Evaluation of Hematopoietic Stem Cell Donors

Abstract

Donation of hematopoietic stem cells, either through bone marrow or peripheral blood collection, is a generally safe procedure for healthy donors. Serious adverse events are uncommon and death is exceedingly rare. Nevertheless, all donors must be carefully evaluated and fully informed prior to donation. This should be done by clinicians having good understanding of the potential physical and psychological complications of donation and the factors that may increase these risks. Additionally, donors and graft products must be evaluated for the potential to transmit infections and other diseases to the recipient and to satisfy an increasing number of national and international regulatory requirements. Donors must be able to provide informed consent without coercion or pressure. Special attention to the clinical, psychological and social needs of pediatric donors is necessary.

Allogeneic peripheral blood stem cell collection as of 2008

“…While an accurate assessment would be problematic, it can be estimated that no less than 20,000 to 30,000 PBSC donors have received rhG-CSF [1], and the number is growing daily. Available evidence indicates that the procedure is remarkably safe, although rare serious adverse events have been described.…”

“…Over 15,000 stem cell donors are harvested every year, and rhG-CSF mobilized PBSCs accounted for 75% of related and 50% of unrelated donor donations in North America alone in 2003 [1]. This manuscript provides a concise outline of the key features of PBSC collection as performed in most transplant or apheresis units worldwide as of 2008.…”

Having a sibling as donor: Patients' experiences immediately before allogeneic hematopoietic stem cell transplantation

“…Siblings who are asked to donate stem cells are in a vulnerable situation, where they may experience emotional stress, pressure, and even coercion from relatives and health professionals (Christopher, 2000;de Oliveira-Cardoso et al, 2010;Horowitz & Confer, 2005;Pillay et al, 2012). The fact that even if the sibling donates there is no guarantee that the patient will survive may exert extra emotional pressure.…”

“…The questionnaire was, based on clinical experiences and earlier studies (Christopher, 2000;Horowitz & Confer, 2005;Wiener et al, 2008;Williams et al, 2003) and was specially developed for the survey in this study purposely to meet the aim of the study. For validation an initial version was sent to five experts in the field at different HSCT centres in Sweden for comments and a new version was tested in a pilot study (Brace, 2008).…”

Potential adult sibling stem cell donors’ perceptions and opinions regarding an information and care model

“…In particular, there were indications that insufficient account was taken of the emotional stress potential sibling donors may experience, as well as the pressure, and even coercion, they may feel from relatives and health professionals. [1][2][3] Earlier publications have highlighted the situation of living family donors and their need for information about the donation process. [4][5][6] Potential donors have found themselves in a stressful or coercive situation, with feelings of being socially isolated, sometimes with a fear of donating.…”