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用于再生疗法的干细胞保存:医疗保健部门的伦理与治理考量

Stem cell preservation for regenerative therapies: ethical and governance considerations for the health care sector.

作者信息

Master Zubin, Crowley Aidan P, Smith Cambray, Wigle Dennis, Terzic Andre, Sharp Richard R

机构信息

Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, 55905, USA.

Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, 55905, USA.

出版信息

NPJ Regen Med. 2020 Dec 1;5(1):23. doi: 10.1038/s41536-020-00108-w.

Abstract

The stem cell preservation industry has grown substantially with private businesses, public hospitals, and academic medical centers considering preserving induced pluripotent stem cells, mesenchymal stem cells, and other cell types of patients and the public in order to potentially use them for stem cell therapy should such an intervention exist in the future. Despite this growth and interest among private firms and academic centers, no study has yet considered the bioethical issues of such platforms. In this article, we explore several ethical and social issues related to the biopreservation of stem cells for future regenerative therapies. We analyze a range of bioethical considerations that public and private institutions should bear in mind as they develop stem cell preservation platforms. These include medical validation of regenerative interventions and their influence on the public understanding of stem cell therapies, the impact of public trust of organizations creating a private, for-profit venture of stem cell preservation, and logistical issues in the governance of the collection including ownership and dispositional authority, informed consent and access, and withdrawal and non-payment. These considerations should be incorporated into current and future stem cell preservation platforms in order to promote the responsible translation of regenerative medicine.

摘要

干细胞保存行业发展迅速,私营企业、公立医院和学术医疗中心都在考虑保存诱导多能干细胞、间充质干细胞以及患者和公众的其他细胞类型,以便在未来有此类干预措施时,有可能将它们用于干细胞治疗。尽管私营公司和学术中心对此兴趣浓厚且该行业不断发展,但尚无研究考虑过此类平台的生物伦理问题。在本文中,我们探讨了与为未来再生疗法进行干细胞生物保存相关的若干伦理和社会问题。我们分析了一系列公共和私营机构在开发干细胞保存平台时应牢记的生物伦理考量因素。这些因素包括再生干预措施的医学验证及其对公众对干细胞疗法理解的影响、公众对创建私营营利性干细胞保存企业的组织的信任影响,以及采集管理中的后勤问题,包括所有权和处置权、知情同意和获取、退出和欠费。这些考量因素应纳入当前和未来的干细胞保存平台,以促进再生医学的负责任转化。

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