A salute for the public cord blood banks in Israel

For the first time, the public cord cell banks of Israel were saluted in a special ceremony at the Knesset on the 18th July, 2011. MK Ze'ev Bielski initiated and proposed the event.

A salute for the public cord blood banks in Israel was held in the Knesset this July. Its central theme was - the need to increase the genetic diversity of the cord blood inventory. It was sponsored by MK Ze'ev Bielski, who has done much to promote this important issue in the Knesset and in other public forums.
A central goal of the event was to publicize the important message that it is vital for public blood banks in Israel to expand their genetic diversity of cord blood units. This will give every patient a chance of finding a matching cord blood donation regardless of his family or community origins.

The ceremony was attended by Knesset Speaker MK Reuven Rivlin, Deputy Health Minister Rabbi Yaakov Litzman, and Science and Technology Minister Daniel Hershkowitz. Also present were Knesset members, doctors, representatives of public cord blood banks in Israel, mothers who generously volunteered to donate cord blood units at birth, cord blood transplant recipients, as well as many other guests who came to thank and salute the activists, leaders, and workers of public cord blood banks in Israel.

At this event, Knesset Speaker Reuven Rivlin emphasized the importance of the cord blood banks. "Recently," he said, "regulations were instated regarding the creation of a public cord blood registry in Israel and I hope that the financing issue will also be settled soon. Today, the effectiveness of a public registry has been thoroughly proved and its obvious contribution to saving lives is unquestioned. On this occasion, as a public representative I would like to thank you representatives of public cord blood banks for your efforts for the public good, and express my appreciation to the thousands of donors who are partners in your sacred enterprise. All Israel are responsible for one another (Sanhedrin 27b). On behalf of the entire Knesset and its members, I would like to strengthen your hands and wish you every success in this important, exceptional project".

MK Zeev Bielski promised to continue his efforts on behalf of the cord blood banks in Israel: "I consider it vitally important to bring Israel to the forefront of medical technology in the field of preserving cord blood in public banks," he said. "This will ensure the potential of saving the lives of hundreds more patients each year in Israel, regardless of their religion, race or gender. Together with MK Haim Katz who placed the subject of cord blood at the top of the agenda of the ARB (Work, Welfare, and Health) Committee that he heads, I will continue to make every effort to significantly increase the diversity of cord blood units. Our goal is to meet the needs of ever patient in Israel who needs a stem-cell transplant to save his life. I salute the dozens of volunteers who have worked for years with amazing determination to transform the dream of saving the sick people of Israel into a reality. The credit is wholly yours!".
(A televised interview with MK Bielski can be found on Arutz 7).

Knesset Speaker Reuven Rivlin

MK Tzipi Hotovely expressed the public's gratitude for everything that has been achieved until now, saying: "I have come to thank a wonderful group of people. It is amazing that a small effort can save the lives of so many people. May we succeed in disseminating the message that a simple blood donation can save lives, for whoever saves a single life is counted as if he preserved the entire world" (Sanhedrin 4:5).
 

The ceremony

In the course of the ceremony, moderated by Mr. Yoram Haggai Sachs, chairman of The National Council of Volunteers in Israel, data was presented to prove the vital importance of enlarging the public cord blood registry in order to save hundreds of more lives every year.

Professor Yitzchak Yaniv, director of Hemato-Oncology at the Schneider Hospital, presented the goals of the public cord blood banks in Israel. These included the collection and preservation of cord blood units from a diversity of sources in the Israeli population, collection and preservation of cord blood units designated for families who need stem cell transplants, and the creation of a large national registry that can adequately handle critical emergencies in the event of widespread radioactive damage.
In his speech, Professor Yaniv presented data of cord blood transplants worldwide, demonstrating that cord blood transplants have increased by over 800% during the past decade. Worldwide, so far, 30,000 stem cell transplants have utilized publicly available cord blood. During 2010, cord blood was used for about 45% of pediatric stem cell transplants and about 22% of adult transplants in the U.S.A.

