Ministers' Deputies
    CM Documents

    CM(2004)47 21 April 2004
    ——————————————

    884 Meeting, 19 May 2004
    6 Social cohesion


    6.3 European Health Committee (CDSP)

    Abridged report of the 54th meeting (Strasbourg, 25-26 November 2003)

    ——————————————

    1. The European Health Committee (CDSP) held its 54th meeting on 25 to 26 November 2003 in Strasbourg under the Chair of Ms Taru Koivisto (Finland). The agenda is set out in Appendix 1. The list of participants is included in the full report, which can be obtained directly from the Health Division.

    2. The CDSP was informed by the Netherlands delegation that under its Chairmanship of the Committee of Ministers (November 2003 to May 2004) the health-related activities of the Council of Europe will be highlighted. A meeting of high officials in the field of health had been organised on 14-15 October 2003 in The Hague. The aim of this meeting was to discuss programming and setting priorities of the Council of Europe's health agenda. The Netherlands Delegation submitted a document with the results of the meeting entitled “Council of Europe's public health and related activities: towards a strategic approach”.

    2.1 The main conclusions of the document were that, within the Council of Europe, health-related issues were dealt with in a rather fragmented way. A co-ordinated approach was missing and visibility needed to be enhanced. A system would have to be elaborated in order to oversee and programme the various health-related activities. The mechanisms to be established to implement this process would be the next step to take. In conclusion, better in-house co-operation and better external co-operation was to be pursued.

    2.2 The document was fully endorsed by the CDSP. The Netherlands delegation would now bring the document to the attention of the Committee of Ministers.1 The Committee is asked to subscribe to the main principles of the strategic approach and to take a decision with a view to entrusting the CDSP, as the only intergovernmental body exclusively dealing with public health and related issues, to start the implementation process described in the document.

    3. The Director General of Social Cohesion, held an in-depth exchange of views with the CDSP on the developments made since the 53rd CDSP meeting as regards the “Integration of the activities of the Partial Agreement in the Social and Public Health Field into the regular programme of activities”. The initiative as proposed by the Secretary General was complemented by presentations made by two advisers, one on legal issues and one on budgetary issues.

    3.1 The legal adviser explained the options to dissolve partial agreements as well as ways and means of integration of Partial Agreement activities into the Programme of Activities financed by the General Ordinary Budget. He said that this was the first time the hypothesis of dissolution of a Partial Agreement of the Council of Europe was raised.

    3.2 The adviser on budgetary issues presented hypothetical budgetary implications of the integration stretched over three years, showing indicative figures as regards in particular staff costs and overheads, as well as Partial Agreement member and non-member states' contributions to the Partial Agreement Budget and to the General Ordinary Budget.

    3.3 The CDSP underlined the fact that lack of written information and missing transparency made it impossible to hold a proper discussion on the Secretary General's initiative.

    3.4 The CDSP concluded that a number of options still remained to be considered as regards the Secretary General's initiative on “integration”. The CDSP reiterated its request for a detailed document setting out: the rationale of the Secretary General's initiative; the legal aspects; the budgetary data and tables setting out details of transfers from Partial Agreement Budget to the General Ordinary Budget; an organisation chart indicating transfers of human resources. The CDSP agreed to take up this item again at its next meeting.

    4. The CDSP reviewed the state of implementation of its work programme for 2003.

    4.1 The CDSP adopted:

    - The draft Recommendation on the impact of information technologies on health care – the patient and internet. This draft Recommendation emphasises the role of the internet as new information source for the patient. Provided that this information is of good quality the use of the internet would lead to a new partnership between health professionals and the better informed patients.

    The draft Recommendation will be transmitted to the Committee of Ministers for adoption at one of its forthcoming meetings.

    - The draft Recommendation on organ trafficking with a view to its submission to the Committee of Ministers for adoption (Appendix 2).

    Reports on organ trafficking have a negative impact on the organ donation rate since they reduce public trust in the transplantation organisation. The draft Recommendation gives guidance to member states on appropriate organisational and legal measures to put in place in order to minimise the risk of organ trafficking. The Recommendation highlights the public health risks associated with organ trafficking while making proposals of how to maintain public trust in the transplant system.

    - The draft Recommendation on autologous blood banks with a view to its submission to the Committee of Ministers for adoption (Appendix 3).

    This draft Recommendation recommends to member states to allow establishments of cord blood bank only if they are from altruistic and voluntary cord blood donation. More generally, the promotion of cord blood donation for autologous use and the establishment of cord blood banks for autologous use should not be supported by member states or their health services.

