title: Deferrals of volunteer stem cell donors referred for evaluation for matched-unrelated stem cell donation.
abstract: To minimize donor risk and maintain public support, volunteer donor stem cell donation, whether by mobilized leukapheresis or marrow aspiration, requires careful donor eligibility assessment. Many contraindications to stem cell donation exist, yet analyses of donor deferral rates are not available. In a 36-month series encompassing 2493 potential stem cell donors, we analyzed frequencies and reasons for deferrals. All were presumed eligible by their registries because of previously submitted structured health questionnaire and formal telephone interviews. After assessment by our center's physicians, 3.3% of donors proved ineligible, but 5.6% more were eligible for only one of the collection methods. Higher deferral rates were associated with female sex, increasing age and mobilized stem cell donation vs marrow. Exclusion criteria were identified with approximately similar frequency by medical history, physical examination and laboratory testing. Reasons for deferrals almost exclusively served to protect donor safety; the rare recipient-directed safety concerns could be, and often were, overridden in agreement with the transplant center. As formal analyses have shown, with careful assessment, stem cell donation is acceptably safe, but the plethora of deferral reasons mandate that only physicians with specific experience should evaluate stem cell donors, that is, this task should not be delegated to paramedical personnel.
authors.affiliation: Department of Cellular Therapeutics/Cell Processing (GMP), German Red Cross Blood Service Baden-Württemberg-Hesse, Frankfurt, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Bräuninger
authors.affiliation: Department of Cellular Therapeutics/Cell Processing (GMP), German Red Cross Blood Service Baden-Württemberg-Hesse, Frankfurt, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Thorausch
authors.affiliation: Department of Cellular Therapeutics/Cell Processing (GMP), German Red Cross Blood Service Baden-Württemberg-Hesse, Frankfurt, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Luxembourg
authors.affiliation: Department of Cellular Therapeutics/Cell Processing (GMP), German Red Cross Blood Service Baden-Württemberg-Hesse, Frankfurt, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Schulz
authors.affiliation: Ambulantes Krebszentrum Schaubstraße, Frankfurt, Germany.
authors.forename: K U
authors.initials: KU
authors.lastname: Chow
authors.affiliation: 1] Department of Cellular Therapeutics/Cell Processing (GMP), German Red Cross Blood Service Baden-Württemberg-Hesse, Frankfurt, Germany [2] Institute for Transfusion Medicine and Immunohematology of the Goethe University, Frankfurt, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Seifried
authors.affiliation: 1] Department of Cellular Therapeutics/Cell Processing (GMP), German Red Cross Blood Service Baden-Württemberg-Hesse, Frankfurt, Germany [2] Institute for Transfusion Medicine and Immunohematology of the Goethe University, Frankfurt, Germany [3] Department of Medicine/Division of Hematology, University of Washington, Seattle, WA, USA.
authors.forename: H
authors.initials: H
authors.lastname: Bonig
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D046148:Donor Selection / Q000379:methods*; D005260:Female; D006801:Humans; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012042:Registries; D012737:Sex Factors; D013234:Stem Cells; D061349:Unrelated Donors
references.citation: Blood Transfus. 2009 Jan;7(1):35-8
references.pmid: 19290078
references.citation: Blood Transfus. 2011 Jan;9(1):46-9
references.pmid: 21084010
references.citation: Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013 Oct;56(10):1352-67
references.pmid: 24002586
references.citation: Transfusion. 2008 Dec;48(12):2531-9
references.pmid: 18717777
references.citation: JAMA. 2010 Apr 28;303(16):1617-24
references.pmid: 20424252
references.citation: Blood Transfus. 2012 Oct;10(4):440-7
references.pmid: 22871823
references.citation: Blood. 2009 Apr 9;113(15):3604-11
references.pmid: 19190248
references.citation: Haematologica. 2009 Jan;94(1):94-101
references.pmid: 19059940
references.citation: Nat Rev Immunol. 2008 Jul;8(7):533-44
references.pmid: 18551128
references.citation: Neurology. 2000 Jun 13;54(11):2147-50
references.pmid: 10851379
references.citation: Curr Opin Hematol. 2013 Nov;20(6):485-93
references.pmid: 24104408
references.citation: Am J Pathol. 2008 Sep;173(3):600-9
references.pmid: 18688037
references.citation: Transfus Med Hemother. 2013 Aug;40(4):225-35
references.pmid: 24179471
references.citation: Bone Marrow Transplant. 1998 Jun;21 Suppl 3:S35-9
references.pmid: 9712491
references.citation: Blood Rev. 2012 Jan;26(1):33-42
references.pmid: 21996651
references.citation: Blood. 2009 Oct 29;114(18):3757-63
references.pmid: 19666868
references.citation: Vox Sang. 2013 Jan;104(1):46-54
references.pmid: 22827736
references.citation: Transfusion. 2008 Sep;48(9):2008-25
references.pmid: 18564401
references.citation: Blood. 2008 Sep 1;112(5):2092-100
references.pmid: 18523146
references.citation: Bone Marrow Transplant. 2013 Sep;48(9):1161-7
references.pmid: 23584439
references.citation: Transfus Med Hemother. 2012 Feb;39(1):17-22
references.pmid: 22896762
references.citation: Haematologica. 2004 Apr;89(4):ECR05
references.pmid: 15075097
references.citation: Blood. 2013 Jan 3;121(1):197-206
references.pmid: 23109243
references.citation: Biol Blood Marrow Transplant. 2012 Nov;18(11):1716-26
references.pmid: 22713691
references.citation: Int J Hematol. 2010 Dec;92(5):765-8
references.pmid: 21120643
references.citation: Bone Marrow Transplant. 1996 Mar;17(3):433-4
references.pmid: 8704701
references.citation: J Appl Genet. 2013 Nov;54(4):441-446
references.pmid: 23959593
references.citation: Bone Marrow Transplant. 2013 Nov;48(12):1506-9
references.pmid: 23892330