Professor Yaniv discussed the genetic uniqueness of Israel's population that consists of an extensive melting pot of various communities from dozens of countries worldwide. Sadly, when an Israeli  patient needs a stem-cells bone-marrow transplant, two thirds of patients find no matching donor among family members. About 30-50% of these patients also cannot find a suitable donor in existing bone marrow registries. The odds are even worse when the patient is a member of a minority community that has inadequate representation in the bone-marrow registries. Furthermore, the search for a suitable donor currently takes an average of about 3-4 months. Due to these considerations, cord blood transplants are an alternative for patients who have no suitable donor in the family or in registries, or when the type of disease does not allow much time to search for a suitable donor in the bone marrow registries.
 

This link leads to a presentation Professor Yitzchak Yaniv showed during his lecture.

Data of public cord blood banks indicate the amazing diversity of the Israeli cord blood donors. They come from about 86 countries worldwide and include many ethnic minorities.
Furthermore, data from the global registry BMDW indicates that approximately 42% of the new units in public cord blood banks in Israel are unique in the world registry in terms of histocompatibility. This demonstrates the urgent necessity of the cord blood registry in Israel and the success public cord blood banks have had collecting cord blood units from the diverse population of babies born today, who well represent the uniqueness and diversity of the Israeli public.

In the course of the ceremony, the audience was deeply touched when Ms. Lara Hila Gin related how doctors diagnosed that she had leukemia AML eighteen months ago. "I began chemotherapy and my career came to a stop," she said. "Nobody in my family was a suitable donor for me and we began searching national and international registries in a race to save my life. Then, one day Professor Reuven Ohr turned to me to me and said, 'We have a wonderful gift for you — we have found a cord blood unit in the public cord blood registry that is a perfect match! I had the transplant on my birthday, receiving my own life as a gift! All this was thanks to a woman I don't even know, who chose to donate a unit to the public cord blood bank when she had a child. I am here to turn to people with influence and declare: We must enlarge the registry and we must increase public awareness. I am a living example of the necessity and importance of the public cord blood registry — it can save hundreds of patients' lives each year".

The hall was moved with emotion at the announcement that Lara's blood unit was collected by the veteran, dedicated cord blood worker of Magen David Edom, Esti Ovadiah, who was actually present in the hall. Esti now personally witnessed how the circle she opened at the time she collected a cord blood unit, closed on the day that unit saved Lara's life.
The woman who donated Lara's cord blood was not present. She was represented by Ms. Moran Elbaum who donated the 10,000th unit to the public cord blood bank of Bedomaich Chayi. In token of this, she was awarded a Certificate of Appreciation dedicated to all cord blood donors in Israel.

Mrs. Shelly Kapusta represented the ICBB Association (Israel Cord Blood Association) that first propose the cord blood law in Israel and has been promoting it for the past eight years. She made an emotional appeal to the audience: "Every year," she said, "hundreds of patients cry out to be fortunate as Lara and myself! I earnestly appeal to the government and to the public: We can and we must increase the diversity of public cord blood banks in Israel, especially for people of genetic minorities and for patients of mixed ancestry. We cry out for larger budgets that will save hundreds of patients in Israel and worldwide".

Professor Shulamit Levenberg and Professor Yitzchak Yaniv

Professor Shulamit Levenberg, head of the Faculty of Tissue Engineering at the Technion and a world scientific leader said: "I am thrilled to be here and to be a partner in this project. As a scientist engaged in research and development of future applications of stem cells, I say that we must have a large and diverse national public cord blood public registry that will save people's lives".
Professor Levenberg discussed future developments scientists are working on to bring the use of stem cells to a broader range of medical applications.
 

Battles and Bureaucracy

For the past eight years, Shelly Kapusta, chairperson of the ICBB (Israeli Association for a Public Cord Blood Bank), together with the public cord blood banks of Magen David Edom and of Bedomaich Chayi, and with the help of MKs and dozens of volunteers, has led eight years of extensive activities in cooperation with the Knesset and various government ministries.  All this has culminated in the first Day of Salute for this important, welcome project, which will help further activities promoting the increasing diversity of public cord blood in Israel with government help, along with the promotion and implementation of legal rules to regulate cord blood banks.