    - The 2003 revision of the technical Appendix (10th edition of the Guide) to Recommendation No R (95) 15 on the preparation, use and quality assurance of blood components.

    4.2 The CDSP took note with satisfaction that the following draft Recommendations had been completed and would be reconsidered with a view to adoption at its next meeting:

    - The draft Recommendation on health and media. This draft Recommendation emphasizes the responsibility of health authorities to provide the general public with health information thus broadening the public's general knowledge about health;

    - The draft Recommendation on teaching transfusion medicine to nurses. This draft Recommendation stresses that only nurses who have been specifically trained in blood transfusion medicine should be allowed to practice it;

    - The draft Recommendation on requirements of facilities eligible for organ transplantation. The draft Recommendation will help member states to develop criteria for the authorisation and/or accreditation of health care facilities carrying out organ transplantation.

    The CDSP made progress on setting a number of principles on how health issues should be addressed in a possible revision of the relevant articles in the Social Charter and agreed to consider the proposed text at its next meeting.

    4.3 The CDSP took note of the progress in the implementation of the work carried out by the Committee of Experts on “Health services in a multicultural society”, “Management of safety and quality in health care – prevention of adverse events in health care, a system approach” and “Hospitals in transition: new balance between institutional and community care”.

    5. The CDSP examined Parliamentary Assembly Recommendation 1626 (2003) on the reform of health care systems in Europe: reconciling equity, quality and efficiency and Parliamentary Assembly 1611 (2003) on trafficking in organs in Europe, and agreed to submit to the Committee of Ministers its opinions on them.

    6. With reference to the European Union Directive on setting standards of quality and safety for the collection, testing, processing, storage and distribution of human blood and blood components (2002/98/EC), adopted on 27 January 2003, the CDSP noted with satisfaction the co-operation between the Council of Europe and the European Commission in this field; it welcomed in particular that the standards of the technical requirements to be elaborated under Article 29 of the said Directive will be compatible with the Council of Europe 10th edition of the Guide to the preparation, use and quality assurance of blood components.

    With the adoption of the 10th edition of the Guide to the preparation, use and quality assurance of blood components, the same technical requirements for blood and blood components will now apply pan-European wide.

    7. The CDSP examined and approved its work programme for 2004. In this context the CDSP was informed of the cuts requested by the Secretary General in the intergovernmental programme. For the intergovernmental programme of the health activities planned in 2004 these amounted to a reduction of
    5.7% compared to the 2003 budget. The CDSP deplored this budgetary reduction which would affect the opportunity to carry out assistance activities in 2004.

    8. The CDSP noted with satisfaction that within the framework of the Joint Co-operation Programme with the Council of Europe Development Bank the importance was growing as regards health assistance activities. In that context the CDSP was pleased with progress made on the health component in the Stability Pact Social Cohesion Initiative by the South Eastern Europe Health Network set up by the Council of Europe and WHO, with the participation of the Council of Europe Development Bank.

    9. The CDSP agreed to hold its next plenary meeting on 15 and 16 June 2004 in Strasbourg.

    Appendix 1

    DRAFT AGENDA

    1. OPENING OF THE MEETING

    2. ADOPTION OF THE AGENDA

    3. REPORT OF THE BUREAU

    4. ELECTION OF A NEW CHAIRPERSON AND OF NEW MEMBERS OF THE BUREAU

    5. DECISIONS OF THE COMMITTEE OF MINISTERS

    5.1 Report of the 53rd meeting

    5.2 Report on laws and/or practices of member states with regard to the issues raised by Parliamentary Assembly Recommendation 1418 (1999) on the protection of the human rights and dignity of the terminally ill and the dying

    5.3 Parliamentary Assembly Recommendation 1611 (2003) on trafficking in organs in Europe

    6. ACTIVITIES OF AND CO-OPERATION WITH OTHER INTERNATIONAL ORGANISATIONS

    6.1 European Commission, WHO (Europe) and the Federation of Red Cross and Red Crescent Societies

    6.2 Meeting of the Chief Medical Officers of the member states of the European Union

    6.3 5th Tripartite meeting (European Commission, WHO, Council of Europe)

    7. INTEGRATION OF THE ACTIVITIES OF THE PARTIAL AGREEMENT IN THE SOCIAL AND PUBLIC HEALTH FIELD INTO THE REGULAR PROGRAMME OF ACTIVITIES

