Use of minors as bone marrow donors: Current attitude and management - A survey of 56 pediatric transplantation centers

Objective: To determine the current attitude about the use of minors as bone morrow donors in pediatric bone morrow transplantation (BMT) centers in North America. Study design: A questionnaire was mailed to 70 North American BMT centers. The questionnaire asked for opinions on a number of ethical and clinical issues pertaining to the use of minors as marrow donors. A case history was included and respondents were asked to check all appropriate answers listed in the survey. Results: Fifty-six (80%) of 70 centers responded. There was general consensus on many issues. Pediatricians endorse the validity of parental consent, even in potentially controversial situations. Most are prepared to extract marrow from young (about 6 months of age) infants and are willing to use the same donor more than once. There is general approval of performing BMT with experimental protocols, and the projected outcome of BMT does not affect the decision to use a minor as a morrow donor. There is less consensus regarding the optimal management of minors donating a large volume of bone marrow. Conclusion: This survey shows a fairly consistent attitude among pediatric BMT centers about the use of minors as marrow donors. The actual management of such donors was not evaluated in detail and requires further study.