Li Hangting, Chen Lingxi, Wu Dijiong, Ruan Jiayin, Wu Xiaolian
Hematology Department, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
J Cancer Surviv. 2025 Aug 30. doi: 10.1007/s11764-025-01887-1.
A second allogeneic hematopoietic stem cell transplantation (allo-HSCT) is often the most effective treatment option for patients experiencing graft failure or disease relapse following a first round of allo-HSCT. Unfortunately, the consent rate for second donation is insufficient to meet treatment needs worldwide. The purpose of this study was to provide a comprehensive understanding of the decision-making experience of unrelated donors when considering making a second donation. This research is essential as it could inform the development of interventions to improve the consent rate for second donation.
This was a descriptive qualitative study that followed the COREQ checklist.
A total of 16 unrelated hematopoietic stem cell donors who completed a second donation were selected by purposive sampling and underwent semi-structured interviews between September and December 2023. Data were analyzed using conventional content analysis.
Data analysis yielded four themes and 11 sub-themes: (1) initial reaction (unexpectedness, immediate consent); (2) locked-in dilemma (worried about the outcome of second donation, faced familial pressure, felt morally hijacked); (3) internal impetus (personal value of helping others, kinship tie, self-efficacy from the first donation, positive impact of the first donation), and (4) external reinforcement (pluralistic social support and societal influence).
To improve the consent rate for second donations, it is necessary to implement targeted education and comprehensive support encompassing personal, familial, and social aspects, while ensuring autonomy. Our analysis suggested that optimizing the first donation experience and fostering positive feedback beliefs are crucial factors when considering a second donation.
By clarifying the decision-making experiences of unrelated donors, this research informs strategies to improve second donation consent rates. Enhanced donor retention directly expands life-saving options for patients with disease relapse or graft failure, potentially improving survival outcomes.
第二次异基因造血干细胞移植（allo-HSCT）通常是第一轮allo-HSCT后出现移植物失败或疾病复发患者最有效的治疗选择。不幸的是，全球范围内第二次捐赠的同意率不足以满足治疗需求。本研究的目的是全面了解非亲属供者在考虑进行第二次捐赠时的决策经历。这项研究至关重要，因为它可为制定提高第二次捐赠同意率的干预措施提供参考。
这是一项遵循COREQ清单的描述性定性研究。
通过目的抽样选取了16名完成第二次捐赠的非亲属造血干细胞供者，并于2023年9月至12月期间对他们进行了半结构化访谈。采用常规内容分析法对数据进行分析。
数据分析得出四个主题和11个子主题：（1）初始反应（意外、立即同意）；（2）锁定困境（担心第二次捐赠的结果、面临家庭压力、感到道德绑架）；（3）内部动力（帮助他人的个人价值观、亲属关系、首次捐赠带来的自我效能感、首次捐赠的积极影响），以及（4）外部强化（多元社会支持和社会影响）。
为提高第二次捐赠的同意率，有必要在确保自主性的同时，实施涵盖个人、家庭和社会层面的针对性教育和全面支持。我们的分析表明，优化首次捐赠体验并培养积极的反馈信念是考虑第二次捐赠时的关键因素。
通过阐明非亲属供者的决策经历，本研究为提高第二次捐赠同意率的策略提供了参考。提高供者留存率直接扩大了疾病复发或移植物失败患者的救命选择，有可能改善生存结果。
