title: Determination of Eligibility in Related Pediatric Hematopoietic Cell Donors: Ethical and Clinical Considerations. Recommendations from a Working Group of the Worldwide Network for Blood and Marrow Transplantation Association.
abstract: Related donors for hematopoietic cell (HC) transplantation are a growing population in recent years because of expanding indications for allogeneic transplantation. The safety and welfare of the donor are major concerns for the transplantation community, especially for related sibling donors of young recipients who are children and, thus, not able to fully consent. Because donation of HC does not improve the donor's own physical health and carries a risk of side effects, careful assessment of medical risks specific to the individual donor, as well as consideration of ethical and legal aspects associated with donation from a child, must be considered. In addition, donor centers must balance the needs of both the donor and the recipient, understanding the inherent conflict parents may have as they can be overly focused on the very sick child receiving a transplant, rather than on the relatively less significant health or emotional problems that a sibling donor may have, which could impact risk with donation. Likewise, consideration must be made regarding the nature of the relationship of the sibling donor to the recipient and also aspects of performing research on pediatric HC donors. In this article, as members of the Donor Issues Committee of the Worldwide Network for Blood and Marrow Transplantation, we review key ethical concerns associated with pediatric donation and then give recommendations for screening potential child donors with underlying health conditions. These recommendations are aimed at protecting the physical and emotional well-being of childhood donors and arise out of the Third International Conference on Health and Safety of Donors sponsored by the Worldwide Network for Blood and Marrow Transplantation.
authors: Pediatric Blood and Marrow Transplantation & Immunotherapy Program, Department of Pediatric Hematology/Oncology, "Dana-Dwek" Children's Hospital, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. Electronic address: menachembi@tlvmc.gov.il.
authors: Menachem
authors: M
authors: Bitan
authors: Department of Pediatrics, Stem Cell Transplantation Unit, Willem Alexander Children's Hospital, Leiden University Medical Centre, Leiden, the Netherlands.
authors: Suzanna M
authors: SM
authors: van Walraven
authors: Department of Transfusion Medicine, Medical University of Vienna, Vienna, Austria.
authors: Nina
authors: N
authors: Worel
authors: Department of Pediatrics, Stem Cell Transplantation Unit, Willem Alexander Children's Hospital, Leiden University Medical Centre, Leiden, the Netherlands.
authors: Lynne M
authors: LM
authors: Ball
authors: Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
authors: Jan
authors: J
authors: Styczynski
authors: Blood and Tissue Bank, Barcelona, Spain.
authors: Marta
authors: M
authors: Torrabadella
authors: Department of Pediatrics, St. Anna Kinderspital, Medical University of Vienna, Vienna, Austria.
authors: Volker
authors: V
authors: Witt
authors: Center for International Blood and Marrow Transplant Research, Froedtert and the Medical College of Wisconsin, Clinical Cancer Center, Milwaukee, Wisconsin.
authors: Bronwen E
authors: BE
authors: Shaw
authors: Pediatric Oncology Institute, Sao Paulo, Brazil.
authors: Adriana
authors: A
authors: Seber
authors: Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Kanagawa, Japan.
authors: Hiromasa
authors: H
authors: Yabe
authors: Medical University of Graz, LKH-University Klinikum Graz, Division of Haematology, Graz, Austria.
authors: Hildegard T
authors: HT
authors: Greinix
authors: Department of Pediatrics, St. Anna Kinderspital, Medical University of Vienna, Vienna, Austria.
authors: Christina
authors: C
authors: Peters
authors: Department of Hematology, Eurocord Office, Hôpital Saint-Louis, Paris, France.
authors: Eliane
authors: E
authors: Gluckman
authors: Oxford University Hospitals NHS Trust, Department of Clinical Haematology, Bone Marrow Transplant Unit, Cancer and Haematology Centre, Churchill Hospital, Oxford, UK.
authors: Vanderson
authors: V
authors: Rocha
authors: Department of Hematology, University Hospital Basel, Basel, Switzerland.
authors: Joerg
authors: J
authors: Halter
authors: Division of Hematology/Hematological Malignancies, Huntsman Cancer Institute/University of Utah School of Medicine, Primary Children's Hospital, Salt Lake City, Utah.
authors: Michael A
authors: MA
authors: Pulsipher
mesh_terms: D000293:Adolescent; D064591:Allografts; D026688:Bioethical Issues; D002648:Child; D002675:Child, Preschool; D046148:Donor Selection / Q000941:ethics* / Q000379:methods*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000941:ethics* / Q000379:methods*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D014019:Tissue Donors / Q000941:ethics*
keywords: Allogeneic hematopoietic cell transplantation; Bone marrow and peripheral blood stem cell donor; Pediatric organ donation