    A. IMPLEMENTATION OF THE CURRENT WORK PROGRAMME

    8. EQUITY IN ACCESS TO HEALTH CARE AND HEALTH PROMOTION – PATIENT'S RIGHTS AND CITIZEN PARTICIPATION

    8.1 Revision of Article 11 of the Social Charter

    8.2 The impact of information technologies on health care – the patient and internet

    8.3 The media and health

    8.4 Health services in a multicultural society

    8.5 Management of safety and quality in health care – prevention of adverse events in health care, a system approach

    8.6 Hospitals in transition: new balance between institutional and community care

    8.7 Transborder mobility of health professionals and its implications for functioning of health care systems

    8.8 Health Promotion and Health Education – the ENHPS

    8.9 Assistance activities

    9. AVAILABILITY OF AND ACCESS TO SAFE AND GOOD QUALITY IN HEALTH CARE SERVICES

    9.1 Blood Transfusion and Immunohaematology

    9.2 Preparation, use and quality assurance of blood components

    9.3 Cellular immune therapies – ways to provide safe products meeting high quality standards

    9.4 Organ transplantation

    9.5 Safety and quality assurance for organs, tissues and cells

    9.6 Assistance activities

    B. FUTURE PROGRAMME AND METHODS OF WORK

    10. INTERGOVERNMENTAL PROGRAMME OF ACTIVITIES FOR 2004 AND FOR 2005/2006

    11. ASSISTANCE PROGRAMME OF ACTIVITIES FOR 2003
    CO-OPERATION WITH THE COUNCIL OF EUROPE DEVELOPMENT BANK

    12. WORKING METHODS

    C. INFORMATION

    13. EXCHANGE OF VIEWS AND INFORMATION

    13.1 7th Conference of European Health ministers on Health, Dignity and Human Rights

    13.2 The Netherlands Chairmanship of the Committee of Ministers of the Council of Europe – Programme in relation to health activities

    D. MISCELLANEOUS

    14. OTHER BUSINESS

    14.1 Draft Recommendation on the protection of the human rights and dignity of people suffering from mental disorder

    14.2 Agreement No. 80 on the transfer of corpses

    14.3 The work of the various bodies of the Council of Europe in the sectors of interest of the European Health Committee

    15. DATE AND PLACE OF THE NEXT MEETING

    Appendix 2

    Recommendation Rec(2004)…
    of the Committee of Ministers to member states
    on organ trafficking

    (Adopted by the Committee of Ministers on … … 2004
    at the … meeting of the Ministers' Deputies)

    The Committee of Ministers, under the terms of Article 15.b of the Statute of the Council of Europe,

    Considering that the aim of the Council of Europe is to achieve greater unity between its members and that this aim may be pursued, inter alia, by the adoption of common action in the field of health;

    Taking into account Resolution (78) 29 on harmonisation of legislation of member states relating to removal, grafting and transplantation of human substances and the final text of the 3rd Conference of European Health Ministers (Paris, 16-17 November 1987), and the World Health Organisation Resolution WHA 42.5 condemning the purchase and sale of organs of human origin;

    Having regard to the Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine (ETS No. 164) and in particular to Articles 19 and 20 thereof;

    Bearing in mind the requirements of the Additional Protocol to the above convention on Transplantation of Organs and Tissues of Human Origin, and in particular that Article 22 requires the prohibition of organ and tissue trafficking; that Article 3 requires member states to have a transplant system in place which allocates organs, and where appropriate tissues, only to those on the official waiting list; that Article 26 requires member states to provide for appropriate sanctions to be applied in the event of any infringement of the provisions contained in the aforementioned protocol; that Article 21 requires that the human body and its parts shall not, as such, give rise to financial gain or comparable advantage,

    Considering that:

    The universal shortage of organs and tissues can lead patients to a desperate search for a transplant which may involve unacceptable practices from a legal or ethical point of view;

    Organ shortage can also encourage illegal organisations to traffic human beings for the purpose of organ transplantation, or to traffic organs obtained as a result of inducement or coercion;

    Organ trafficking may undermine public confidence in organ and tissue transplantation services, decreasing the public's disposition to legitimate organ donation, thereby exacerbating the shortage of organs and tissues for transplantation,

    Recommends that the governments of member states conform with the requirements set out in the appendix to this recommendation.

    Appendix to the recommendation:

    Article 1 – Object

    Member states should protect the dignity and identity of all persons and guarantee without discrimination their fundamental rights and freedoms with regard to organ and tissue transplantation.

