Pssst…wanna buy some stem cells?

It seems there’s nothing to stop you now, you know.

It used to be that compensating individuals for donating peripheral blood stem cells (PBSCs) was a crime, a felony actually.  Up to five years in a federal prison.  For anyone involved in a PBSC donation for which compensation or some type of payment had been made.  This included the recipient of the “illegally” gotten stem cells.

There’s been a battle raging for many years over the inclusion of PBSCs under the terms of the National Organ Transplant Act, and it finally hit the courts three years ago when MoreMarrowDonors.org and the Institute for Justice and others challenged the determination.

First, they lost.

Then, on appeal, they won.

The U.S. Attorney General asked for a re-hearing.

The federal Ninth Circuit Court of Appeals said, sorry, but no.

Finally, this past April in what was pretty much a little-noticed about-face, Attorney General Eric Holder, without comment, said there’d be no appeal to the U.S. Supreme Court.

What this means is that people who donate stem cells can indeed be paid.

As a result of this litigation, donation of PBSCs is now an exception to the Transplant Act.

The exclusion, by the way, doesn’t include traditional bone marrow donations – the one where they stick a needle in your hip and suck out marrow directly from the bone. PBSCs have replaced the traditional method to a great extent with as much as 75 percent of transplants being done with stem cells.

Call me an idealist maybe, but I’ve always thought that people who donate some piece of their body are doing it out of the goodness of their hearts, not for the betterment of their wallets.

But that’s just me.

There’s a slew of folks, apparently, who don’t feel like I do.  I’m not saying they’re right or wrong.

So, is this just a cynical reaction to the realities of today’s health care, or is it a groundbreaking move that will mean more donors, more potential matches, and, presumably, more multiple myeloma survivors?

Keep in mind that any invasive procedure, no matter how otherwise routine it may be, carries some level of increased risk – no matter how small.  That includes harvesting of PBSCs.

When it comes to getting compensation for stem cell donation, is it greed, or is it a just compensation for the inconvenience and maybe a tiny bit of risk?

The argument of the plaintiffs was that it was wrong in the first place to regard regenerative stem cells the same way that irreplaceable organs are treated.

Shaka Mitchell, president and founding member of MoreMarrowDonors, said in a statement after the Attorney General’s acquiescence that the decision is going to expand options beyond the existing match system, which she called “woefully inadequate.”  As many as 1,000 people in the United States die each year because they can’t find a match, she claimed.

MoreMarrowDonors plans a pilot program that would give donors a $3,000 scholarship, a housing allowance, or a gift to the charity of their choice.

Speaking for the losing side, Michael Boo, chief strategy officer for the National Marrow Donor Program, said in a statement that the exception represents a “misguided view” that there will be a salutary impact on the donation of PBSCs.  A disappointed Blood Marrow Donor Program says that “compensation will limit treatment options for patients, decrease the quality of donations, and divert much-needed money from areas where it can help a wider range of patients.”

As for me, I’m still stuck on the whole idea that a certain portion of our population needs to be compensated in order to lure them into donorhood.

I worry about the underlying belief that “money talks.”

There are those who don’t think that voluntary donations are adequate any more and believe that financial incentives are the way to go to expand the stem cell donor base.

I wonder, though, how this works now.

By being exempted from the Transplant Act, are PBSCs now on the open market?

MoreMarrowDonors’ pilot plan is a reasonable one, it seems to me, but is there anything to stop someone now from setting up shop and putting PBSCs up for sale?  And how are they paid for?  Insurance?  Out-of-pocket?

The cost of staying alive with myeloma is already daunting.

I rationalize my concern over this financial reward system by reflecting about those who might be unable to find a good match among the 18.5 million or so donors on the domestic and international registries.  There are 9.5 million voluntary donors on the National Blood Marrow Donor Program’s Match Registry.

Why shouldn’t those without a good match in the traditional registry system be allowed to go out into the marketplace where some kind of monetary incentive might find them the right match?

If I put myself in their shoes, I’d say, “Damn straight, give me every option there is.”

Most people don’t get a familial match and are forced to go out to the national registry.

I guess I come down on the side of survival.

Although compensating people for donations just seems to be so cynical a view of what we think of people’s motivation nowadays.

Is this what we’ve come to?