Practice patterns for evaluation, consent, and care of related donors and recipients at hematopoietic cell transplantation centers in the United States

• Published in: Blood 2010-06, Vol.115 (24), p.5097-5101
• Main Authors: O'Donnell, Paul V., Pedersen, Tanya L., Confer, Dennis L., Rizzo, J. Douglas, Pulsipher, Michael A., Stroncek, David, Leitman, Susan, Anderlini, Paolo
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Child; Conflict of Interest; Donor Selection - standards; Family; Health Care Surveys; Hematologic and hematopoietic diseases; Hematologic Neoplasms - therapy; Hematopoietic Stem Cell Transplantation - standards; Hospital Bed Capacity; Humans; Informed Consent - standards; Living Donors; Medical sciences; Physician Executives; Practice Patterns, Physicians' - standards; Surveys and Questionnaires; Transplantation; Transplantation, Homologous; United States
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2010-01-262915

Conflict of interest may arise when 1 physician serves 2 persons whose medical care is interdependent. In hematopoietic cell transplantation (HCT) from unrelated donors and in the setting of solid organ transplantation from living donors, the standard of care is for donors and recipients to be managed by separate physicians to provide unbiased care. However, the practice patterns of evaluation and care of related donors and recipients are not well described. A survey of HCT centers in the United States was conducted by the Donor Health and Safety Working Committee of the Center for International Blood and Marrow Transplant Research to determine the type of provider involved in medical clearance, informed consent, and medical management of hematopoietic cell collection and the relationship of that provider to the HC transplant recipient. The response rate was 40%. In greater than 70% of centers, transplantation physicians were involved or potentially involved in overlapping care of the HC transplant donor and the recipient. These patterns were similar between transplantation teams caring for adult or pediatric donors and recipients. Among responding centers, medical management of recipients and their related donors by the same provider is common, a practice that has the potential for conflict of interest.