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Blowback: Pay bone-marrow donors? Give it a shot

John Wagner is a professor at the University of Minnesota Department of Pediatrics, where he directs the Blood and Marrow Transplant Program. He is a plaintiff in the lawsuit challenging the federal ban on compensating bone-marrow donors. For more information, visit ij.org/BoneMarrow. If you also have a bone to pick regarding a recent Times article, editorial or Op-Ed and would like to participate in Blowback, here are our FAQs and submission policy.

The Times' March 1 editorial  suggests that a proposal to provide modest compensation to bone-marrow donors carries too many risks without promising enough benefits to implement even on a trial basis. Rather than disregard the proposal outright, I think it is important to consider all the options.

As a bone-marrow transplant specialist who is continuously faced with finding suitable donors for many children with deadly illnesses such as relapsed leukemia, my task is to leave no stone unturned. All too often, donors back out or are not available at the time they are needed. Unless recent updates suggest otherwise, prior reports from marrow donor registries have documented a 30% attrition rate, a persistent problem despite intensive efforts in donor education and awareness.

It is bad enough to have patients who lack a matched donor, but even worse is when a matched donor is identified but then backs out. I have a list of patients who have experienced this problem; some were left without good alternatives.

Let me be clear: I do not know if our compensation proposal will solve the problem of donors backing out altogether or not being available at the time patients needs them. But if alternative strategies have so far failed to solve this important and costly problem, I believe we need to consider other options.

The way the proposed program would work is simple: Potential marrow donors would sign up with a nonprofit group, MoreMarrowDonors.org, at the time they register. Then, if called on to donate because the tissue type matches a patient's (which could be months or years after registering, if ever), the donor would be entitled to either a $3,000 college scholarship, a $3,000 housing allowance or a $3,000 payment to the charity of his or her choice as compensation.

The hope is that these modest payments would encourage more people to sign up and follow through with the marrow collection at the time requested should a patient need their lifesaving marrow. The funds for the compensation would come from charitable giving. Wealth or influence wouldn't matter, as we "choose" the donor on the basis of genetic type, rather than the donor "choosing" simply to make a random donation for money.

Of course, we need to consider all risks, but I think this proposal addresses The Times' concerns. The editorial, for example, suggests that financial incentives might encourage people to conceal their health histories. While a possible risk, it is likely a low one. First, the vast majority who sign up are doing so for altruistic reasons. And again, we call on them because they happen to match children or adults with life-threatening diseases. Of course we want them to be honest, but we also presume that every donor may not even be aware of possible prior exposure to infectious diseases. Every donor is extensively tested.

Importantly, patients and their families are made aware of the risks of bone-marrow transplantation, including the risk of diseases passed through the donated cells. While it is our aim to keep those risks as low as possible, there are others that need to be considered as well -- such as the risk of no donor at all, delayed donation or the use of an alternate donor who is less well matched.

Now, federal law prevents us from considering the option of compensation, which promises to at least reduce the number of donors -- currently about one-third -- who aren't available when we need them. As an advocate for our patients, I believe we should consider all options for overcoming this major obstacle, which all donor registries have tried unsuccessfully to address for decades.

When the ban was proposed, lawmakers didn't consider the fact that we actually choose the donor, that the "organ" -- bone marrow -- regenerates itself, or the relative ease of extraction. Comparing this to selling a kidney is foolish.
           
Obviously, what we are proposing represents a change from the status quo, and I understand that new ideas will always face resistance. But compensating marrow donors has the potential to save lives while doing no harm. We ought to see, under medically supervised conditions, if it will work. Our patients, quite literally, cannot afford to wait.

-- John Wagner, MD

RELATED:

Blowback archive

Battling over bone marrow

 

Comments () | Archives (33)

The comments to this entry are closed.

maya paczuski

My late husband had two bone marrow donors back out after waiting months to get an answer. Eventually the doctor's went to a third who was not a good match and my husband died. Although the new bone marrow 'took', his new immune system ended up attacking his body. Why not pay donors. It will save lives.

JW

There are jobs (like mine) that have heavy physical requirements and no light duty. Compensating a donor for time missed from work would certainly be appreciated, especially if the donor has used all of their sick leave. I am actually medically ineligible to donate. If I weren't however, the bone pain would render me unable to perform my work duties for at least one week, possibly two. Compensation would be necessary. It is not heartless, but rather an economic reality for some people.

William

These days many bone-marrow donations do not involve puncturing the hip bone and withdrawing marrow -- which can be painful, but is usually controlled for.

I am a recepient of TWO seperate, 9 years apart, stem-cell transplants as they are usually referred to now.