    Member states should make it clear to all that organ trafficking exploits human beings and is illegal, and should take all possible measures to prevent organ trafficking (see Article 4).

    Article 2 – Scope and definitions

    1. The provisions of this recommendation shall apply to all living persons and to the removal of organs, tissues and cells from those recently deceased.

    2. The provisions of this recommendation applicable to tissues shall apply also to cells, including haematopoietic stem cells.

    3. The provisions of this recommendation do not apply to blood or blood derivatives.

    4. For the purposes of this recommendation the term “organ and tissue trafficking” applies to:

    · The transportation of a person to a place for the removal of organs or tissues without his or her valid consent;
    · The transportation of a person to a place for the removal of organs or tissues with his or her consent but in contravention of legislation or other controls in operation in the relevant jurisdiction;
    · The transplantation of removed organs and tissues, whether transported or not, in contravention of legislation or other regulations in operation in the relevant jurisdiction or in contravention of international legal instruments.

    5. For the purposes of this recommendation:

    · The term “transplantation” covers the complete process of removal of an organ or tissue from one person and implantation of that organ or tissue into another person, including all procedures for preparation, preservation, storage and transportation.
    · The term “removal” refers to removal from the body of an organ or tissue intended for transplantation, by a surgical procedure or by other means.

    Article 3 – Prevention

    Prevention of organ trafficking should be undertaken in an integrated way by:

    · Improving organ and tissue availability by well-established means such as those described in the Council of Europe consensus document “Meeting the organ shortage: current status and strategies for improvement of organ donation” (1999);
    · Approving a legal framework which strictly forbids any kind of commercialisation of the human body and its parts consistent with the Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine (ETS No. 164). Legislation should be extended to citizens going abroad. However, medical care should not be denied;
    · Assuring the traceability of human organs and tissues through the accreditation and control of centres for procurement and/or transplantation, tissue banks, and the follow up of patients;

    · In the case of a living donor transplant, member states should provide for official authorisation of all such transplants;
    · In all cases where the living donor is a foreign citizen, the relevant officially recognised bodies in the country of transplantation and in the home country of the living donor must be informed;
    · In the case of a living donor, all payments to the donor should be strictly prohibited and considered a criminal offence.

    This provision should not apply to payments which do not constitute a financial gain or a comparable advantage, in particular:

    - compensation of living donors for loss of earnings and any other justifiable expenses caused by the removal or by related medical examinations;

    - payment of a justifiable fee for legitimate medical or related technical services rendered in connection with transplantation;

    - compensation in case of unjustified harm resulting from the removal of organs or tissues from living donors.

    Article 4 – Legal instruments

    1. Member states should ensure that there are legal instruments in place which prohibit the trafficking of persons for the purpose of organ or tissue transplantation and the trafficking of organs and tissues themselves.

    2. Member states should ensure that those legal instruments prohibit:

    · The removal of organs and tissues except in centres or circumstances recognised for the purpose and by health professionals with appropriate training and experience;
    · The implantation of organs and tissues except in centres or circumstances recognised for the purpose and by health professionals with appropriate training and experience;
    · Financial gain from the human body or parts of the body intended for transplantation;
    · Advertising with the intention of securing persons or organs or tissues for trafficking or for financial gain;
    · Organising or running an organisation or service involved in organ or tissue trafficking.

    3. Member states shall ensure that legislation provides for appropriate sanctions to be applied in the event of any infringement of the provisions of this recommendation.

    Article 5 – The transplantation system

    1. Member states shall ensure the provision of a nationally recognised transplantation system which guarantees equitable access to transplant services.

    2. National transplant waiting lists should be established in compliance with the Council of Europe's Recommendation Rec(2001)5 on the management of organ transplant waiting lists and waiting times.

    3. The system shall ensure that:

    · Appropriate information is recorded on all organs and tissues removed for the purposes of transplantation;
    · All organs, and where appropriate tissues, are only allocated to persons who are on a nationally recognised waiting list;
    · Appropriate information is recorded on all organs and tissues used for implantation or other purposes;
    · Information on the risks associated with organs obtained illegally is provided.

    4. The information provided should ensure traceability from donor to recipient but shall be collected, processed and communicated in accordance with regulations relating to confidentiality and personal data protection.

    Article 6 – International co-operation

    1. Organ trafficking is a universal problem. Therefore international co-operation is required to combat it.

    2. Member states should ensure full co-operation with all other states and with international agencies, including law enforcement agencies, in order to combat organ trafficking, and apply the sanctions provided for in this recommendation to any person or entity involved in organ trafficking.

