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A proposed plan for the management of adult sibling donors

Bone Marrow Transplantation volume 42, pages 357–358 (2008)Cite this article

Siblings who are asked to donate haematopoietic stem cells are in a vulnerable position. Potential sibling donors must be fully informed, orally and in writing, and be able to provide informed consent without pressure or coercion.1, 2, 3 To achieve this, one must focus on the management of confidentiality in terms of donor volunteer status and strive to protect the integrity of the sibling.4, 5 At our centre we decided to improve this aspect in the care of potential sibling donors, enabling an early termination of the process for those not willing or unable to donate. We also wanted to improve the information to, and the follow-up of sibling donors.

In September 2005, a novel structure for the management and care of potential sibling donors was introduced at our centre. A fundamental change was that all physicians within our referring region were instructed not to perform HLA-typing of siblings by themselves. Instead, the physicians were asked to provide our transplantation (stem cell transplantation (SCT)) coordinator with identity data of the siblings, after their consent. The SCT-coordinator administers all further contacts with the siblings and also their HLA-typing. First, a written information folder about HLA-typing and haematopoietic stem cells donation, stressing that typing and donation are voluntary, is sent to the siblings. An initial telephone contact is then made by the SCT-coordinator, giving the sibling an opportunity to ask questions and to decline HLA-typing and donation. If there are any doubts about the suitability of the sibling as a donor, a visit to the SCT physician, including extended information and a medical check-up, is undertaken before HLA-typing is performed. If a sibling is willing to donate and declares himself/herself to be healthy, samples for HLA-typing are drawn without any prior visit. Siblings who decline to donate or who already have obvious medical contraindications at the time of the initial telephone contact are not typed. The SCT-secretariat receives HLA-typing results of all the siblings. However, these are not sent to the physician responsible for the patient. The SCT physician makes a note in the patient's record that (a) there is an HLA-matched potential sibling donor(s) and the donor identity(ies) or (b) the patient has no suitable sibling donor, but no reason is given for why the sibling(s) cannot donate, and the patient never receives information about the reason.

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Authors and Affiliations

  1. Department of Haematology, University Hospital, Lund, Sweden

    A Kisch, A Lindmark & S Lenhoff

  2. Blood Centre Department, University Hospital, Lund, Sweden

    J Dykes

Authors
  1. A Kisch
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  2. J Dykes
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  3. A Lindmark
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  4. S Lenhoff
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Correspondence to A Kisch.

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Kisch, A., Dykes, J., Lindmark, A. et al. A proposed plan for the management of adult sibling donors. Bone Marrow Transplant 42, 357–358 (2008). https://doi.org/10.1038/bmt.2008.172

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