Ban On Payment For Bone Marrow Donations Challenged In Lawsuit

Paying individuals for the donation of their bone marrow may become legal, if a lawsuit filed by the Institute for Justice (IJ) succeeds in overturning the current ban. The lawsuit was filed on October 28 in federal court on behalf of patients, doctors, and parents of sick children.

The IJ sued the United States Attorney General Eric Holder over the National Organ Transplant Act of 1984, which makes human organ sales illegal, including financial compensation for bone marrow donations. An overturn of the ban could have a large impact on physicians, donors, and especially patients, including those with myelodysplastic syndromes (MDS).

Bone marrow transplants are an important part of treatment in various types of blood cancers. The stem cells, after being separated from the donated bone marrow and inserted into the recipient’s bloodstream, begin to repopulate the patient’s bone marrow with new blood cells.

For MDS patients, a bone marrow transplant is the only known treatment that can bring about long-term remission. However, a transplant is not an option for all MDS patients; it is generally most effective in younger, healthier patients.

The non-profit group MoreMarrowDonors.org recruited the IJ to file the lawsuit to overturn the ban and allow for compensation to be made to donors.

“We think that there is much folly in a government law standing between a patient and a potentially life-saving program,” said Shaka Mitchell, president of MoreMarrowDonors.org. “To that end, we decided this suit is of paramount importance.”

MoreMarrowDonors.org is proposing a pilot program that will compensate the most needed donors, especially minorities, with $3,000. The money would be in the form of a scholarship, housing grant, or donation to charity. Donors and patients would be matched anonymously through a national registry.

“Our hypothesis is that many people drop off the registry or fail to follow through once contacted because they cannot afford time away from work or other commitments. By providing small scholarships, housing allowances, and gifts to charity, we think we can prevent some of the attrition that eventually leads to patients unable to find marrow matches,” added Mitchell.

In the past, transplants required the removal of bone marrow directly from the pelvic bone. The procedure has become much less invasive and painful since the development of medications that prompt the donor’s stem cells to leave the bone and enter the bloodstream. A machine filters these mobilized stem cells from the circulating blood, and the stem cells are then frozen until transplantation.

But the donor and recipient must still be perfect matches in a bone marrow transplant – even more so than in a kidney transplant. This is where the problem arises – matches are hard to come by, and patients do not have the luxury of time to wait for a match.

An overturn of the current ban could result in more donors in bone marrow registries and a higher potential for matches among MDS patients seeking a bone marrow transplant.

The National Organ Transplant Act of 1984 was originally enacted to prevent the sale of kidneys and other organs that do not regenerate. But critics argue that the original law banning compensation for organs was not meant to pertain to bone marrow – unlike a kidney, bone marrow renews itself.

“Bone marrow got stuck in the statute – by mistake,” said Jeff Rowes, the IJ’s lead attorney on the case. He described bone marrow donation as an unusual form of blood donation. “No reason to treat them like kidneys or livers,” he added.

Criticism and ethical concerns over the proposed payment of bone marrow donors have also been raised (see The New York Times Opinion blog). Some wonder if compensation will negatively affect the number of altruistic donors on the registry.

There is also concern that payment will encourage individuals to conceal health conditions in order for donations to be accepted, leading some to worry about the affect an overturn may have on the quality of the donations.

The lawsuit may take a number of years to work its way through the federal court system. In the meantime, coverage of the lawsuit in the news media may raise awareness of the shortage of bone marrow donors and trigger an influx of donors to the registry.

“The goal is to make a serious dent in the shortage of bone marrow donors,” Rowes said. “Maybe save 1,000 lives a year.”




Origianl story can be found at http://www.mdsbeacon.com/news/2009/11/12/ban-on-payment-for-bone-marrow-donations-challenged-in-lawsuit/