    3. Member states should present a full report of any allegations or instances of organ trafficking within their territory to the Secretary General of the Council of Europe.

    Article 7 – Information for the general public

    Member states should ensure that the general public is fully informed about organ trafficking and the penalties which may be incurred. In particular:

    · Accurate information about organ and tissue donation and transplantation should be provided;
    · Organ and tissue donation should be promoted as positive behaviour that contributes to saving lives and improving the health of many people;
    · False reports on organ trafficking may alarm the general public and adversely affect organ and tissue donation and should be refuted.

    Appendix 3

    Recommendation Rec(2004)...
    of the Committee of Ministers to member states
    on autologous cord blood banks

    (Adopted by the Committee of Ministers on … … 2004
    at the … meeting of the Ministers' Deputies)

    The Committee of Ministers, under the terms of Article 15.b of the Statute of the Council of Europe,

    Considering that the aim of the Council of Europe is to achieve greater unity between its members and that this aim may be pursued, inter alia, by the adoption of common action in the field of health;

    Taking into account Resolution (78) 29 on harmonisation of legislation of member states relating to removal, grafting and transplantation of human substances and the final text of the 3rd Conference of European Health Ministers (Paris, 16-17 November 1987);

    Having regard to the European Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine (ETS No. 164) and in particular to Articles 19 and 20 thereof;

    Having regard to the Additional Protocol to the Convention on Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine concerning the Transplantation of Organs and Tissues of Human Origin (ETS No. 186);

    Considering that:

    The principal current use of blood cells collected at the time of birth from the umbilical cord (cord blood) is the collection of haematopoietic progenitor cells (HPC) that can be transplanted into patients with acquired or congenital diseases of the bone marrow. It is likely that such cells will, in the future, constitute a valuable source of cell therapies for the treatment of a wide range of diseases;

    Cord blood stored only for autologous use, that is,. by the donor or his or her immediate family, is only very rarely used. Furthermore, there is no scientific evidence that umbilical cord blood can be stored for long enough to be of any use to the vast majority of donors. Such storage could limit altruistic donation and thereby limit the possibility of treating those in need;

    The unregulated collection of blood at the time of birth could distract the staff caring for mother and child at a critical time;

    Even if it is the case that these children do, in the future, develop diseases requiring an HPC transplant, there is evidence to suggest that it is preferable to use allogeneic transplantation to achieve the “graft vs. tumor effect” in hematological diseases. In cases of congenital disease and in some leukaemias with intrauterine cell mutations, autologous HPC transplantation is contraindicated;

    The health services of member states should only provide their citizens with proven clinical and cost effective therapies as resources are always limited;

    With the aim of ensuring the availability of transplant treatments for an increasing number of people,

    Recommends to the member states that:

    1. If cord blood banks are established, they should be based on altruistic and voluntary cord blood donation and used for allogeneic transplantation and related research.

    2. The promotion of donation for autologous use and the establishment of cord blood banks for autologous use should not be supported by member states or their health services.

    3. Accurate information should be provided to the population about the advantages and disadvantages of cord blood banks.

    4. Where autologous cord blood banks are being established, the promotional material or information provided to families must be accurate, and fully informed consent to cord blood storage must be obtained.

    5. Autologous cord blood banks that are being established must meet the quality and safety standards set out in the Council of Europe's Guide to safety and quality assurance for organs, tissues and cells.

    EXPLANATORY MEMORANDUM

    On autologous cord blood banks

    The principal current use of umbilical cord blood (UCB) is the collection of haematopoietic progenitor cells that can be transplanted into patients with acquired or congenital diseases of the bone marrow. In addition, it is known that umbilical cord blood could be a source of stem cells.

    Autologous umbilical cord blood banks reserve the use of stored UCB for donors who develop pathologies that can be addressed by haematopoietic progenitor cell (HPC) transplantation. In certain cases, these banks also allow the use of a donor's UCB by his or her relatives.

    Some of the reasons given by the industry supporting the creation of these banks are analysed below:

    Autologous UCB banks as a source of HPC

    Reasoning:

    UCB can be stored for possible future use if the child or its relatives develop pathologies that might be curable by HPC transplantation.

    Explanation:

    § Currently, umbilical cord blood is one of the sources of HPC; these cells can be used to treat patients with acquired or congenital diseases of the bone marrow.

