Coalition of international health organizations oppose compensation for bone marrow donors

Mar 23 2010

Voicing concern about the potential impact on patient and donor safety, nine leading international health organizations have formed a coalition to oppose compensating people who provide bone marrow for transplantation.

“To risk potentially undermining support for marrow donation by allowing donor compensation is irresponsible and short-sighted.”

The organizations — each a leader in the field of transplantation and transfusion therapies — have joined forces in the face of a lawsuit aimed at overturning current U.S. law regarding bone marrow donation. The Institute for Justice is seeking to reverse the National Organ Transplant Act of 1984, as it applies to the prohibition on compensating bone marrow donors.

Bone marrow transplantation can be the best option for a cure for thousands of patients battling leukemia, lymphoma and other critical illnesses.

“Decades of experience and research have shown that a donor system that relies on the human, purely altruistic desire to help others is safer than one that focuses on personal gain,” said Jeffrey W. Chell, M.D., chief executive officer of the National Marrow Donor Program® (NMDP). “There is no sound evidence that compensating donors will save more lives or increase racial diversity of donors. In fact, doing so may expose marrow recipients to greater risks of infectious diseases.”

The coalition includes the NMDP, America’s Blood Centers, AABB (formerly American Association of Blood Banks), the American Society for Blood and Marrow Transplantation, American Society of Histocompatibility and Immunogenetics, the American Society of Transplantation, International Society of Cellular Therapy, The Transplantation Society, and the World Marrow Donor Association.

They oppose changing the current law, citing these reasons:

Protecting Recipient and Donor Safety

A complete and truthful health history is critical to ensure that individuals are eligible to donate and that donated cells are free from infectious diseases. There is a substantial body of experience that people wanting to sell their body parts are more likely to withhold medical details and information that could harm patients.

Maintaining Altruistic Motivations

Studies have shown that compensating donors would deter those who are willing to donate for purely altruistic reasons. The eight million members of the Be The Match Registry® — in addition to the five million volunteer donors on international registries — are proof that people do not need material incentive to save a life. Current law already allows donors to be reimbursed for out-of-pocket expenses and lost wages. The NMDP and other organizations maintain funds expressly for this purpose.

Avoiding the Creation of Markets in Marrow Donation

Compensation has the potential to create markets for marrow, which could have detrimental effects for both donors and patients. Sellers influenced by possible financial gain could ignore the health risks associated with donation or be coerced by third-party organizations that would profit from a marrow sale. In addition, markets put physicians in the morally dubious position of carrying out medical procedures solely so that sellers may profit.

”The creation of markets is likely to elicit criticism from groups that oppose treating the human body and its parts as property,” said Art Caplan, professor of bioethics at the University of Pennsylvania. “To risk potentially undermining support for marrow donation by allowing donor compensation is irresponsible and short-sighted.”

Ensuring Patients’ Access to Treatment

While the Institute for Justice’s lawsuit alleges compensation might increase patients’ access to bone marrow, the opposite is true.

Changing the U.S. law to allow compensation for marrow donors would set a precedent that could hurt the current voluntary systems for organ and blood donation, potentially undermining some patients’ access to safe organ transplants and blood transfusions. If donors were compensated, the United States would no longer conform to international standards for the use of volunteer donors in cell therapies. Thus, patients in the United States may be unable to have access to the worldwide search process. This would restrict Americans’ chances of finding a match and lives may be lost.

The historical record clearly established that paid blood donors were more likely than voluntary donors to transmit infectious agents, such as HIV and hepatitis viruses. It is a matter of concern that such increased risk could also occur among paid marrow donors.

The NMDP is a global organization that works with leading transplant centers and 70 donor registries in 35 countries. These international partnerships are vital to helping increase patients’ access to potential donors, coalition members say. In fact, about half the transplants facilitated by the NMDP in 2008 involved either an international donor or patient.

“In the best interests of patients and donors, the existing law must be upheld,” said Dr. Chell, who called on U.S. Attorney General Eric Holder to vigorously defend the challenge.

Source The Institute for Justice