What are the Registries of hematopoietic stem cell donors?
The first successful bone marrow transplantation from unrelated donor to patient with leukemia was performed in 1979. Later this method was used successfully for the treatment of severe blood, oncological, congenital and other diseases in cases when the other therapy was ineffective. The transplantation of bone marrow, or hematopoietic stem cells (the modern term) is used for both adults and children. The main concomitant problem that limits the wide application of this method is a search for the compatible donor. The natural relation may serve as a donor but unfortunately only 30% patients have a compatible related one due to the large variability of specific human factor sets (so called HLA-types). Therefore in other cases the unrelated donor can help only. The search for these people is performed by special Registries of prospective unrelated donors of hematopoietic stem cells (Banks of marrow donors) worldwide. What is the Registry? Virtually it is a computer database including information about prospective donors and their HLA-types. If the transplantation of hematopoietic stem cells is necessary but related donor is absent the Registry receives the request for a suitable HLA-type donor from the Transplant Centre (medical facility where transplantation is carried out). The Transplant Centre should be informed if the Registry has suitable HLA-type donor. After request conformation the Registry carries out more complex confirmatory HLA-typing and infection disease testing. The positive results and donor informed written consent for a hematopoietic stem cell collection lead to the medical examination of selected donor. The donor without medical contraindications is considered as a suitable one for a hematopoietic stem cell donation. The more previously examined prospective donors are presented the more chances to find suitable donor for an individual patient.
The first Registry in the world was founded in USA because it were Americans who introduced the bone marrow transplantation in clinical practice for the first time. The quantity of Registries became grow quickly. Later the USA National Registry combining separate Registries was created. This system became distribute gradually in Europe, Asia and Australia. At last, the International Net (e.g. EMDIS in Europe) including donor databases of various National Registries was established. Today the International Registry (IBMTR) contains information about more than 10 millions prospective donors. Such system allows to perform a quick and efficient search for unrelated donor independently of patient country. The hematopoietic stem cell donation is a honorary right of each citizen in advanced countries. The campaigns for recruiting of prospective unrelated donors of hematopoietic stem cells contribute to increase of Registry database. The first Russian Registry was created in Saint-Petersburg in 2000 at the base of Saint-Petersburg State Medical University named under academician I.P. Pavlov. The Karelian Registry was founded in 2001. Today it includes about 3200 prospective donors from different regions of Russia.
How can I become a donor of unrelated hematopoietic stem cells?
You should sign an Agreement that You agree to join Registry as a potential hematopoietic stem cell donor and provide relevant samples (usually 5.6 ml) of blood from peripheral vein for HLA-typing. The testing results are registered in database ensuring strict confidentiality of donor. The volunteer will be allocated a unique donor number by way of identification. Only unique donor number will be used in communication. You will be informed if later the suitable patient appears. In this case You may be asked make a final decision to become a real donor. The careful laboratory investigation for the confirmation of donor and patient identity is performed. Moreover a medical examination is necessary to assess donor’s fitness for the donation procedure. The positive results and final approval of donor for harvest are necessary for the donation of hematopoietic stem cells to patient. At each stage of the process Your anonymity is kept strictly according to the ethic reasons. The Anonimity, Voluntariness and Gratuitousness are the main principles at the heart of any Donor Movement and Registry creation.
The new donor recruitment is performed during special campaigns or individually.
The information about new campaigns appears at our web-site regularly. But each campaign requires the large and difficult preparation so they are conducted rarely. If You want to become a member of Registry outside the campaign or help to conduct campaign in Your city You should contact with us by the following e-mail: firstname.lastname@example.org.We are ready to include the new donors from Russia in Registry.
What methods of hematopoietic stem cell harvest are exist?
The hematopoietic blood cells (sources of all blood cells) are located mainly in bone marrow and less in peripheral blood. The hematopoietic stem cell collection for the transplantation from selected donors takes place in so called Collection Centre. The Collection Centre is a medical facility with special equipment.
There are 2 methods of hematopoietic stem cell collection:
- From the peripheral blood
The special remedy (Neupogen or Granocit) that stimulates the hematopoietic stem cell going out from the bone marrow to the blood is administered subcutaneously to donor during 5 days before hematopoietic stem cell collection. Such adverse reactions as fever, bone and muscle pain are possible. They may be relieved by paracetamol administration and disappear after cessation of drug injections. The hematopoietic stem cell harvest is carried out by means of the special apparatus (blood separator) to which donor is connected. The blood of donor is passed through the separator for a few times and hematopoietic stem cells are selected in the plastic package. This painless procedure lasts for 6–7 hours and donor should be relatively immovable but he/she may eat, read or watch TV. This procedure is performed in special room of Collection Centre. The donor can go home 2–3 hours after the collection procedure termination.
- 2. From the bone marrow
This procedure is performed under general anesthesia in the operation room of Collection Centre. The bone marrow is collected by syringe through several punctures in iliac bone and sacrum and put in the plastic package. The surgery lasts for 30–40 minutes. The donor must stay in the medical facility during 2 days after procedure termination.
The volume of hematoplastic cells in both methods is not exceed 200 ml. The own hematopoesis of donor restores during 7–10 days. Usually the donor’s preference for a type of hematopoietic stem cell collection is taking into account.
Who can become a donor of hematopoietic stem cells?
Any person aged 18–55 without hepatitis B and C, tuberculosis, malaria, AIDS, cancer and psychic disturbances.