The importance of commitment in Stem Cell donation: addressing the crisis

In an era where nearly 43 million stem cell donors are registered globally through the World Marrow Donor Association (WMDA), the challenge of tracing and contacting eligible matched donors poses a substantial hurdle for patients in need of transplants. A startling revelation from a recent WMDA global trend report revealed that 50% of registered donors were removed from the database in 2023 due to untraceability or contact issues. This alarming statistic highlights a growing crisis that could jeopardise the lives of countless patients awaiting life-saving procedures.

The South African Bone Marrow Registry (SABMR) has voiced grave concerns over this troubling trend. Currently, the odds of finding a suitably matched donor stand at a disheartening 1 in 100,000. For patients belonging to certain ethnic or mixed backgrounds, the likelihood decreases significantly due to the complexities of genetic diversity. In South Africa alone, the situation is compounded, with a staggering 11% of donors unable to be contacted—an impediment that could ultimately determine whether patients receive the life-saving transplant they desperately need.

The significance of accurate tissue typing, conducted via Human Leukocyte Antigen (HLA) testing, illustrates the critical nature of a broad and diverse registry. Jane Ward, the Deputy Director of the SABMR, emphasises the importance of commitment from registered donors: “Once someone signs up as a stem cell donor, a certain degree of commitment is required, as lives quite literally hang in the balance.” Finding a matched donor can make the difference between a patient receiving the transplant that could save their life or missing out on a vital opportunity.

Maintaining a viable registry isn’t without its challenges. Factors leading to the removal of donors range from medical issues and immigration to reaching the age limit or personal withdrawal from the registry. Notably, once individuals develop a medical condition after signing up, they are no longer eligible to donate. Similarly, donors older than 61 are retired from the registry, as younger donors are associated with better patient outcomes.

Ward highlights that donors have the autonomy to withdraw at any point before donation: “Most donors are delighted to hear that they have been chosen to donate and potentially save a life.” Yet, recent trends indicate a rising number of donors feel disheartened, often due to a lack of understanding about the donation process, sometimes exacerbated by family dissuasion.

In response to these alarming statistics, the SABMR is set to launch a new campaign aimed at strengthening donor retention and engagement. This initiative will involve:

• Regular education and awareness efforts to emphasise the importance of stem cell donation.
• Conducting annual anniversary surveys with registered donors to assess ongoing commitment.
• Post-donor drive recommitment questionnaires targeting newly recruited or potential donors.

Through these efforts, Ward reiterates the profound impact each donor has on the likelihood of finding a suitable match and improving patient outcomes. There is a particular call for younger donors to join the registry, as the SABMR database ages past the three-decade mark. “We’ve seen the impact first-hand of what a successful transplant means, providing hope to patients and families who would otherwise face an uncertain future,” she stated. “Therefore, we urge all donors to keep their contact information updated, as inaccuracies can severely affect a patient’s chance of finding a match and ultimately surviving.”