Significant Improvements in the Practice Patterns of Adult Related Donor Care in US Transplantation Centers

Chloe Anthias; Bronwen E Shaw; Deidre M Kiefer; Jane L Liesveld; Jean Yared; Rammurti T Kamble; Anita D'Souza; Peiman Hematti; Matthew D Seftel; Maxim Norkin; Zachariah DeFilipp; Kimberly A Kasow; Muneer H Abidi; Bipin N Savani; Nirali N Shah; Paolo Anderlini; Miguel A Diaz; Adriana K Malone; Joerg P Halter; Hillard M Lazarus; Brent R Logan; Galen E Switzer; Michael A Pulsipher; Dennis L Confer; Paul V O'Donnell

doi:10.1016/j.bbmt.2015.11.008

Significant Improvements in the Practice Patterns of Adult Related Donor Care in US Transplantation Centers

Biol Blood Marrow Transplant. 2016 Mar;22(3):520-7. doi: 10.1016/j.bbmt.2015.11.008. Epub 2015 Nov 18.

Authors

Chloe Anthias¹, Bronwen E Shaw², Deidre M Kiefer³, Jane L Liesveld⁴, Jean Yared⁵, Rammurti T Kamble⁶, Anita D'Souza², Peiman Hematti⁷, Matthew D Seftel⁸, Maxim Norkin⁹, Zachariah DeFilipp¹⁰, Kimberly A Kasow¹¹, Muneer H Abidi¹², Bipin N Savani¹³, Nirali N Shah¹⁴, Paolo Anderlini¹⁵, Miguel A Diaz¹⁶, Adriana K Malone¹⁷, Joerg P Halter¹⁸, Hillard M Lazarus¹⁹, Brent R Logan²⁰, Galen E Switzer²¹, Michael A Pulsipher²², Dennis L Confer²³, Paul V O'Donnell²⁴

Affiliations

¹ Anthony Nolan Research Institute, London, UK. Electronic address: chloe.anthias@anthonynolan.org.
² Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA.
³ Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN, USA.
⁴ Department of Medicine, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, NY, USA.
⁵ Department of Medicine, Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA.
⁶ Division of Hematology and Oncology, Baylor College of Medicine Center for Cell and Gene Therapy, Houston, TX, USA.
⁷ Division of Hematology/Oncology/Bone Marrow Transplantation, University of Wisconsin Hospital and Clinics, Madison, WI, USA.
⁸ Department of Medical Oncology and Haematology, CancerCare Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada.
⁹ Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL, USA.
¹⁰ Winship Cancer Institute of Emory University, Atlanta, GA, USA.
¹¹ Division of Hematology-Oncology, Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA.
¹² Department of Oncology, Spectrum Health, Michigan State University, Grand Rapids, MI, USA.
¹³ Division of Hematology/Oncology, Vanderbilt Medical Center, Nashville, TN, USA.
¹⁴ Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA.
¹⁵ Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
¹⁶ Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain.
¹⁷ Tisch Cancer Institute, Mount Sinai Medical Center, New York, NY, USA.
¹⁸ Department of Hematology, University Hospital Basel, Switzerland.
¹⁹ Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH, USA.
²⁰ Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, WI, USA; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA.
²¹ University of Pittsburgh, VA Medical Healthcare System, Pittsburgh, PA, USA.
²² Division of Hematology, Oncology and Blood and Marrow Transplantation, Children's Hospital of Los Angeles, USC Keck School of Medicine, Los Angeles, CA, USA.
²³ National Marrow Donor Program/Be The Match, Minneapolis, MN, USA.
²⁴ Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

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% of 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 Foundation for the Accreditation of Cellular Therapy and the Joint Accreditation Committee-International Society for Cellular Therapy and European Society for Blood and Marrow Transplantation standards resulting from the CIBMTR study would have significantly impacted practice. Accordingly, we conducted a follow-up survey of US transplantation centers to assess practice changes since 2007, and to investigate additional areas where RD care was predicted to differ from UD care. A total of 73 centers (53%), performing 79% of RD transplantations in the United States, responded. Significant improvements were observed since the earlier survey; 62% centers now ensure separation of RD and recipient care (P < .0001). This study identifies several areas where RD management does not meet international donor care standards, however. 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 made.

Keywords: Accreditation; Hematopoietic cell donation; Related donor.

Publication types

Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adult
Female
Guideline Adherence / standards*
Hospitals, Special / standards*
Humans
Male
Practice Patterns, Physicians' / standards*
Retrospective Studies
Tissue Donors*
United States

Abstract

Publication types

MeSH terms

Grants and funding