It is now four years since the approval of the Cord Blood Law presented to the Knesset by Minister Moshe Kahlon, which supports the increase of public registries by 1000 additional cord blood units per year. Now, about a year after funding for the public banks began, and about a month after the rules for operating public cord blood banks were set up, the public banks have so far stored about 8,000 cord blood units. These are available to public hospitals in Israel and abroad.
 

Population of Israel

Every year, about 800 new patients join the population of patients in need of a bone marrow\stem cells transplant. Only about 25% of them succeed in finding genetically suitable donors in their direct family; most patients are forced to search for a suitable donor in a frantic race against time. Appropriate donations may be found among volunteer donors, or among cord blood units donated by mothers that are available for immediate use.

Israel's population consists of many ethnic groups of varying origin. Patients from small groups that have little representation in donor registries find it more difficult to find matches in existing registries due to their unique genetic variation. Patients of mixed ancestry, that is, whose parents are of different origins (a phenomenon that is increasing due to marriage between different communities and ethnic groups) often have unique tissue classification that combines the characteristics of their diverse origins. This often makes it very difficult to find them an appropriate cord blood donation. In light of this, the public banks and the ICBB association seek to expand government support for public banks to enable them to collect thousands more units a year, which will significantly increase the genetic diversity of units as well as the chances of finding a match, when needed, for every patient in Israel.
 

Public Cord Blood Banks in Israel

The Bedomaich Chayi public cord blood bank founded in 2006 is active in the Shaare Zedek and Bikur Holim hospitals of Jerusalem. It has 3,000 cord blood units in storage. Since 2002, the public cord blood bank of the Magen David Edom has worked in the maternity ward of Wolfson Medical Center, Ichilov Hospital, Nahariya Hospital, and the Red Crescent Hospital of East Jerusalem. It presently has 3800 units present. Another bank operates in the Shiba Hospital at Tel Hashomer.

Until 2010, these organizations were financed solely by donations collected themselves. As mentioned, since July 2010, the Health Ministry gives these banks a total of about 3 million shekels annually. This is divided among all the banks and enables them to slightly increase their public task of collecting and storing additional units.

Expanding the genetic diversity of cord blood units has run into budgetary problems; the cost of collecting cord blood donations, testing that includes a full genetic profile, and deep freeze storage, amounts to approximately 5,000 shekels per unit. At present, the goal of the cord blood banks is to increase state support for collecting and storage of blood units to help the hundreds of additional patients each year in Israel who need transplants to save their lives. 

MK Zeev Bielski, Ms. Lara Hila Gin, Ms. Moran Elbaum, Ms. Esti Ovadiah,
Prof. Eilat Shinar, Mrs. Shelly Kapusta, Mr. Yoel Yosef Bucksbaum.
 

Public Cord Blood Banks Worldwide

Worldwide, and particularly in Europe and the United States, 139 public cord blood banks are currently in operation and have about 500,000 cord blood units available for patients via international databases. In many countries, governments have allocated extensive funds to enlarge the public cord blood registries, understanding the importance and necessity of having large cord blood registries available to save the lives of thousands of patients each year.

In 2005, the U.S. federal government allocated $19 million to increase the public registry by 150,000 cord blood units and for the purpose of targeted publicity and collection of cord blood from minority populations that have small representation in existing registries. An additional budget of $30 million exists today to increase the growth of the public registry and promote research in the field. In 2008, Spain accepted a national program to increase the national registry by 5000 cord blood units annually. In 2002, the Australian Government allocated $20 million to store 22,000 cord blood units in public banks. In Britain and France also, large budgets were allocated with a target of achieving 50,000 units in both countries. Only 4 months ago, the Canadian government allocated $48 million to increase its national registry.

As already mentioned, since the second half of 2010, Israel has allocated about 3 million shekel annually to enlarge the public cord blood registry. This will enable the storage of hundreds of units annually. We hope that this budget will be significantly increased in order to increase diversity and help us respond to every patient who needs a bone marrow/mast cell transplant, particularly patients from minority groups or of mixed-race origin. Our dream is for no patient to be left behind.