Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Donor Identification

The importance of identifying a back-up donor for unrelated stem cell transplantation


The importance of identifying a back-up donor, once a primary suitable unrelated stem cell donor has been found, is often underestimated. Transplant centres erroneously count on the unrelated volunteer donors to be willing, available and medically fit for actual donation. According to our data, which includes 502 unrelated donor work-up procedures performed for 425 Dutch patients between 1987 and 2002, one of 11 work-ups ended in the primary requested donor failing to donate. Of all donor-related cancellations (N=46), 78% of the procedures were deferred due to medical reasons and 22% due to nonmedical reasons. Most of the donors deferred for medical reasons were female (P=0.005). In 50% of the cases for which a back-up donor was already identified, the patients were transplanted with a delay of less then 2 weeks; when no back-up donor was available, the median delay increased to 18 weeks. We strongly encourage implementing a search for at least one back-up donor in the primary search. Identifying a back-up donor can save precious time and complicated logistic rescheduling.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others


  1. Oudshoorn M, Cornelissen JJ, Fibbe WE et al. Problems and possible solutions in finding an unrelated bone marrow donor. Results of consecutive searches for 240 Dutch patients. Bone Marrow Transplant 1997; 20: 1011–1017.

    Article  CAS  PubMed  Google Scholar 

  2. Stroncek D . Results of bone marrow transplants from unrelated donors. Transfusion 1992; 32: 180–189.

    Article  CAS  PubMed  Google Scholar 

  3. Switzer GE, Dew MA, Stukas AA et al. Factors associated with attrition from a national bone marrow registry. Bone Marrow Transplant 1999; 24: 313–319.

    Article  CAS  PubMed  Google Scholar 

  4. Kollman C, Weis T, Switzer GE et al. Non-HLA barriers to unrelated donor stem cell transplantation. Bone Marrow Transplant 2001; 27: 581–587.

    Article  CAS  PubMed  Google Scholar 

  5. Oudshoorn M, Falkenburg JHF, Ebeling LJ et al. Unrelated bone marrow transplantation as a rescue procedure following inadvertent loss of an autologous bone marrow graft. Bone Marrow Transplant 1996; 18: 461–463.

    CAS  PubMed  Google Scholar 

  6. Heemskerk MBA, Van Walraven SM, Cornelissen JJ et al. How to improve the search for an unrelated haematopoietic stem cell donor. Faster is better than more. Bone Marrow Transplant, in press.

  7. Bone marrow donors worldwide 2004;

  8. Gratwohl R, Hermans J, Niederwieser D et al. Female donors influence transplant-related mortality and relapse incidence in male recipients of sibling blood and marrow transplants. Hematol J 2001; 2: 363–370.

    Article  CAS  PubMed  Google Scholar 

  9. Kollman C, Howe CW, Anasetti C et al. Donor characteristics as risk factors in recipients after transplantation of bone marrow from unrelated donors: the effect of donor age. Blood 2001; 98: 2043–2051.

    Article  CAS  PubMed  Google Scholar 

  10. Ottinger HD, Muller CR, Goldmann RF et al. Second German consensus on immunogenetic donor search for allotransplantation of haematopoietic stem cells. Ann Hematol 2001; 80: 706–714.

    Article  CAS  PubMed  Google Scholar 

  11. Hurley CK, Fernandez Vina M, Setterholm M . Maximizing optimal haematopoietic stem cell donor selection from registries of unrelated adult volunteers. Tissue Ant 2003; 61: 415–424.

    Article  CAS  Google Scholar 

Download references


We thank Professors Els Goulmy and Ilias Doxiadis at the Leiden University Medical Centre, Department of Immunohematology, for a critical reading of the manuscript and for helpful suggestions.

Author information

Authors and Affiliations


Corresponding author

Correspondence to S M van Walraven.

Rights and permissions

Reprints and permissions

About this article

Cite this article

van Walraven, S., Heemskerk, M., Lie, J. et al. The importance of identifying a back-up donor for unrelated stem cell transplantation. Bone Marrow Transplant 35, 437–440 (2005).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


This article is cited by


Quick links