Unrelated Donor Transplants

Unrelated donor (UD) hemopoietic stem cell transplants (HSCT)are being increasingly used, as shown by the annual survey of the European group for Blood and Marrow Transplantation (EBMT): in Europe the number of recorded UD transplants was 752 in 1995 and it was 3617 after 10 years in 2005 (Fig. 19.1), suggesting that most transplant Centres are becoming more confident with the procedure, and that clinical results justify the investment in clinical care and research.Several factors have contributed to this very significant increase in activity: improved human leukocyte antigen (HLA) typing technology, better matching criteria, increased size of the world wide donor pool and improved transplant programs. We will briefly outline each of these different factors. We will not discuss in this chapter transplants from unrelated cord blood, since this is a procedure with specific characteristics; we will restrict the discussion to transplants from unrelated donors who are filed in the National Donor Registries and then in the World Wide File.