No puntures are made in the donor's bone. The stem-cells necessary for the transplant are removed from the donor's circulating blood. Almost no pain of any kind for the donor. Some IV sticks. Recovery is fast and usually uneventful.

Consider being typed and signing up with the National Donor Center in Minneapolis. The life you safe might be yours, or a relative's or one of the other inhabitants of this earth. Without my two tranplants I would have been DEAD in 1997 at the latest. Instead I am reading the L A Times and making this comment.

William

Forgot to mention that this is 2011, which means I have grown "old" from my original "death" diagnosis in 1995. I was then 54 and told by my expert that "You are too old for a transplant." He planned to give me some Morphine while I died (medical talk: paliative care.) Never, never listen to "experts", in this case a City of Hope trained Hema/Oncologist, who didn't know what he was talking about. On December 13, (a Friday), 1996 I had a transplant from an unrealted donor in Germany at the Hutchinson in Seattle. And when it became necessary, I fought like hell and had second tranplant, also an unrelated donor in Germany. That was on June 30, 2007 and I am "still walking and talking" at 69 years-of-age, soon to be 70.

Sixteen years of life (and more to come) but only because I was aggressive and also lucky. Good luck -- it is in your hands -- to anyone attempting to obtain a transplant.

It was not easy! My understanding is that for every 100 patients that could benefit from a transplant only 9 NINE receive one. All kinds of reasons, but often lack of knowledge on the part of the patient. The "doctor" or "doctors."

Be aggressive and work the system well. Know what you are up against and find a way to go around, through or over.

Soon to be a MATCH

I am one step away from being a bone marrow donor. According to www.bethematch.org website, there are two methods of donation.

"There are two methods of donation: peripheral blood stem cells (PBSC) and bone marrow. The patient's doctor chooses the donation method that is best for the patient.
PBSC donation is a nonsurgical procedure that takes place at a blood center or outpatient hospital unit. For 5 days leading up to donation, you will be given injections of a drug called filgrastim to increase the number of blood-forming cells in your bloodstream. Your blood is then removed through a needle in one arm and passed through a machine that separates out the blood-forming cells. The remaining blood is returned to you through the other arm. Your blood-forming cells are back to their normal levels within 4 to 6 weeks.

Marrow donation is a surgical outpatient procedure that takes place at a hospital. You will receive anesthesia and feel no pain during the donation. Doctors use a needle to withdraw liquid marrow from the back of your pelvic bone. The marrow replaces itself completely within 4 to 6 weeks."

I signed up because I wanted to help save a life. I know that if I was in need, I would hope someone would be kind enough to help save me. As for the money, I don't expect any compensation, but when I told some friends and family about my donation, they inquired how much I would be receiving.
@Maya - I'm so sorry for your loss.
@William - Glad you're still here!!! : )

Richard

There are lots of people who make money from various forms
of organ donations. Ironically, the one person who is giving the
organ, arguably the most irreplaceable part, is the only one who
by law NOT be compensated.

Kind of like jury duty where you are expected to work as your "duty",
but everyone else (other than the defendant of course) manages to
get compensated.

TomL

This is an important conversation. I have donated almost 15 gallons of blood and platelets to date, and I'm on the marrow registry, so I really understand the incredible needs which contrast with the shortage of donors. At this point in my life, I won't be swayed by monetary compensation.

But I am increasingly frustrated by emerging policies which will ration organs (e.g. kidneys) in favor of youth and young adults, rather than people (generally middle aged or older) who have been longest on a waiting list. How does that make any sense, with so many people who won't donate blood or sign on as organ donors - yet they expect blood and organs to be available should they need it? I don't get it.

Rather than pay people to donate blood, organs or tissue, why not prioritize recipients based on their or their immediate family members actual commitment to make the same donations? Quid pro quo.

lyndagraze


Companies do give out samples. They are looking to put their products in potential consumers' hands. They wouldn't do it if it didn't work one of the place that always worked is "123 Get Samples" search online

Melissa

Donating bone marrow is such a simple, human thing. It should be required of everyone, as is jury duty. Small compensation with proof, such as missed basic day wages for those who require time off from work to donate, along with a small gas or transportation stipend. This is something we all should be doing, period.

dee

I think this is a great idea. The 'payment' process that gives three limited choices--none of which puts the money into the donor's hands--is well considered. Handling the issue this way encourages young, healthy people to donate (help with college fees/housing), gives some assistance with housing costs, and/or benefits charities. What's to lose? The big winner, of course. would be the recipients. Great plan...hope it 'wins'!

ddm97

At the hosptial where I work we get 4 hours of comp time for every unit of blood we donate (that's the equivalent of $125 for me) plus we get 2 hours release time to make the actual donation. It's a perq to encourage donation. What's the difference between that and donating bone marrow? The hospital tests my blood to make sure it's safe before giving to a patient--I don't determine where it goes after I donate it. Providing some small level of compensation for unrelated donors, including organs, may help to encourage people to at least think about the possibility of donation and therefore may help more people make a decision to sign up to be a donor.

