Friday, October 27, 2017

Bone marrow and blood stem cell update

Here's an article that recounts the recent events regarding payment to donors of blood stem cells.

Hope for to-marrow: the status of paid peripheral blood stem cell donation under the National Organ Transplant Act 
Kelly Todd
Journal of Law and the Biosciences, Volume 4, Issue 2, 1 August 2017, Pages 412–423


The National Organ Transplant Act (NOTA), enacted in 1984, bans the exchange of bone marrow and a number of other human organs for valuable consideration. At the time NOTA was enacted, bone marrow could only be harvested by aspirating bone marrow tissue from a donor's bone cavities. However, recent medical and technological advances now allow doctors to use a much less invasive apheresis method, which collects the transplantable stem cells from a donor's peripheral blood stream. In 2009, the Court of Appeals for the Ninth Circuit held that such donations do not fall into the category of “bone marrow” under NOTA, and can therefore be compensated. Not long after the court's final ruling, the Department of Health and Human Services (HHS) proposed a rule to explicitly bring hematopoietic stem cells back under the purview of NOTA. The transplant community, seeing compensated donation as a solution to the shortage of altruistic bone marrow donors, fiercely opposed the rule. After years of limbo, HHS officially withdrew the proposed rule in August, 2017, which will allow groups to financially incentivize potential peripheral blood stem cell (PBSC) donors. This commentary addresses the moral and ethical issues implicated by paid PBSC donation, the role that regulation could play, and the potential impacts of paid PBSC donation on the transplant community, Ultimately, this article concludes that providing financial incentives to PBSC donors will likely have an overall positive impact on the transplant community by encouraging more donors to join the registry, and motivating donors to follow through with their donations once matched.

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