / Q000706:statistics & numerical data*; D005260:Female; D005312:Fetal Blood / Q000637:transplantation; D006801:Humans; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D018579:Patient Selection; D011364:Professional Practice / Q000706:statistics & numerical data; D017150:Public Sector / Q000706:statistics & numerical data; D013997:Time Factors; D014481:United States / Q000453:epidemiology