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While the ethical considerations spelled out below are important for all involved to think about when considering a minor as hematopoietic stem cell donor, one key question has been left out. “What does the child think?” Would you yourself donate stem cells to your sibling?
I can’t speak for all hematopoietic stem cell donors of course, but I can draw on my experiences as a long-term survivor of an autologous stem cell tranplant patient (my own stem cells) who may have had an allogeneic stem cell transplant if any of my siblings had been a match. See the study’s explanation below.
Had I been able to donate stem cells to one of my siblings or had one of my siblings been able to donate to me, we should share a bond for the rest of our lives.
Are you considering a BMT? Scroll down the page, post a question or comment to learn more about the complicated world of hematopoietic stem cell transplantation.
” Minors may ethically serve as stem cell donors provided specific criteria are met…”In the past half-century, hematopoietic stem cell transplantation has become standard treatment for a variety of diseases in children and adults, including-
“There are 3 sources of allogeneic hematopoietic stem cells: bone marrow, peripheral blood, and umbilical cord blood; each has its own benefits and risks. Children often serve as hematopoietic stem cell donors, most commonly for their siblings.”
Compared with unrelated donors, human leukocyte antigen (HLA)–matched biological siblings are usually preferred as donors because risks for transplant-related complications are decreased.
The AAP statement reviews the ethical issues concerning minors being stem cell donors, considering traditional benefit/risk calculations for the donor as well as for the recipient. The review also assesses the circumstances in which a minor may ethically be a hematopoietic stem cell donor, how to reduce risks to the donor and recipient, details of the informed-consent process, the role for a donor advocate or other protective safeguard, and other ethical concerns.
Specific AAP recommendations regarding minors acting as hematopoietic stem cell donors include the following:
Five criteria must be fulfilled for children who are medically appropriate potential donors to ethically serve as hematopoietic stem cell donors: