Using umbilical cord blood stem cells for myocardial infarction and stroke is ethically challenging.

摘要

Editor - It is disingenuous for stem cell-researchers such as Copeland et al (Clin Med August 2009 pp 342-5) to claim that 'hUCB (human umbilical cord blood) is readily available, and presents little ethical challenges'. They must be aware that until the feto-placental circulation is interrupted by human professional intervention, that blood has a life-sustaining function. Without cord clamping, placental transfusion occurs and most of the blood then resides in the neonate. Pressure to separate mother and baby has created an apparent 'waste product' that may be valuable to researchers (and vested commercial interests). The earlier the cord is clamped, the more hUCB is 'readily available' for collection and the less is available for the neonate. Growing awareness of the impact of this irreversible intervention during the transitional circulation has led professionals responsible for the health and wellbeing of the new mother and baby to take a more cautious view.1 In view of findings of long-term developmental problems in children apparently successfully resuscitated after birth, we hypothesised that early clamping may lead both to neonatal depression and inadequate cerebral oxygenation.2'3 Physicians caring for adults and concerned about the alleviation of damage to adult vital organs must be aware of the ethical concerns about the use of vital material taken at birth.