The establishment and growth of China’s umbilical cord blood banks

Umbilical cord blood banks offer patients and clinicians an alternative source for haematopoietic (blood) stem cells for the treatment of diseases and injuries. Hybrid public-private economic strategies, national planning and governmental licensing policies have fostered the development of a large network for umbilical cord blood banks in China. Dr Hung-Chieh Chang illustrates how these and other factors continue to influence the growth of cord blood banks in China.

What background and points are discussed?

China’s UCB bank system is primarily composed of seven banks that obtained national operating licenses from China’s Ministry of Health. Other non-approved UCB banks exist, however they call themselves ‘stem cell banks’ to avoid violation of regulations and China’s national plan. Approved UCB banks do not receive financial support from the state and must generate their own revenue. Private banks charge families to store a child’s UCB, which can be used later by the family if needed. Public banks rely on donations of UCB, which are sold to clinicians/patients. Almost all approved UCB banks in China use a hybrid system that provides both services. In a case study cord blood bank examined by Dr Chang, all donated and private UCB units are searchable for patient-donor matches, but if a private UCB unit is requested, families have the choice to keep, donate or sell it. Approved UCB banks in China operate in different regions, only being able to accept donations from hospitals in their designated region. However, banks are permitted to distribute UCB units across regions to build their network of consumers. Dr Chang’s field research revealed issues that hinder more widespread use of UCB and efforts UCB banks are making to improve their networks. China is currently in need of a UCB registry like it has for bone marrow. The lack of a single platform makes finding UCB units for patients difficult. Increasing doctor’s awareness and confidence in UCB is an on-going challenge. UCB banks are attempting to inform doctors of the many benefits UCB treatments offer, such as: patient-donor matches are often easier to find; complications such as graft vs. host disease are less likely; and combining UCB with bone marrow stem cell treatments can improve results when patient-donor matches are not ideal. Summits and conferences organised by UCB banks have invited prominent speakers to give talks on UCB transplants and provide oncologists with opportunities to network with UCB banks. A recent rise in distrust of doctors across China is another current problem. Many patients are frustrated with the financial kickbacks doctors receive from pharmaceutical companies, particularly when out-of-pocket costs for treatments can be substantial. There is also the need to inform the public and build public confidence in UCB and other stem cell treatments. Some people in the public claim that UCB banking and treatments are fraudulent practices. To counter this, efforts have been made to report positive UCB treatment outcomes on TV, offer public lectures and produce informative material for internet sites and social media platforms.