How transplant centers deal with the dextran shortage: recommendations for comparing alternatives.
In the United States, dextran 40 in 0.9% NaCl is the preferred reagent for the thawing and preparation of cord blood units for hematopoietic stem cell transplantation. The recurring nationwide shortage of this reagent could have implications that extend to the avoidance of cord blood for transplantation.



To address the shortage, the National Marrow Donor Program and its Cord Blood Advisory Group sought to identify available alternative reagents or manufacturers. A sample of transplant centers (TCs) were surveyed to determine their process to compare these alternatives. The TCs were then asked to share their comparability protocols for review.



The 12 TCs that responded to the survey studied various types of alternative reagents and manufacturers of the standard dextran 40 in 0.9% NaCl. Four TCs submitted their protocols from which a model comparability protocol was created for centers who need assistance.



Whether comparing dextran 40 in 0.9% NaCl to that of a different manufacturer or a different reagent, the results of the comparability studies submitted by the TCs indicated equivalency. During a shortage, the model comparability study protocol can be used as a reference to establish an alternative to dextran 40 in 0.9% NaCl.
Department of Immunology and Observational Research, Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota.
Colleen
C
Brady
M.D. Anderson Cord Blood Bank, University of Texas M.D. Anderson Cancer Center, Houston, Texas.
Sue
S
Armitage
ClinImmne Labs, University of Colorado Cord Blood Bank, Aurora, Colorado.
Brian
B
Freed
Department of Cord Blood, Biorepository, and Affiliated Services, National Marrow Donor Program, Minneapolis, Minnesota.
Merry
M
Duffy
Department of Cord Blood, Biorepository, and Affiliated Services, National Marrow Donor Program, Minneapolis, Minnesota.
Anne
A
Gass
Department of Immunology and Observational Research, Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota.
Stephen
S
Spellman
Carolinas Cord Blood Bank, Duke University Medical Center, Durham, North Carolina.
Joanne
J
Kurtzberg
St Louis Cord Blood Bank, SSM Health Cardinal Glennon Children's Hospital, St Louis, Missouri.
Donna
D
Regan
D000925:Anticoagulants / Q000494:pharmacology; D000094902:Blood Banking / Q000379:methods*; D000075202:Contraindications; D036101:Cord Blood Stem Cell Transplantation; D003911:Dextrans / Q000494:pharmacology / Q000600:supply & distribution*; D005312:Fetal Blood / Q000187:drug effects*; D006801:Humans; D011795:Surveys and Questionnaires; D014481:United States
D000925:Anticoagulants; D003911:Dextrans