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When a minority person needs a bone marrow transplant, it can be hard to find a perfect match. One reason is that blacks and hispanics are more genetically diverse than northern europeans. Another is that the bone marrow registry (people who have been typed and are willing to donate marrow to help
a stranger) consists largely of northern european types. For various reasons, minorities register as marrow donors less often than whites.
I propose that donated blood undergo HLA (human leukocyte antigen) typing. This is no crackpot scheme. Blood donors are already altruists willing to help a stranger. The white cells (which is the part that is HLA typed) is waste and is seperated from the red blood cells and discarded. If cost is an issue, only donated blood from minority communities could be typed.
It baffles me why this is not already done, but many things about the blood banking industry baffle me.
Minority donors
http://rarediseases...eekly/aa080801a.htm [bungston, Oct 04 2004, last modified Oct 21 2004]
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If such a thing works, I'd certainly be in favor of this. Even if the donor had to pay a small amount, I think many would. When I checked in to it, it cost $50 to register and be typed as a marrow donor. So far, it hasn't cost me anything to give 30-some pints of blood. |
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There is some extra cost for ANA, ESR, complement, and electrophoresis of leukocytes. These tests are diagnostic of several conditions and are of greatest benefit to the recipient of donated tissue. |
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this is a good idea. to make things easier for future generations, all children should have their HLA typed at birth. |
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i suspect advances in immunosupression will continue so that exact HLA matching will become an increasingly less important factor in matching donors and recipients, as it has in kidney donation. |
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How would you get around the issue of
blood donor anonymity? I understand
that this is considered an immutable
policy in the field. |
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If blood donors were really anonymous, there would be no way for them to call you to tell you if your HIV test were positive. Also, how would they know who their all-star donors were so they could call and beg for blood when the tank was low? |
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Yes, they know who you are. I had a co-worker who received a letter from the blood services stating that he was no longer eligible to give blood. And, yes, they definitely do call. |
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I guess I stand corrected. I looked at
several recruitment .org sites and they
all went on about anonymity, why it's so
important, and so on; but I really don't
have any personal knowledge on this.
I can see where if the information got
mishandled, it could be a big problem
for the donor - stress about being
hounded by patients in desperate need
for a rare match, influence peddling.
But there's probably a way around that
with appropriate reg's. Certainly no one
would argue with the basic intent of the
idea. |
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Why go the expense of typing for bone marrow donations from people who are not proposing to donate bone marrow via a painful surgery? |
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"You get all you can from those altruistic types." |
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The logical core is that you are soliciting involuntary bone marrow donations. |
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So after donating blood- you find that you are a match for someone? |
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My willingness to have blood painlessly extracted to the betterment of my health does not extend to having my hip bored into to deliver marrow to a suffering anonymous person. |
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I would have real reservation giving marrow for anyone but a close family member, in fact I would not do it. Donating blood does not mean that I would be willing to be a living donor of any kind. |
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If I would potentially be solicited for painful medical procedures based on donating blood- the result is that I would cease donating blood, and I think many people would too. |
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I do not wish to be apporached with other peoples needs for my tissue via a painful surgery to save their life. The answer is "No", testing for marrow compatability is a waste of money, and presents a real liablity risk from people who would sue for emotional distress- on both sides of the donor equation. |
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There are so many serious legal and ethical problems with this. |
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[Xy] - it is all about convenience. Blood donors have already shown up. The checkbox as proposed by [q2] would solve your worries. |
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hmm, I think [xylene] edited the comment since my answer was posted. Marrow harvests are more and more a thing of the past. Most donors give stem cells, which is more time consuming but otherwise similar to donating platelets. |
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I agree that it would need to be voluntary. |
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