Legislators are hoping to spin medical gold out of what used to be an afterthought.

In their most recent sessions, at least 10 states enacted legislation that will expand the storage of cord blood, the blood that remains in the umbilical cord and placenta after the birth of a baby. Generally, the "after-birth" is discarded as medical waste. However, science has found that post-natal blood is a rich source of the stem cells that can be used in lieu of bone marrow for certain transplants and for medical research into treatments for illnesses such as Parkinson's disease (see box, below). "What used to be medical waste is now a medical miracle," said Colorado Representative Dianne Primavera.  

But if cord blood is precious, few programs exist to help parents donate. "When my wife and I tried to donate our daughter's cord blood, we found it extremely onerous and difficult to do so," said California Assemblyman Anthony Portantino. As a remedy, the Golden State enacted AB 34, which establishes a statewide cord blood collection program within the Department of Public Health. The department will contract with up to five blood banks to store cord blood, seek donations from patients and hospitals, educate the public and train health professionals on how to retrieve and store the resource.

Program officials also will look for ways to increase donations from minority patients. Marrow transplants require that donor and recipient have a nearly identical genetic match, which can increase the difficulty of matching patients of differing ethnicities. Expected to cost $3 million to $5 million per year, the program will be funded by general revenues and private donations.

Down South, the Peach State enacted "Keone's Law" (SB 148), named for Keone Penn who in 1998 was cured of sickle cell anemia through cord blood treatment. “Tragically, after most births, the umbilical cord is thrown away as medical waste,” said Senator David Shafer. The law calls for Georgia to create a network of private and public blood banks that will collect and store postnatal blood and tissue. Additionally, starting in 2009, every pregnant woman in Georgia is to receive information from her doctor on the options available for donating and storing cord blood unless the doctor specifically objects on religious grounds.  

The Legislature will provide start-up funds and Georgia taxpayers will have the option of contributing part of their tax refunds to the commission or they may donate money on top of taxes owed. The commission also may seek federal funding or establish a foundation to solicit private donations.

In Colorado, legislators enacted a law (HB 1372) to create the Adult Stem Cell Cure Fund, which will provide financial resources to public blood banks. The law also will create a public awareness campaign to encourage new mothers to donate to these banks, which will become part of a federally funded national registry. (In 2005, Congress passed HR 2520, which makes funds available to blood banks in order to create a national registry similar to the one for bone marrow.)  Money for the fund would come from a voluntary income tax check-off. Colorado has 14 other such tax check-offs, which have raised between $47,000 and $244,000 in the past year for their respective causes.

"Sadly, many are not aware that the umbilical cord contains life-saving cells that can be used to treat diseases, find cures and save lives," said New York Senator John DeFrancisco. The Empire State's SB 1265, will establish a program within the Department of Health to develop a public education campaign on the benefits of cord blood banking and research. Similar educational efforts are included in new laws in Illinois (HB 642), Louisiana (HB 861), Oklahoma (HB 3060), Pennsylvania (HB 874), Texas (HB 709) and Washington (HB 2431). Public cord banks already exist in Massachusetts, New Jersey and Virginia.

"ETHICAL" STEM CELLS Cord blood is becoming more popular as an alternative to bone marrow transplants for treating diseases such as Leukemia. Cord blood does not have to match a patient's blood and tissue type to the same extent that bone marrow does, which helps ease recovery and makes finding a donor match easier. Additionally, patients receiving cord blood transplants suffer fewer instances of graft-versus-host disease, a condition where transplanted cells reject the host, limiting the patient's chance of survival. The cells that come from cord blood are sometimes called "ethical stem cells," since they are free of most of the controversies that surround embryonic stem cells. In 2004 the Vatican put out a document fully supporting the use of umbilical cord blood in medical research. According to the National Institutes of Health, "Stem cells, directed to differentiate into specific cell types, offer the possibility of a renewable source of replacement cells and tissues to treat diseases including Parkinson's and Alzheimer's diseases, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, and rheumatoid arthritis."