Significant Improvements in the Practice Patterns of Adult Related Donor Care in US Transplantation Centers
Year: 2020
Type: article
Study design: Observational Study
Abstract: Recent investigations have found a higher incidence of adverse events associated with hematopoietic cell donation in related donors (RDs) who have morbidities that if present in an unrelated donor (UD) would preclude donation. In the UD setting, regulatory standards ensure independent assessment of donors, one of several crucial measures to safeguard donor health and safety. A survey conducted by the Center for International Blood and Marrow Transplant Research (CIBMTR) Donor Health and Safety Working Committee in 2007 reported a potential conflict of interest in >70% US centers, where physicians had simultaneous responsibility for RDs and their recipients. Consequently, several international organizations have endeavored to improve practice through regulations and consensus recommendations. We hypothesized that the changes in the 2012 FACT-JACIE Standards, resulting from the CIBMTR study, will have significantly impacted practice. Accordingly, a follow-up survey of US transplant centers was conducted to assess practice changes since 2007, and investigate additional areas where RD care was predicted to differ from UD care. 73 centers (53%), performing 79% of US RD transplants responded. Significant improvements were observed since the earlier survey; 62% centers now ensure separation of RD and recipient care (P<0.0001). However, this study identifies several areas where RD management does not meet international donor care standards. Particular concerns include counseling and assessment of donors before HLA typing, with 61% centers first disclosing donor HLA results to an individual other than the donor, the use of unlicensed mobilization agents, and the absence of long-term donor follow-up. Recommendations for improvement are described.
DOI: 10.17615/mhj6-7307
Authors: Kamble, Rammurti T., Malone, Adriana K., Shah, Nirali N., Kiefer, Deidre M., D'Souza, Anita, Liesveld, Jane L., Lazarus, Hillard M., Savani, Bipin N., Shaw, Bronwen E., Switzer, Galen E., Seftel, Matthew D., Kasow, Kimberly A., Anderlini, Paolo, Halter, Joerg P., DeFilipp, Zachariah, Pulsipher, Michael A., Diaz, Miguel A., Hematti, Peiman, Confer, Dennis L., O'Donnell, Paul V., Norkin, Maxim, Yared, Jean, Abidi, Muneer H., Logan, Brent R., Anthias, Chloe
Institution: University of North Carolina at Chapel Hill
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: U.S. Department of Defense, U.S. Department of Health and Human Services, Amgen, GlaxoSmithKline, Sanofi, WellPoint, Health Research, Teva Pharmaceutical Industries, Ariad Pharmaceuticals, Celgene, HistoGenetics, Osiris Therapeutics, Tarix Pharmaceuticals, Therakos, University of Minnesota, Blue Cross and Blue Shield Association, StemCyte, Medical College of Wisconsin, Otsuka America Pharmaceutical, Sigma-Tau Pharmaceuticals, Actinium Pharmaceuticals, Chimerix, Incyte, Otsuka America, Kiadis Pharma, Swedish Orphan Biovitrum, Medac, Health Resources and Services Administration, Genentech, Onyx Pharmaceuticals, U.S. Navy, Allos Therapeutics, Takeda Oncology, National Heart, Lung, and Blood Institute, Office of Naval Research, National Cancer Institute, National Institute of Allergy and Infectious Diseases
Awards: G1384772222, G1515501300, G1769371581, G205138692, G2108949772, G2220088171, G2814340220, G317906537, G3231857129, G4298420724, G4930744573, G5569911400, DEVELOPMENT OF MEDICAL TECHNOLOGY FOR CONTINGENCY RESPONSE TO MARROW TOXIC SUBSTANCE, G7160503914, G8122066879, G8872364087, G8876996369, A Data Resource for Blood and Marrow Transplants and Adoptive Cellular Therapy Research
OpenAlex ID: W4297971833