Worel Nina, Buser Andreas, Greinix Hildegard T, Hägglund Hans, Navarro Willis, Pulsipher Michael A, Nicoloso de Faveri Grazia, Bengtsson Mats, Billen Annelies, Espino German, Fechter Mirjam, Giudice Valeria, Hölig Kristina, Kanamori Heiwa, Kodera Yoshihisa, Leitner Gerda, Netelenbos Tanja, Niederwieser Dietger, van Walraven Suzanna M, Rocha Vanderson, Torosian Tigran, Vergueiro Carmen, Weisdorf Daniel, Yabe Hiromasa, Halter Jörg P
Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria.
Blood Transfusion Centre, Swiss Red Cross, Basel, Switzerland; Department of Hematology, University Hospital Basel, Basel, Switzerland.
Biol Blood Marrow Transplant. 2015 Dec;21(12):2052-2060. doi: 10.1016/j.bbmt.2015.08.009. Epub 2015 Aug 10.
The number of allogeneic hematopoietic stem cell (HSC) transplants performed globally each year continues to increase. Advances in HLA typing, better supportive care, and administration of reduced-intensity conditioning regimens allow treatment of older patients with older sibling donors. Pretransplant donor assessment and testing are very important processes affecting the quality and safety of donation. For unrelated HSC donors detailed recommendations for health assessment have been published, allowing donation only if they are unrestrictedly healthy. Eligibility criteria for related donors are less strict and vary significantly between centers. In situations where a family donor does not meet the suitability criteria for unrelated donors, involved physicians often struggle with the decision whether the matched relative is suitable for donation or not. On behalf of the Worldwide Network for Blood and Marrow Transplantation Standing Committee on Donor Issues, we intended to develop a consensus document with recommendations for donor workup and final clearance of family donors who would not be able to serve as unrelated donors because of their age or pre-existing diseases. This article covers different topics intending to support decision-making, with the goal of minimizing medical risk to the donor and protection of the recipient from transmissible diseases.
全球每年进行的异基因造血干细胞(HSC)移植数量持续增加。HLA分型技术的进步、更好的支持性护理以及采用低强度预处理方案,使得老年患者能够接受来自年长同胞供者的移植治疗。移植前供者评估和检测是影响捐献质量与安全的非常重要的环节。对于非血缘造血干细胞供者,已发布了详细的健康评估建议,只有在他们完全健康的情况下才允许捐献。亲属供者的合格标准没那么严格,且各中心之间差异很大。当家庭供者不符合非血缘供者的适配标准时,相关医生常常难以决定匹配的亲属是否适合捐献。代表全球血液和骨髓移植网络供者问题常务委员会,我们打算制定一份共识文件,针对那些因年龄或既有疾病而无法作为非血缘供者的家庭供者,给出供者检查及最终批准的建议。本文涵盖了不同主题,旨在支持决策制定,目标是将对供者的医疗风险降至最低,并保护受者免受传染病感染。