Cord blood bank expands to Maui

Mothers who give birth on Maui now have a chance to save lives here and across the globe through the Hawaii Cord Blood Bank, which collects umbilical cord blood that normally would be discarded and saves it for use in vital stem cell transplants.

"When mothers realize they have this opportunity to do this at no cost, who wouldn’t want to do that?" said Wes Lo, chief executive officer of Maui Memorial Medical Center. "That’s just my personal feeling. If you get a chance to save somebody’s life, even if you don’t know who they are, you’re going to take it."

The expansion of the Hawaii Cord Blood Bank from Oahu to Maui Memorial, the only hospital on the island that delivers babies, broadens the pool of potential donors for patients suffering from cancers such as leukemia and some genetic diseases.

Hawaii’s ethnic diversity makes it hard for local patients to find matches on national registries, but it also makes cord blood cells donated by island-born babies especially valuable. Although the Hawaii Cord Blood Bank is small, having banked about 2,000 units, it has a match rate on par with banks 10 times its size, according to Dr. Randal Wada, who volunteers as its medical director.

"Over the past several years, we’ve been matching some 1.5 percent to 2 percent of our inventory each year," Wada said. "The reason is that we are not competing with any other cord blood banks elsewhere. We are finding donors for patients who couldn’t find them anywhere else."

Since it was founded in 1998, the Hawaii Cord Blood Bank has made 97 matches, with stem cells going to patients as far away as Turkey, Brazil, Australia and France. After a baby is delivered and the umbilical cord is cut, the blood left behind is collected and stem cells processed and frozen until needed. The rationale for giving is simple, advocates say.

"What better way to celebrate a baby’s birth than to give someone else a second chance at life?" Wada asked. "How often can you get the chance to do something that is safe, easy and free that could save someone else’s life?"

Cord blood recently surpassed bone marrow as a stem cell source for transplants involving unrelated donors in the United States, according to the National Marrow Donor Program. The use of cord blood in transplants, which dates back to 1988, has been growing in part because stem cells from newborns are more flexible or "forgiving" than adult stem cells, so matching requirements are not as stringent.

"The end result is that generally you don’t have to match as well, and you can still get equivalent outcomes," Wada said. "That makes it particularly attractive for minorities."

Cord blood is also readily available because it has already been collected, which is important when patients with aggressive diseases might not have time to wait a month to track down an adult donor.

But both sources of stem cells are important, noted Wada, a pediatric oncologist and professor at the University of Hawaii Cancer Center, who also is medical director for the Hawaii Bone Marrow Registry. Adult donors can be registered cheaply and in large numbers based on an oral swab of their DNA. They donate bone marrow only if a match is found.

Cord blood must be collected on the chance it will be needed and stored until then, a costly undertaking.

Launched with a gift from the late Emily Castle, the Hawaii Cord Blood Bank has a small staff housed in two cubicles at Kapiolani Medical Center. Unlike other cord blood banks that employ workers to collect the cord blood, the Hawaii operation is largely a labor of love.

"This whole program runs on the efforts of a vast volunteer network that includes not just the families that are attracted to this opportunity to be of service to people, but the hundreds of nurses and doctors who take time out of their incredibly busy routines to do the collecting and help with packing and assembly," Wada said. "For this to be implemented here is really saying a lot for the public spirit of the people of Hawaii."

The move to Maui was made possible through a $50,000 grant to Hawaii Pacific Health from Hyun­dai Maui’s Tournament of Champions, and the support of Hawaiian Airlines and Action Courier Express, which will ship the units to the Puget Sound Blood Center, where they are stored and tied into an international computer registry.

Lo credited the doctors and nurses at Maui Memorial for taking on the pilot program at their hospital, which delivers close to 2,000 babies a year. The staff was trained this month on procedures and is ready to roll as expectant mothers sign up.

"We’re really excited because we’ve had people contact us from the neighbor islands to participate, and in the past we’ve had to say, ‘I’m so sorry,’" said Nola Faria, program director for the Cord Blood Bank. "This will be nice for people who are generous who want to give back to the community."

One challenge for the nonprofit bank is confusion resulting from advertising by private, for-profit companies that urge expectant mothers to bank cord blood for their own children’s possible use in future, for fees that run to thousands of dollars. As a general policy, the American Academy of Pediatrics discourages private storage of cord blood for "biological insurance."

Wada said the decision to bank privately or publicly "happens to be a real personal one." However, he added, "From my perspective as a physician who also does transplants, for a family that doesn’t have a strong history of some condition that requires transplant, there is much greater utility in spending the money you would spend to bank this privately and instead buy Pampers or start a savings account for your children’s college education."

"If more people would donate to this public resource at no cost to them," Wada added, "they would really be building something that could potentially be of much greater use in the future."