Public stem cell bank: dump not, donate cord blood

The Jeevan Blood Bank, based in Chennai, plans to launch Jeevan Stem Cell Bank before the end of March.

The accent is on public banking with 70 per cent of its initial capacity of 2,500 units earmarked for the said purpose.

The main source of stem cells will be umbilical cord blood that is otherwise dumped as waste.

Dr. P. Srinivasan, Chairman, spoke to R. Prasad on how the new initiative will help meet the requirements of Indians living here and abroad for treating numerous medical conditions. Excerpts:

Why is it called a public stem cell bank and not public cord blood stem cell bank?

Science is developing and new sources of stem cells are being found. Currently, stem cells can come from three sources — embryonic, peripheral and cord blood.

We don’t know from what other sources the stem cells would come in the future. Hence we decided to call it stem cell bank.

Thiry per cent of your capacity will be for private stem cell banking. So why have you called it a Public Stem Cell Bank?

Though it is actually named Jeevan Stem Cell Bank, we called it Public Stem Cell Bank in the Press Release. It is because our stress is on public stem cell banking. But we did clearly mention in the Release that 30 per cent will be for private banking.

What is the compulsion to get into private stem cell banking?

It is to cross subsidise public stem cell banking and make the project viable. We have adopted a well known model practised abroad.

What is the difference between public and private stem cell banking?

When people opt for private storage, the stem cells, say cord blood stem cells, will be exclusively available to the family members when required.

Public stem cell banks are a lot like blood banks. The donor has no right over the stem cells banked.

So what happens to stem cells stored in the public bank?

These cells will be given to any person who needs stem cells, provided there is an acceptable tissue match. We will make available a portion of the cells collected, for research as well.

Have you initiated any steps to identify potential end users of publicly stored stem cells?

Yes, we have already done that. Clinicians feel there is a vacuum [in the availability of stem cells] and are positive about the potential availability of stem cells for transplantation.

Will a person be charged for storing stem cells in a public bank?

No. The person is actually donating the cells and so will not be charged.

What is the charge for storing in a private bank?

People will be charged Rs70,000 as an one time payment inclusive of storage.

What about those who store stem cells in the public bank?

We intend to give it free to poor patients but charge Rs.1 lakh for others. If it is sent to other countries, the cost will vary from one country to another.

Is there a demand for stem cells from people living abroad?

Yes. If you consider the U.S., on an average, hundred searches are made every year for matching stem cell donors. The probability of finding such a match [by Indians] is higher among the Indian population.

It may take about 6-9 months to find a match. So if you have a sufficiently high number of units stored in public banks, the search period is cut and helps save time.

Will a person who has donated stem cells be charged if he wants them at a later date?

The person will be charged only the prevailing processing fee. If the unit donated is available, the family would get it. Else, an alternative tissue-compatible unit would be offered subject to availability.

Since your programme depends on revenue earned from private banking, will there be a conflict of interest when you approach a potential client?

There will be no conflict of interest.

Having said private banking will support the public banking, we definitely need to market private banking to such potential clients who insist on storing the stem cell for their family use and to those parents with a child that has an abnormality which could be corrected by a transplant from the sibling’s matching stem cell.

I believe, private banking still has a role and hence the need for Jeevan to venture into this domain.

To create such an awareness Jeevan will depend on clinicians who believe in evidence based medicine and our philosophy.

Are you solely dependent on revenue from private banking to sustain public banking?

We are indeed looking at alternative sources of revenue. We have identified a few. Making stem cells available for research is one main source of income.

Grants from Central and State Governments, funds from NRIs and other organisations, and donations from public, philanthropists and corporate are other possible revenue sources.

Offering our testing facilities to others is another source. Currently HLA testing is done for tissue matching. But the ideal one is molecular testing (PCR).

We will use PCR for testing stem cells. Testing using PCR is required for complying with international standards and be a part of international stem cell registry.

We intend to make PCR testing available to patients who need organ transplantation.

Testing blood for HIV and Hepatitis B and C is currently through Elisa. Molecular testing (PCR) is compulsory in the U.S., some parts of Europe, Singapore, Malaysia and Thailand. So we are looking at offering PCR based testing to other blood banks.

When do you think you will break-even?

We would be able to do it in three years’ time.

What will you do if you are flushed with funds?

It would help us to increase the number of units stored in the public stem cell bank.

Will you make it a fully dedicated public stem cell bank if you have surplus funds?

I only expect Jeevan Stem Cell Bank to become a predominantly public stem cell bank sometime in the future.

(Dr. Srinivasan can be reached at 044-28351200/28350300. Email: srinivasan@jeevan.org)

Published in The Hindu on