Limits of the allogen stem-cell transplantation

The default of transplantation in case of a disease where it is medically indicated is usually caused by the lack of a proper (HLA identical) donor. The search for a proper donor primarily starts in the family (relative donor) and secondary in the population (stranger donor). Ideally the allogen graft – the stem-cell to be transplanted – comes form relative donor, e.g. from the brother/ sister of the sick child.
 
Most of the patients waiting for stem-cell transplantation and for a proper donor – in the lack of HLA identical family donors – have to look for stranger stem-cells, so they have to look for a voluntary bone-marrow donor or donated umbilical cord blood stem-cells, which happens with the help of international donor  registers and umbilical cord blood registers.
 
In March, 2006, 43 country’s 58 bone marrow donor registers and 21 country’s 37 umbilical cord blood stem-cell registers altogether scored 10.313.714 donors and umbilical cord blood units. At the same time in the Hungarian register only 5.049 medically screened donors were registered. Consequently the donor was a Hungarian citizen only in two cases out of the 109 Hungarian patients transplanted by stranger donor between 1990 and 2005, in the rest of the cases the stem-cells arrived from abroad (in 67 cases from Germany). 
 
According to the data of the Board of Haematopoietic Stem-cell Transplantation for Children, in 2004/2005, out of 26/25 requests, a proper donor for the transplantation had been found only in 13/15 cases.