Biomedical Engineering Reference
In-Depth Information
(Faden
et al
., 2003). When the BTeP contains autologous cells, there is of
course no compatibility problem. The issue is, however, crucial in allogeneic
BTePs. choosing BTePs that are less histocompatible, or that are for other
reasons less suited, will increase the risks attached to the BTeP and place
an extra burden on the recipient of the BTeP in the form of the need for
life-long immunosuppressive medication or other negative side effects.
Determining how strong the match between the cells in the BTeP and the
donor needs to be in the case for allogeneic BTePs (caplan, 2007) and how
the availability of cells will be secured, will be necessary. This implies that
the specific cell choice for the construction of the BTEP and the regulation
and conduct of cell sourcing will have an impact on the number of people
who will eventually be able to receive a biologically compatible BTeP.
Yet it will always be in the best interest of the recipient that the BTeP
is as compatible as possible. This can only be achieved if (1) the variety of
donors is large, (2) BTePs are constructed using appropriate cells and (3) the
donated cells are accessible to all who might benefit from them. Otherwise
discrimination on the basis of histological characteristics is unavoidable.
consequently, efforts should be made to establish mechanisms that allow for
the efficient and safe procurement and distribution of cells from all groups
in the population, including populations that have so far not been reached or
that have been reluctant to participate in donation schemes. They should be
made aware of the consequences of their absence in the donation process.
experiences of organ donation, umbilical cord blood banking and bone
marrow registries indicate that there are large disparities between social,
religious and ethnic groups with regard to their willingness to participate
in donation schemes. The reasons for this non-participation may vary, but
ultimately lead to an underrepresentation of some groups of the population
in cell banks and therefore also to a shortage of histocompatible cells, tissue
and organs for treatment of these groups.
Differences in the willingness to donate need to be anticipated, if we do
not want to reproduce these disparities for BTePs (Ballen
et al
., 2002; Faden
et al
., 2003). equally, strategies to address the needs of minority groups will
have to be initiated from the very design of cell banks on. if those most in
need of BTePs should be able to get a compatible product, the establishment
of public stem cell banks seems the most obvious option. The organisation
of cell repositories, however, also has economic consequences. creating a
cell repository that is accessible to a large number of people, with a large
number of samples, requires a specific approach and, above all, a large
investment and will probably be funded differently than a repository aimed
at the storage of privately donated samples for autologous use (Faden
et al
.,
2003).
