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October 20, 2011

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Donors back off at moment of truth

ABOUT 10 percent of Shanghai's 100,000-plus voluntary bone marrow donors eventually decide to say "no" to actual donations when they become matched with patients, says the city's marrow donor program.

Nationwide, approximately 20 percent of the overall 1.32 million donors decline to donate bone marrow when matched with patients for various reasons, an act that does not break any laws or regulations but can hasten the death of a patient, according to Beijing Daily.

Compared to other countries, the Chinese rejection rate is low. In the US, the percentage of voluntary donors who break their promises has at times reached 50 percent, and the rate has gone as high as 60 percent in other Asian countries, the paper said.

The statistics caught wide public attention in July after a donor in Yunnan Province refused to proceed while in the middle of a donation when a hospital's machines failed to make proper readings on her blood. The error and subsequent argument by doctors created doubt for the donor and her family about the safety of the procedure.

The donor's decision stopped the transplant operation and led to the death of the patient, said the newspaper.

Patients who are ready to receive new stem cells from donors must go through procedures to destroy their own immune and hematopoietic systems, leaving them unprotected from viruses, said officials with the Shanghai Marrow Donor Program under the Red Cross Society of China.

If donors suddenly change their mind and refuse to donate, a patient can deteriorate quickly, said an official surnamed Jiang with the program.

"But the Yunnan case is a very rare one," Jiang said. "In Shanghai the donors must sign agreement letters where they are informed of the serious consequences of the pre-transplant procedures to the patients, and they should promise not to change their minds."

Some Shanghai donors decide to decline because they joined the program years earlier, often while they were university students, without giving serious thought to the consequences. Years later, when they are suddenly informed they've matched to a patient, they hesitate, said Jiang.

Some may be forced to decline because they are sick, pregnant or away on vacation, while others may face heavy pressure from their families who fear the transplant may damage donors' own health, according to the official.

"The fears are understandable but totally unnecessary," said Jiang. "In a short period after operations, the donors may feel tired but they recover very soon. No consequences to the donors after operations have ever been found in their life."

According to officials with the China Marrow Donor Program, some donors registered their information in the database about 10 years ago and now cannot be reached because their phone numbers or addresses have changed.

In 2006, a patient sued a donor who suddenly declined to go through with a transplant, but as the laws and regulations have made clear, the donations are voluntary and donors bear no responsibilities for changing their mind. The patient lost the lawsuit, Beijing Daily noted.


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