US Court of Appeals rules stem cell donors can be paid

A ruling from a US federal appeals court means that blood stem cell donors may now receive a form of payment for their donation. A federal law that prohibits payment for organs does not apply to stem cells taken from bone marrow using a new method which avoids the extraction of bone marrow itself, the court said.

The National Organ Transplant Act allows donors to be paid for gamete and blood donations, but prohibits payment for solid organ donation, including bone marrow. The older method of obtaining stem cells involves removing bone marrow from a donor's hip, which is invasive and can be painful. Payment for this method remains illegal and a felony under US law introduced by Congress in part to prevent poorer people from being exploited and lured into undertaking risky medical procedures for financial gain.

The alternative method now used to obtain the majority of stem cells for transplant involves the donor being injected with a drug, which causes stem cells to move out from the bone marrow and into the blood. Once blood has been taken from the donor, it is then filtered, and the stem cells are removed.

Representing the three-judge panel of the ninth US Circuit Court of Appeals, Judge Andrew Kleinfeld wrote: 'Once the stem cells are in the bloodstream, they are a subpart of the blood, not the bone marrow'.

The legal action was bought against the US Government by the Institute for Justice in 2009, which is a non-profit law firm representing a coalition of patients and families affected by blood disorders, a doctor from Minnesota who specialises in bone marrow treatments, and California group Moremarrowdonors.org. The group said it wanted to encourage more people to donate by offering up to $3,000 in the form of scholarships, housing allowances, or gifts to charities.

Bone marrow and stem cell transplants are important techniques in the treatment of leukaemia and other blood disorders such as lymphoma, but the need for the donor to be a genetic match means that many people die waiting for a transplant. Jeff Rowes, a lawyer at the Institute for Justice claims the ruling 'could save thousands of lives'. He says almost 3,000 Americans die each year because they cannot find a donor.

The US Department of Justice is currently considering whether it should petition the Court of Appeals to reconsider its decision, or whether it should seek an appeal to the US Supreme Court.