Library Lady

How about forgiving $3000 of student loans? I bet a lot of people would go for that!

Shelby

When you register to donate marrow there is only about 1/20,000 chance of being selected to donate .

Grace Lee

Several years ago, I was asked by someone to donate bone marrow to a friend of a friend, and I was given a poster with the picture of a little girl. The person thought of me because I'm Asian and she said Asians had a particularaly hard time finding donors. I never followed up, partly because I heard it was a really painful procedure. I have to say, I would be more willing to follow through if it meant receiving a couple of thousand dollars toward my student loan payment. I know that doesn't sound very altuistic, but if everyone were so much more noble than me, we wouldn't be having this conversation.

miles becom

I would do it for nothing, sign me up. I give blood, why not marrow?

miles becom

One more time, the Government is protecting me from myself. Or is it protecting me from you? That could help reduce the budget, the Government could get out of saving me from myself.

Avsec B

OBAMA = STALIN = BUSH…USA = USSR....WHO, WHY, AND HOW RUINED YOU…FROM 911 TO AUSTRALIAN FLOODS – ARIZONA SHOOTING – WIKILEAKS is CIA - ESKIMO SARAH PALIN'S "BRIDGE TO NOWHERE" -- LEARN ABOUT REAL HUMAN FLASH EATING MACHINE OR SO CALLED ECONOMY - BREAST FEEDING INSANITY -- CIVIL RIOTS IN ARAB COUNTRIES - NEWS/MEDIA or simply CENSORSHIP AND BIG FAT WORLD OF LIES !!??? - NEW WORLD ORDER POLITICAL PARTIES(REPUBLICANS = DEMOCRATS) http://bostjanavsec1.blogspot.com/

OBAMA = STALIN = BUSH…USA = USSR....WHO, WHY, AND HOW RUINED YOU…FROM 911 TO AUSTRALIAN FLOODS – ARIZONA SHOOTING – WIKILEAKS is CIA - ESKIMO SARAH PALIN'S "BRIDGE TO NOWHERE" -- LEARN ABOUT REAL HUMAN FLASH EATING MACHINE OR SO CALLED ECONOMY - BREAST FEEDING INSANITY -- CIVIL RIOTS IN ARAB COUNTRIES - NEWS/MEDIA or simply CENSORSHIP AND BIG FAT WORLD OF LIES !!??? - NEW WORLD ORDER POLITICAL PARTIES(REPUBLICANS = DEMOCRATS) http://bostjanavsec1.blogspot.com/

Avsec B

OBAMA = STALIN = BUSH…USA = USSR....WHO, WHY, AND HOW RUINED YOU…FROM 911 TO AUSTRALIAN FLOODS – ARIZONA SHOOTING – WIKILEAKS is CIA - ESKIMO SARAH PALIN'S "BRIDGE TO NOWHERE" -- LEARN ABOUT REAL HUMAN FLASH EATING MACHINE OR SO CALLED ECONOMY - BREAST FEEDING INSANITY -- CIVIL RIOTS IN ARAB COUNTRIES - NEWS/MEDIA or simply CENSORSHIP AND BIG FAT WORLD OF LIES !!??? - NEW WORLD ORDER POLITICAL PARTIES(REPUBLICANS = DEMOCRATS) http://bostjanavsec1.blogspot.com/

OBAMA = STALIN = BUSH…USA = USSR....WHO, WHY, AND HOW RUINED YOU…FROM 911 TO AUSTRALIAN FLOODS – ARIZONA SHOOTING – WIKILEAKS is CIA - ESKIMO SARAH PALIN'S "BRIDGE TO NOWHERE" -- LEARN ABOUT REAL HUMAN FLASH EATING MACHINE OR SO CALLED ECONOMY - BREAST FEEDING INSANITY -- CIVIL RIOTS IN ARAB COUNTRIES - NEWS/MEDIA or simply CENSORSHIP AND BIG FAT WORLD OF LIES !!??? - NEW WORLD ORDER POLITICAL PARTIES(REPUBLICANS = DEMOCRATS) http://bostjanavsec1.blogspot.com/

Olden Atwoody

I protest Federal funding of technologies that were not specifically cited in the Bible.

Ken Murray

I think this is an idea worth trying.

