OID-06. Arrangement of the donor search in the context of pandemic and socio-economic limitations in Belarus: problems and solutions

Summary

Hematopoietic stem cell transplantation (HSCT) has been used in the Republic of Belarus for more than twenty years. This treatment option often presents the only chance to save the patient’s life. Effective donor search is one of the essential components of successful transplantation. The COVID-19 pandemic and further economic and social restrictions have had a significant impact on the logistics of the donor search, presenting the coordinators with a number of problems that need to be addressed immediately.

Results

The main problem is the lack of the required numbers of HLA-compatible donors in the National Registry. After 2020, the chance of finding a matched donor has significantly decreased due to the outflow of the population and the general health deterioration in the donors amid the COVID-19 pandemic. This problem is solved by searching outside the republic: Russia, Kazakhstan, Poland, Germany, and other countries. Germany and Poland remain the leading suppliers of stem cells, providing 86% of the total number of HSCTs performed in 2018-2022. This fact is explained not only by a large number of potential donors in the registries but also by the diversity of HLA phenotypes. However, the COVID-19 pandemic and the following social and economic events have significantly reduced patients’ chances for successful donor search, first of all, due to the complex logistics of this process at all stages. Thus, in 2020, the number of unrelated allo-HSCTs performed in Belarus decreased by a half (from 32 cases to 16). The current situation requires comprehensive solutions involving all interested parties (medical institutions, the Ministry of Health, services at the state border and customs, courier companies, et al.). One may list the following measures that may contribute to recovery of pre-pandemic HSCT activities: (1) visa-free regimen when entering through Minsk National Airport; (2) allowing couriers to arrive in the country without quarantine measures and providing a certificate of vaccination; (3) arrangement of delivery through third countries (Turkey, Lithuania, and others); (4) implementation of financial calculations via the intermediary banks. Looking for donors in Russia is an option. At the moment, the situation is complicated by lack of a unified Donor Registry and agreements on long-term cooperation between the institutions. However, the experience of stem cell transplantation from Russian donors suggests advances in such cooperation, by mutual engagement of the both sides. Moreover, within the framework of the Union State, it is possible to arrange effective logistics of the donorship process at all stages.

Conclusions

Current donor search is a task with many unknowns. However, HSCT remains the only chance for survival in most patients. It is our destiny to involve all potential resources, to establish partnerships, and also increase the popularity of the very idea of stem cell donation in order to timely implementation of these chances.

Keywords

Hematopoietic stem cell transplantation, donor search, registry, Belarus.