Children as haematopoietic stem cell donors: ethically challenging and legally complex

Shih-Ning Then, Ian H Kerridge and Michael Marks
Med J Aust 2018; 208 (8): . || doi: 10.5694/mja17.00758
Published online: 7 May 2018

Clinicians should be aware of the particular physical and psychological risks of haematopoietic stem cell donation in the paediatric setting, and the varying laws between states and territories

Allogeneic donor blood and bone marrow transplantation can treat a range of malignant and non-malignant diseases. For children with aplastic anaemia, severe combined immunodeficiency, leukaemia, sickle-cell disease, thalassaemia and inborn errors of metabolism, it may provide the only possibility of cure and long term survival. Although associated with considerable recipient mortality (5–12% transplant-related mortality at one year)1 and morbidity, advances in tissue typing, supportive care, patient selection, conditioning regimens and the prevention and treatment of graft-versus-host disease have dramatically improved outcomes, with up to 80% of recipients becoming long term survivors of bone marrow transplant.2

  • 1 Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, QLD
  • 2 Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW
  • 3 Royal Children's Hospital, Melbourne, VIC
  • 4 University of Melbourne, Melbourne, VIC


Competing interests:

Shih-Ning Then is currently a member of the NHMRC Organ and Tissue Working Committee. The views expressed in this article are those of the authors and do not represent the views of the Committee.


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