From staff and wire reports

The Third National Bank has set up shop at Duke University Medical Center.

Medical center?

The bank isn't really that kind of bank at all, but one that takes deposits of umbilical-cord blood collected from voluntary donors at three North Carolina hospitals. The cord blood is the only known substitute for bone-marrow transplantation. The Duke bank is the nation's third. Its first donation moved from holding status into the bank vault this week. The goal is to increase the pool of available blood units for transplantation by 6,000 to 7,000 during the next two years, said Joanne Kurtzberg, a physician who is the main investigator for the project at Duke.

Kurtzberg, a specialist in pediatric hematology and oncology and a pioneer in umbilical-cord blood transplant, has performed about a quarter of the transplants done worldwide.

Based at Duke, the Carolinas Cord Blood Bank is supported by a five-year, $8.8 million grant from the National Heart, Lung and Blood Institute, part of the National Institutes of Health.

It is one of three newly funded cord-blood banks in a project that aims to both increase the chances of finding patients compatible cord blood for potentially life-saving transplants and to find the best ways to collect, process and store the cord blood.

Just four years ago, umbilical cords were part of the cast-off waste of afterbirth. But since the first successful transplant of umbilical-cord blood from an unrelated donor to a young Duke patient, one-time medical waste has taken on a viable second purpose, Kurtzberg said.

"I think of cord blood as the ultimate in recycling," she said. "It's a material that is normally discarded, but it can be life-saving." Umbilical-cord blood can substitute for marrow in a transplant because the blood is rich in immature cells, called stem cells, that generate developing and mature blood cells.

The tissue-type match between the donor and recipient doesn't need to be as close as in a bone-marrow transplant, probably because the immature cells in the cord blood don't trigger rejection of tissue, specialists said.

Cord blood from unrelated donors has been used in transplants for about 500 patients for whom no matching donor of bone marrow could be found. Without transplant, physicians said, all the patients would have died. With a transplant, about half have survived, Kurtzberg said.

Most of those transplants have been made possible through a single cord-blood bank established at the New York Blood Center by Pablo Rubenstein. Since 1992, the New York bank has collected about 8,000 units.

With the addition of the three NHLBI-funded banks — the Duke-based bank and another not yet in operation on the East Coast, plus one on the West Coast — the overall pool is expected to be boosted by 15,000 units in the next two years, Kurtzberg said.

Officials at the centers operating the new banks hope as many as half the units collected will be from minority donors. The Duke-based bank is expected to increase the pool for black patients, while the bank based at the University of California Los Angeles is expected to increase the number of units available for Asian and Hispanic patients.

The number of potential bone-marrow donors for minority patients is so low that odds for an acceptable match are very limited. We think we can increase the chances for successful transplant by banking the cord blood of healthy minority babies who are born full term to healthy mothers," Kurtzberg said.

Duke will house the Carolinas Cord Blood Bank, processing and storing cord blood collected at Duke Hospital and Durham Regional Hospital in Durham, and at Carolinas Medical Center in Charlotte.