The natural question following the news that California's 9th Circuit Court of Appeals had ruled that bone marrow sales weren't a major federal crime was, what's the bone marrow market like? According to a lawyer in the case, the price for your precious, precious marrow can reach $3,000. But don't quit your job just yet: There's about a 1-in-540 chance you'll actually get the opportunity to donate. As it turns out, this is not a legitimate moneymaking scheme because of the difficulty in finding the right genetic match among the more than seven million people currently listed by the National Marrow Donor Program. You probably will be able to get compensated if your name gets called, but you'd have a better chance of winning most California scratchers.
The case came in the form of a lawsuit from Maine mother Doreen Flynn, whose three daughters suffer from Fanconi anemia, the Los Angeles Times reported. A site called Moremarrowdonors.org wanted to offer "$3,000 scholarships or housing payments to attract new registrants to the National Marrow Donor Program," according to the Times, but until Thursday marrow donations were prohibited under the 1984 National Organ Transplant Act. Flynn and her legal team from the libertarian Institute for Justice successfully argued that since the body replenishes marrow the way it does blood, selling it wasn't the same as, say, selling a kidney. The Times reports that the federal government had banned marrow sales because of the "painful and risky" process once required to extract the stuff.
In the last 20 years, though, medical advances have brought about a less intrusive method by which the life-saving marrow stem cells are harvested from a donor's bloodstream in much the same way as blood is drawn at a blood bank. The new process, known as apheresis, filters out excess marrow stem cells that circulate in the bloodstream, as opposed to the surgical extraction method, known as aspiration, which inserts a large needle into the hip bone and siphons out the cells.
But the process still requires a time commitment, said Jeff Rowes, the lead lawyer for Flynn. Between a physical exam to make sure the donor is healthy enough to give, a series of preparatory injections that encourage marrow creation but can make the subject feel ill, a six-hour or so procedure to actually donate the bone marrow, and a few days' recovery time, being a donor is not an easy job. "What you’re doing is paying for the person’s time," Rowes said. "Something like a mortgage payment for a month, or a housing allowance, or a $2,000 or $3,000 scholarship," he said, would encourage more people to agree to donate if they were ever called. Rowes said there was currently no way to get cash for a marrow donation, largely because the only outfit offering the compensation was Moremarrowdonors.org. "The infrastructure doesn’t exist right now. That is something that will have to pop up," he said.
But even if a market for marrow does develop, it's unlikely people will be able to use it to actually make money. According to Marrow.org, only one in 540 people registered as donors will be called to actually make a donation. That's because the chances of making the in-depth genetic match are pretty slim, unlike organ donations, which require little more than compatible blood types to be successful, Rowes said. Marrow.org explains:
Doctors look for a donor who matches their patient's tissue type, specifically their human leukocyte antigen (HLA) tissue type. HLAs are proteins — or markers — found on most cells in your body. Your immune system uses these markers to recognize which cells belong in your body and which do not. The closer the match between the patient's HLA markers and yours, the better for the patient.
The reason for even offering compensation, then, is to try to encourage people who registered as marrow donors to keep their contact information current, to encourage them to actually donate if they get the call, and to try to encourage more minorities to register as donors. "The average donor right now happens to be a middle-aged white person," Rowes said. "If you’re African American or something like that you have higher odds of being called up." Last year, a Long Island woman died after four people refused to donate marrow even though they were genetic matches. "That’s exactly the kind of situation where, if we had a standard practice of saying, if you come in and donate bone marrow we’re going to pay you, say, 2,000 for your time, I think that would make a difference."
The risk, of course, is that competition will drive the price for a donor up to the point where it's unaffordable. But proponents of compensation say even if the price went up to $7,000 for a donation, it would still be a drop in the bucket compared to the $500,000 to $1 million Rowes said a bone marrow transplant procedure can cost a recipient.