Human Cell and tissue transplantation
Human cells and tissues for transplantation can save lives or restore essential functions. For example:
- a corneal graft can restore sight in corneal blindness;
- the transplantation of haematopoietic stem cells can cure congenital or acquired diseases including some leukaemias (haematopoietic stem cells can be collected from living donors, either as bone marrow or from peripheral blood. Additionally, they may be collected as cord blood drawn from the placenta during or after delivery.)
See further information on Haematopoeitic Stem Cells
- the transplantation of a human heart valve often constitutes the best replacement situation and recipient patients do not require long term anti-coagulation therapy.
Ethics of procurement
In the consent for donation, professionals should provide the necessary information regarding the intended use of the tissues and the process.
Health products of human origin
Human cells and tissues for transplantation represent a special class of basic essential healthcare products, as well as being the potential starting material for much more complex biotechnology products in the future. As with all transplanted material of human origin they carry risks of disease transmission which must be controlled by the application of stringent donor selection criteria and comprehensive quality systems.WHO has held several global consultations on human cells and tissues for transplantation, (download report below) where participants recognized the significant global circulation of certain human tissues and cells and the substantial role played by a commercial market in many of these tissue and cell products. Transparency and the openness to scrutiny in these activities are essential to ensure public support and understanding. Robust bidirectional Donor-Recipient traceability is a prerequisite to achieve effective vigilance and surveillance worldwide. For this reason, Resolution WHA63.22 encourages the implementation of globally consistent coding systems.
In WHA63.22 Resolution, Member States are urged to collaborate in collecting data including adverse events and reactions and WHO is requested to facilitate access for Member States to appropriate information. WHO has guidance tools for reporting severe adverse events and reactions.
Work carried out during and after the global consultations has resulted in the development of WHO Aide-Memoires specifying basic requirements in this field (downloadable below).
Report of the First Global Consultation on Safety and Quality Requirements for Cells and Tissues for Transplantation, Ottawa, November 2004.
Report of the Second Global Consultation on Safety and Quality Requirements for Cells and Tissues for Transplantation, Geneva, 7-9 June 2006
Aide-Mémoire on Key Safety Requirements for Essential Minimally Processed Human Cells and Tissues for Transplantation
Aide-Mémoire on Access to Safe and Effective Cells and Tissues for Transplantation