Hematopoietic Stem Cell Donor and Recipient Evaluation

Chowdhury, Mita Roy; Lassiter, Martha; Javed, Rizwan; Katewa, Satyendra

Donor selection and evaluation is crucial to hematopoietic stem cell transplantation. Evaluation of donor fundamentally assesses the risk of infectious disease transmission to the recipient and improves the quality of hematopoietic progenitors cell (HPC) product. It also minimizes the chances of adverse donor reactions during the donation process. Ideally, the donor evaluation should involve eliciting a detailed medical history, high-risk behavior, and psychosocial evaluation followed by a complete physical examination and a battery of investigation. Any abnormal finding would not necessarily lead to donor deferral but help the clinical team to closely access the risk versus benefit. It is mandatory to take informed written consent from all donors. Special considerations are taken in autologous patients and pediatric donors to obtain a good quality HPC product. A thorough review and evaluation of all vital organ function in the recipients should be completed to determine transplant eligibility. The disease status at the time of HSCT will help the physician determine the conditioning regimen to prescribe. Pre-transplant psychosocial risk factors are said to predict survival after HSCT. The hematopoietic cell transplant comorbidity index (HCT-CI) is a commonly used tool to score pre-transplant comorbidities that predict non-relapse mortality and survival. Patient and donor education is a vital part of care for HSCT patients, their families, and informal caregivers. Proper documentation of consents, procedures, and treatment plan should be done in compliance with regulatory guidelines. FACT-JACIE International Standards Accreditation covers clinical program related to cellular therapy. Accreditation requires trained, competent staff and a quality management plan, which includes policies and standard operating procedures for a cellular therapy program.