    The creation of autologous UCB banks and the promotion of donations for autologous use could endanger altruistic and voluntary UCB donations, essential for an important number of patients (in Spain, for example, more than 400 people a year need non-related donations). There is an international system in place for locating compatible donors. There are 8.5 million bone marrow donors in the world and about 141 000 stored units of voluntarily donated UCB. Even though the number of donors seems to be increasing, due to the need for HLA compatibility between donor and recipient, only 30-40% of patients succeed in finding a compatible donor. For that reason, a decrease in altruistic and voluntary donations will make it increasingly difficult to find HLA compatible donors.

    § The probability that the autologous UCB stored in these banks will be used (in other words the probability that these children will develop a pathologies requiring HPC transplantation) is very low. The vast majority of autologous stored UCB units will never be used.

    § Even if it is the case that these children do, in the future, develop diseases requiring an HPC transplant, there is evidence to suggest that it is preferable to use allogeneic transplantation to achieve the “graft vs. tumor effect” in hematological diseases. In cases of congenital disease and in some leukemias with intrauterine cell mutations, autologous HPC transplantation is contraindicated.

    However, if UCB is donated to a normal UCB bank it can be located in the future either for autologous or heterologous use.

    Autologous UCB banks as a source of stem cells

    Reasoning:

    UCB could be a source of stem cells for the child in the future. It could be used to obtain cells or even organs for transplantation. For this reason, the storage of UCB of all newborns is justified.

    Explanation:

    § From a scientific point of view, at present, the clinical use of stem cells from UCB is a promising treatment but is still in a research phase. Two ongoing experimental trials in mice demonstrate the potential of stem cells from UCB to regenerate nervous tissue. However, these studies are still in an early experimental phase and no clinical trials have been carried out in humans. Stem cell production from adult tissue is also a possibility and the methodology will probably be improved in the future.

    § Stem cells are also being used in clinical trials to regenerate heart muscle, but these cells can be harvested from adults. On the other hand, the development of organs from stem cells is not yet a realistic option.

    § The storage of UCB of all newborns would mean the creation of a significant number of UCB banks (autologous banks), and also the collection, storage and preservation of a very large number of UCB units. Sooner or later, these banks would fall under the auspices of national health systems, resulting in very high costs without any clear benefits.

    § The other option is private UCB autologous banks. Parents who voluntarily wish to store their child's UCB could do so by paying the bank for the collection, preservation and storage of UCB units. Such banks already exist in countries such as the United States, the United Kingdom and Germany, but are prohibited in countries such as Italy.

    At present there is no scientific rationale for the universal storage of UCB. It is not justified that parents pay for an unproven service without definite therapeutic use. There is therefore a need for controls, to facilitate the provision of accurate information to the family, and to ensure that proper informed consent is obtained. Autologous blood banks should be regulated by the same rules and should meet the quality standards recommended by the Council of Europe.

    § There is a conflict of interest between parental freedom to invest money as they choose and the obligation of the administration, for public health reasons, to restrict this type of commercialisation.

    UCB mixed banks (autologous banks and voluntary banks)

    A UCB unit could be divided in two parts, one to be stored for autologous use and the other to be donated voluntarily to an allogeneic bank.

    § It is necessary to take into account that the viability of a UCB transplantation is dependent on the number of HPCs. Using only 50% of the volume of the unit could endanger the success of a transplant.

    § The other possibility is to collect a UCB aliquot of newborns and create a bank of UCB samples for their use in the future, and donate the rest of the UCB to an allogeneic bank. Currently, cellular expansion techniques are not well developed, therefore the collection of this aliquot is without value as its subsequent growth is not feasible.

       

    Name

    Country

    Start of
    activity

    Number
    UCB

     

    Europe

    2000

    7 500

     

    Germany

     

     

     

    United Kingdom

     

     

    Cryo – Cell

    Belgium

     

     

     

    Netherlands

     

     

     

    Austria

     

     

     

    Ireland

     

     

     

    Switzerland

     

     

    Cryo care (part of Cryo-Cell)

    United Kingdom

    2001

    917

    Vita 34

    Germany

    1997

    12 000

    New England Cord Blood Bank

    United Kingdom

    2002

    300

    New England Cord Blood Bank

    Turkey

    2002

     

    Vita cord

    Austria

    2002

     

    Lifecord

    Austria

    2002

     

    Cryocare

    Germany

    2001

    2 000

     

    Ireland

    2002

     

Note 1 It has been done at the 880th Deputies' meeting (7 April 2004. item 6.5).


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