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Variations in practice in UK transplant centers: results of a related donor care survey

Bone Marrow Transplantation volume 51, pages 1612–1614 (2016)Cite this article

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The results of retrospective analyses suggest that related donors (RDs) are at greater risk of donation-associated adverse events, including death, compared with unrelated donors (UDs).1, 2 This occurs in part because RDs are frequently accepted as hematopoietic cell (HPC) donors with morbidities for which an UD would be deferred.3, 4 In the UK, the Human Tissue Authority (HTA) is responsible for implementation of legislation regarding collection, storage and use of tissue from living donors, the cornerstone of which is informed consent.5 Joint accreditation of ISCT and EBMT (JACIE) accreditation, required to ensure reimbursement, necessitates compliance with standards aimed at protecting the health and interests of relatives donating, and preventing disease transmission to transplant recipients.6 However, unlike UD practice where World Marrow Donor Association (WMDA) Standards7 define best practice at each stage of the donor care pathway, neither Foundation for the Accreditation of Cellular Therapy (FACT)-JACIE Standards nor the HTA Code of Practice, do so. Although both mandate donor virology tests to prevent disease transmission to recipients, standards regarding RD health are more generic, for example, requiring the existence of policies rather than defining their content. International organizations including the Worldwide Network for Blood and Marrow Transplantation (WBMT)8 and the WMDA9 have produced consensus recommendations that are more definitive, but we do not know how extensively these have been adopted by transplant centers.

This study aimed to investigate current UK related donor (RD) practice by examining compliance with FACT-JACIE Standards and international consensus recommendations and investigating how assessment of donor medical suitability is conducted across transplant centers. We also sought to determine the views of UK RD care physicians regarding current care pathways and attitudes to guideline development.

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Acknowledgements

We thank physicians from the following transplant centers for their participation in this study: Aberdeen Royal Infirmary; Addenbrookes Hospital; Alder Hey Children's Hospital Liverpool; Beatson West of Scotland Cancer Centre, Glasgow; Belfast city Hospital; Imperial College, London; Manchester Royal Infirmary; Nottingham University Hospital; Oxford University Hospitals NHS Trust; Queen Elizabeth Hospital, Birmingham; Royal Devonshire Hospital; SE Scotland Clinical Apheresis Unit; Sheffield Children's Hospital; St Bartholomew’s Hospital; St George’s Hospital; St James’ University Hospital Leeds; The Royal Marsden; University College Hospital, London; University Hospitals Bristol; The Christie University Hospital of Wales; Wessex Blood and Marrow Transplant Programme.

Author contributions

CA and BES designed the study, CA, BES and KK performed the research, CA analyzed the data, all authors wrote the paper.

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Authors and Affiliations

  1. Anthony Nolan Research Institute, UCL Cancer Centre, London, UK

    C Anthias & J A Madrigal

  2. Department of Haemato-oncology, The Royal Marsden Hospital Downs Rd, Sutton, UK

    C Anthias

  3. Department of Haemato-oncology, Oxford University Hospitals NHS Trust, Oxford, UK

    A Peniket

  4. BSBMT, Guy’s Hospital, London, UK

    K Kirkland

  5. Department of Medicine, Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Wisconsin, WI, USA

    B E Shaw

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  1. C Anthias
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  2. A Peniket
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  3. K Kirkland
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  4. J A Madrigal
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  5. B E Shaw
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Corresponding author

Correspondence to C Anthias.

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The authors declare no conflict of interest.

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Supplementary Information accompanies this paper on Bone Marrow Transplantation website

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Anthias, C., Peniket, A., Kirkland, K. et al. Variations in practice in UK transplant centers: results of a related donor care survey. Bone Marrow Transplant 51, 1612–1614 (2016). https://doi.org/10.1038/bmt.2016.220

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