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Donor Search: The Process from A-Z

Donor Search: The Process from A-Z. National Marrow Donor Program for 2009 Transplant Financial Coordinators Association Laura Olesen, RN, CHTC. A ncient History of the NMDP. Established - October 1986 First transplant - December 1987 10 Transplant Centers 8,000 Donors 26 Donor Centers

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Donor Search: The Process from A-Z

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  1. Donor Search: The Process from A-Z National Marrow Donor Program for 2009 Transplant Financial Coordinators Association Laura Olesen, RN, CHTC

  2. Ancient History of the NMDP • Established - October 1986 • First transplant - December 1987 • 10 Transplant Centers • 8,000 Donors • 26 Donor Centers • 100th transplant – February 1989 The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  3. Current Status of the NMDP • 7 million donors on Be the Match Registry • ~37,000 join each month • 5 million donors thru international partners • 300,000 cord blood units • 350 (400) transplants per month (12-15 per day) • 166 member Transplant Centers (35 Intl) • 35 Cooperative Registries • 56 member Donor Centers (6 Intl) The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  4. Donor Registration www.marrow.org The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  5. Donor Registration The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  6. Donor Registration • Donor Registration Criteria: • Between ages of 18 and 60 • Meet minimum health guidelines • Commit • Cost? • Receive a kit or “in-person” The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  7. Donor Registration The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  8. General Overview – Search Process The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  9. Free Patient info submitted by member transplant center or referring physician through OPA All inclusive, donors and cords Results immediately available Search based on HLA type of patient Member transplant center “acts on” the search results by requesting a donor or cord “do something” Fee for services and Preliminary Search Formal Search The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  10. HLA??? HLA ………………………………Human Leukocyte Antigens HLA-A……………………………HLA locus HLA-A, B, DR, C, DQ …. HLA loci compared between donor and patient HLA-A*02……………………. Antigen HLA-A*0201……………….. Allele – unique protein ------------------------------------------------------------- HLA-A*02XX………………..Low level typing HLA-A*02AB………………..Intermediate level typing (02AB = 0201/0202) HLA-A*0201…………………High resolution/allele specific typing The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  11. HLA Typing Example XX = Could be any associated allele, testing not specific BC = Could be 1302 or 1303 AB = Could be 1501 or 1502 The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  12. HLA Typing Example XX = Could be any associated allele, testing not specific BC = Could be 1302 or 1303 AB = Could be 1501 or 1502 The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  13. SAMPLE The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  14. Improve/Confirm Donor’s HLA • Donors have HLA typing verified • Transplant center selects donors for additional HLA typing • Could be a cheek swab or blood sample • May include infectious disease testing • Several different typing services offered by the NMDP (DR, HR, CT) DR Request HR and/or CT Request The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  15. Improve/Confirm Donor’s HLA The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  16. Match Found! • Transplant center selects the donor that is the best match for the patient. • HLA – most important criteria • Infectious disease test results • Age, gender, availability, CMV status, product type • TC proposes type of stem cell donation • Marrow • Peripheral Blood Stem Cell (PBSC) • Donor “work up” begins The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  17. Donor Workup • Steps in the Donor Workup Process: • Information Session • Sign Consent • Physical Exam and Testing • “Cleared” to Donate • Pre-donation activities • Blood samples for testing, TC and/or research • Collect auto units or receive Filgrastim • Donate! Work Up Process The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  18. Information Session All information necessary to make an informed decision about whether or not to donate Information about why, where, how, risks, alternatives, benefits, confidentiality, insurance, etc. Sign a donation consent Physical Exam Determine if donation is safe for the donor Determine if the stem cells will be safe and effective for the recipient Collection center or apheresis center physician performs the examination Donor Workup The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  19. Aspirated from the “posterior aspect of the iliac crest” Surgical procedure about 1-2 hours General or epidural anesthesia Same day surgery or one night stay Surgical coding Stem Cell Donation The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  20. Requires use of Filgrastim Collected via Apheresis techniques One or two day collection, 3-5 hours per day No hospital stay unless complications or central line Lab coding Stem Cell Donation The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  21. Transplants Facilitated The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  22. Transplants by Diagnosis The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  23. Marrow or PBSC Patient has already received preparative regimen Stem cells are collected and delivered immediately as a liquid product Transported in a “cooler” using frozen gel packs or at room temperature Are considered irreplaceable and must be hand carried under constant supervision Stem Cell Transport The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  24. Timely Donor Recovery • Monitor recovery until back to normal • Marrow issues – average 21 days • Nausea/vomiting • Pain, bruising, swelling at collection site • Prolonged muscle soreness • PBSC issues – average 5 days • Bone pain, malaise • Fatigue • Pain, swelling, bruising at needle sites The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  25. Zoom, Zap – a Second Donation • Additional blood samples for testing or T-cells • Unit of whole blood for T-cells • Leukapheresis for T-cells • Peripheral blood stem cells • Marrow Second Donation The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  26. Second Donations Second Donation The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  27. The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  28. The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

  29. The NATIONAL MARROW DONOR PROGRAM® operates the Be The Match RegistrySM.

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