However, I would be fairly sure that there is nothing in the federal law preventing the option of donation to a charity of the donor's choice, AS THEY DERIVE NO BENEFIT whatsoever.

So go ahead with that. Demonstrate it works, the other options become easier to sell.

contraryjim

Do you have something that belongs to you and NO other, why shouldn't you have the right to sell it to an informed buyer? Why is it of concern to your neighbor or government?

On principle, I'll NOT DONATE any body part, alive or dead, but I'll sell it for a reasonable sum, perhaps $1.00 when & to whom I desire.

IF this is the land of the FREE, then we must act so - refuse dictatorial laws.

contraryjim

"... Donating bone marrow ....t should be required of everyone, ...". This is not a world in which I would live - "be required" a tax to be paid with body parts. And of course these "know it alls" will prevent you from leaving this world voluntarily.

Red Williams

Why would you decide how these people would be paid? This isn't "payment." This is control. Not good. If you want their services, give them cold, hard cash. That would be fair.

Cheryl

I think it would be fair to compensate donors for their time and the risks to their own health.

Heck, even blood donors at least get cookies and juice when they donate a pint of blood.

eddie

I think its sad, when we get to a point in our society in which we have to consider paying someone to save another human beings life. I use to run a yearly bone marrow registration drive at UCLA and the biggest issue we had was people being misinformed! I think a better job has to be done about educating potential donors. When I found out that some pain might be involved in the process, it still did not deter me b/c i thought about the end product of that pain, and that was the opportunity to save someones life!

Fred Wright

Without a doubt I believe we should compensate donors to encourage the use of this procedure. However, I think it's feasible to give each donor $7,000 rather than $3,000 as recommended by the doctor. Moreover it should be in the form of cold cash. Yes it would be nice if we were all so generous as to care for our fellowman, but the fact is we don't have enough donors and too many back out at the last minute. I wouldn't mind my tax dollar going toward this procedure to save lives. It makes more sense to me than the Bush tax cuts!

RickRussellTX

So-called "moral opposition" to payment for organ donations is actually murdering people by withholding essential medical treatment.

If people were allowed to sell organs or bone marrow for money, there would be more organs and bone marrow available for transplant. More patients would live. Even if sales were made directly to wealthy clients, that would free up more organs and bone marrow for general use, and bring more people to the donation table to start with so more matches would be identified.

Not allowing the sale of organs results in more people dying while waiting for treatment, often in tremendous pain and at great expense to the health care system. It's a classic example of our monkey-brain idea of fairness being completely and utterly wrong, in a way that results in negligent homicide.

V Fematt

I am a donor and my receipient is alive and dancing in Florida. She had a second chance in life. We celebrated 5 years of her second "rebirth" this past November. I would do it again with or without compensation. If compensation would increase the size of the donor pool - then allow it. It could be the life of a friend or family that is saved.

E Dove

I donated blood and platelets for years and within months of going on the National Marrow Registry I was called to donate. The method of donation was by peripheral blood stem cells which required taking two injections of fligrastim daily to stimulate the production of blood cells. The reactions to the injections were extreme, headaches and sever muscle aches. Because of the size of my veins, the collection required a catheter inserted into the jugular vein more invasive than the usual donation process. The discomfort was worth it and I would do it again without hesitation. I learned the identity of my recipient one year post transplant and we have remained in touch for the last five years, five years and this gentleman has remained in remission. I urge everyone to sign onto to the registry; there is no greater reward than being able to help save a life.

RC

It's kinda stupid how people would back out right when they're needed. There are people counting on them and then they suddenly change their mind & say "Oh hey, it just hit me. Yeah i don't think I can do this." Seriously, you should have thought of that before volunteering. Not trying to make it sound like bribery, but paying donors to live up to their promises works out best.

k. Smith

What are the costs involved with being a donor? What about those that do not have insurance? Travel costs? Time loss(work)? When you add up the value of being a donor to the compensation they are offering it seems pretty simple. No one is going to get rich from being a marrow donor except the person who will gain life sustaining treatment. Lets not deny people the opportunity to try. Maybe there can be a trial county or state or hospital.

Carol


It is a wonder that bone marrow isn't sold on the black market.
Hospitals charge a half million dollars to the insurance co for the transplant operation.They charge around $400 for a pint of blood ( They only pay a donor about $30) They can afford to pay more than they do.
I think the government should stay out of this matter.
It is up there with sex changes, abortions or being a surrogate mother and drug research.
If a person wants to sell a part of their body for research or to save a life it should be up to that individual and the doctors not the government. I bet you could go to other countries and sell your body parts

las vegas entertainment deals

If I will donate my bone marrow, are my bones to be cut?


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