Kai@Chicago

考慮了幾週，我們決定要把臍帶血捐出去~

看了很多資料後，誠心地建議所有的待產媽媽，若不考慮自費存臍帶血，請考慮把臍帶血捐出去吧！與其讓臍帶血就這麼被丟入垃圾桶，還不如幫孩子做做善事，捐出去救人一命。

最後決定將臍帶血捐出去的主要原因是: (資料來源: (A) http://www.babycenter.com/0_private-cord-blood-banking-is-it-for-you_1369773.bc; (B) http://www.slate.com/id/2245134/)

(1)  In most cases, it's better not to treat a child with his own cord blood. (對於大多數的兒童癌症，免疫不全病例或其他先天疾病來說，最好"不要用孩子本身的"臍帶血來治療，因為她/他的臍帶血裡很可能帶有同樣的病原細胞~)

In the case of many childhood cancers and immune deficiencies, a child would not be given his own cord blood. Those stem cells would probably carry the disease genetically, meaning that you'd be reintroducing those defective cells into the child.

In fact, for many cancers and genetic disorders, patients are actually better off with someone else's cells, rather than their own.

Consider leukemia. (譬如說白血病) Only a subset of leukemia patients need a new set of blood-producing cells. And for those who do, doctors may prefer to try traditional bone-marrow transplants from well-matched family members or other donors. They may also try cord blood from these sources. But they typically won't use a patient's own cells. That's because his cord-blood cells might contain the abnormality that gave rise to the cancer.

(2) Your baby's cord blood might not have enough stem cells to treat you or other adults in your family. (以目前技術而言，若病發於七八歲以後(>40KG)，通常初生兒儲存的臍帶血份量都不夠用來治療，而必須另外找別人的臍帶血。不過關於這一點，未來的技術有可能會改進，可由一袋臍帶血中的stem cell成功複製更多。但幹細胞增生技術從目前的動物實驗到臨床應用，還有一大段距離，絕不容易。~)

One unit of cord blood typically doesn't contain enough stem cells to treat most adults.

According to William Shearer, a professor of pediatrics and immunology at Baylor College of Medicine in Houston and coauthor of the 2007 American Academy of Pediatrics statement on cord blood transplants, researchers have not been able to routinely expand the number of stem cells in a unit of cord blood. But there have been successful transplants involving a combination of two or three cord blood units from unrelated donors – another way of stretching this scarce resource.

(3) Unless you select your private bank carefully, the cord blood you bank privately may not be suitable for transplants. (市面上臍帶血銀行眾多，尚未有公定規範，若不慎選，等過了十年二十年需要用的時候，很可能發現當初存的臍帶血已經不敷使用了~ )

If the day comes when one of your children needs the cord blood you've stored privately, your child's doctor may reject it. The practices and standards of private banks vary, and your sample may not contain enough stem cells for a successful transplant. It's crucial, if you decide to store cord blood privately, that you choose a private cord blood bank carefully.

(4) You may be able to get donated cord blood back. (未來有可能可以將當初捐出去的臍帶血拿回來用，不過前提是那份臍帶血尚未被別人用掉。據美國的公捐臍帶血銀行資料顯示，公捐臍帶血的被使用率約為10%左右，也就是說有90%的臍帶血還保存在公捐臍帶血銀行理，所以未來能找回來用的機率還是相當大的~)

If you donate your cord blood to a public bank, it's available for the public and any potential matching patient, as well as for research. That means that there's no guarantee that you'll be able to access it if you need it for your family later. But if the need does arise and your donation is still available, you'd have access to it just as anyone else would.

"If the cord blood you donated is the optimal one for a given transplant, it will be available to you unless it has already been used by another person," says Lawrence D. Petz, chief medical officer of StemCyte, a cord blood bank with both a public and a private division. "The likelihood of it having been used is low, since less than 10 percent of publicly banked units are used."

(5)  AAP doesn't recommend private storage except in very unusual cases – when a child in the family has leukemia, for example. The ASBMT also encourages public donation and points out that the likelihood of using one's own cord blood is very small (the group estimates the chance at less than 4/100th of 1 percent). (美國醫師協會AAP並不建議一般家庭自費儲存臍帶血，除非家族裡有血液相關遺傳疾病。AAP鼓勵大家公捐臍帶血，因為存放在私人臍帶血銀行裡，將來自己會需要用到的機會近乎微乎其微。而由於是私存，阻絕了這份臍帶血及時被真正需要的人使用的機會，等到未來幾十年後，這份臍帶血到底還能不能用，誰也不能保證~)

"Placing cord blood in a private bank eliminates the opportunity for public use – for a child with leukemia who really needs it, for example," says Karen Kuhn Bullen, an associate professor of medicine at Harvard Medical School and director of the Center for Leukemia at Massachusetts General Hospital Cancer Center. In addition, she says, there's no guarantee that the blood a parent stores in a private bank will be viable when the child reaches adulthood.

The American College of Obstetricians and Gynecologists (ACOG) takes no official position for or against cord blood banking, but says the chances are slim that a child – or even a family member – will ever use that saved cord blood. The organization points to a 1 in 2,700 (or lower) chance that a child will use his own saved cord blood. ACOG also points out that no one knows how long cord blood can successfully be stored.

 芝加哥的臍帶血公捐銀行網址: http://www.lifesource.org/