‘Let your child arrive saving a life’ is how Dr. Saranya Narayan, Medical director & Co-founder of Jeevan Blood Bank and Research Centre, Chennai, describes the thought behind cord blood donation. In a Q&A she elaborates on why there is an urgent need to build an inventory of stem cell units, the potential life savers.
What is cord blood donation ?
The blood collected from the umbilical cord of the newborn is a rich source of stem cells. This blood is collected after obtaining informed consent from the parents and is sent to a cord blood bank, where the stem cells are separated, tested, processed, and preserved at -196 degree centigrade using liquid nitrogen. Technically, there is no expiry date and these stem cells can be preserved for a lifetime. Scientifically, evidence exists that they can be stored for up to 24 years. The stem cells can treat around 70 blood related disorders and genetic disorders including thalassemia, sickle cell anaemia, leukaemia, and immune related disorders. Families can donate their baby’s cord blood to a public cord blood bank where someone else who needs it can use it. This is subject to HLA (Human Leucocyte Antigen) compatibility between the donor and the recipient. Jeevan is a public cord blood bank.
What are the benefits of stem cell banking?
Every year, 10,000 children are born with thalassemia and every year over a lakh people are identified with leukaemia. If they were to look for a HLA match for treatment, there is no inventory of any great size in India yet. A HLA match is ethnicity dependant. When an Indian is looking for a match there is a greater likelihood of finding a match within an Indian inventory.
This will be easier when we have that many more stem cell units. Currently, those who can afford it, approach the banks in the West where they spend enormous amounts of money to obtain it. At Jeevan, to process one stem cell unit it costs Rs.30, 000. For families that have donated the cord blood and when they require a unit, we just charge them the processing cost of Rs. 30,000. For families with an annual income of less than Rs. 5 lakhs, it is free. For those with an annual income between Rs.5 lakhs and 10 lakhs, we charge a lakh and for those with an annual income above 10 lakhs we plan to charge 2- 3 lakh.
We are taking baby steps in stem cell banking. We want to make it affordable for everyone. At our blood bank, over the last 20 years, we have seen over 30 thalassemic patients right from two years to 20 years. They require repeated blood transfusion and it leads to morbidity in such children.. Emotional and financial costs add to their woes. A stem cell transplant is the only chance of a cure for these young children.
How do you approach the donors?
We preferably approach donors in the third trimester, the seventh month of the pregnancy. They don’t have to pay anything. They have to register. We follow stringent procedures and take into account the maternal history, family history for any hematologic or genetic illnesses. The pregnancy has to be a healthy one. We only collect cord blood from single pregnancies and not twins as we need a minimum of 70 ml sample. The collected sample has to reach us within 36 hours. We process it and store it at our own cost. Though there is awareness, throwing the cord blood into the dustbin still continues. The obstetricians are the pivot for this programme and need to be committed to this concept of cord blood donation. We distribute pamphlets, banners and posters, and counsel families. We have very strict sample acceptance criteria. It is heart warming that many doctors are keen and willing to learn about the correct process.
How do you plan to spread the awareness?
We are doing it in a phased manner in the four southern states. We have tied up with hospitals. In places like Hyderabad and Bangalore, the IT sector has people from everywhere including Bihar, Orissa and Madhya Pradesh, and is a fair representation of the Indian population. In Coimbatore, we have seven or eight hospitals that have been supportive.
How many stem cell units are available at Jeevan. How does one access it?
The information about the stored stem cell units are uploaded on the BMDW (Bone Marrow Donors worldwide), an international database. It can be accessed by anyone across the world. Many transplant centres do send us requests. On an average we receive about 30-40 requests each month.
We have collected 6,600 samples so far. Of which we have stored close to 4,000 units. In 2013, Tamil Nadu Government was the first government to realise the importance of this programme and has given us funding to the tune of of Rs. nine crores spread across three years. It has accelerated our collection to a big extent. The funding will help us process 3,000 samples. We also have also taken loans through World Bank funded programmes to process another 5,000 samples. We are looking at funding from NRIs and philanthropists too to help us.
What do the families say?
Most of them ask ‘what is there in it for me’. We tell them, it is about contributing for the next generation. We tell them not the let the precious sample to go into the dustbin. It gives somebody else a chance to live.
