Donation and Ethics
Advances in science and healthcare technology have led to more biologic products being collected to sustain and improve the quality of human life. Challenges exist to monitor and ensure appropriate access and availability of safe products both in the domestic and global arenas. Efforts to increase the availability of these products may also increase the opportunities for transmission of infectious pathogens, including prions, viruses, bacteria, and parasites. The implications are amplified when there are multiple recipients from the same donor. The demand for organs, cells, corneas and tissues has grown immensely over the last two decades and, as a result, demand often exceeds supply, particularly for organs. More than 100 million red cell concentrates or whole blood units are transfused annually, more than 100,000 patients receive an organ transplant worldwide every year and this is estimated to only coverless than 10 % of the needs. Millions of patients receive tissues and cells of human origin. With medical and scientific advances, more complex procedures are being developed, incorporating MPHO that include composite materials and cells, whole hands and faces and genetically manipulated cells. Advances in stem cell biology have also amplified the demand for transplantation resulting in growing unrelated donor registries and cord blood banks throughout the world. The ability to match donors and recipients has also led to augment the sharing of these materials across national boundaries. It is now estimated that half of the unrelated stem cell and cord blood transplantation now cross national borders between donor and recipient. Current practices in transplantation raise several questions that need to be addressed jointly by clinicians, scientists, health regulators and ethicists as well as representatives of civil society, in particular donors and recipients.