1
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Ong JQL, Lim LJH, Ho RCM, Ho CSH. Depression, anxiety, and associated psychological outcomes in living organ transplant donors: A systematic review. Gen Hosp Psychiatry 2021; 70:51-75. [PMID: 33721612 DOI: 10.1016/j.genhosppsych.2021.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/24/2021] [Accepted: 03/01/2021] [Indexed: 12/23/2022]
Abstract
With increasing demands for living organ donations, understanding the prevalence of depression and anxiety, which are the commonest psychiatric disorders in donors following organ transplantation, will serve to improve psychiatric care to safeguard donors' mental wellbeing. This descriptive systematic review examines all observational studies in English investigating prevalence of depression and anxiety in adult transplant donors using bibliographic databases. Sixty-two papers were included (kidney, n = 25; liver, n = 25; bone marrow, n = 7; uterus, n = 2; lung, n = 1; kidney and lung concurrently, n = 2). Post-transplantation depression and anxiety prevalence rates (Depression: 0-46.9%, Anxiety: 0-66.7%) did not differ significantly from pre-transplantation and were largely comparable to the general population. Other psychiatric disorders observed included bipolar disorder, conversion disorder, adjustment disorder and sleep disorder. Other psychological outcomes observed included lower quality of life, lower satisfaction of life and regret after donation. Pre-donation risk factors such as poor physical/psychological health status, and post-donation risk factors such as complicated post-surgical recovery and poor physical/psychological health in recipients were identified, predisposing donors to poor psychological outcomes. Individuals with risk factors should be monitored and provided with social support, psychoeducation, psychotherapy and long-term follow up. Future studies should adopt consistent methodological approaches to improve comparability between various studies. More research investigating poor psychological outcomes in other organ donors besides kidney and liver donors, donors who have past psychiatric history, unrelated and parent donors is warranted.
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Affiliation(s)
- Jun Q L Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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2
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Zomerdijk N, Turner J, Hill GR, Gottlieb D. Experiences and unmet needs of family members requested to donate haematopoietic stem cells to an ill relative: findings from a prospective multi-centre study. Support Care Cancer 2020; 29:635-644. [PMID: 32424644 DOI: 10.1007/s00520-020-05520-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 05/06/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Despite well-documented physical effects of haematopoietic stem cell (HSC) donation, far less attention has been focused on the psychosocial impact for family donors. This study aimed to better understand the psychosocial aspects of HSC donation by family members, focusing, in particular on their needs for information and supportive care. METHODS Thirty-one adult HSC family donors from two clinical hospitals were interviewed before, during and 1 month after HSC donation. Interviews explored ambivalence, motivation, perceived pressure, preparedness, the donor-recipient relationship, information and support received and suggestions for improvement. RESULTS Three main themes about the donation experience were identified: 'call to arms' (focused on the recipient, stressful urgency, making meaning of being a donor, decisional ambivalence), 'proceeding with donation' (living in limbo, unsettling uncertainty, pervasive pain, feeling supported) and 'after the dust settles' (feeling discarded, downplaying role, residual symptoms, dealing with adverse recipient outcomes). Underlying system and communication issues included time for consideration prior to donor work-up, management of confidentiality, information inadequacy and access to support. Donors wanted information about the emotional challenges specific to being a family donor, such as ways in which previous donors coped with recipient death. For donors whose recipient had died, the priority for improved care was follow-up support. CONCLUSION Our findings emphasise a gap in information and supportive care for family donors and the need for a protocol specifically designed to inform and support family donors before, during and after HSC donation.
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Affiliation(s)
- Nienke Zomerdijk
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia. .,Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. .,Bone Marrow Transplant Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. .,School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia.
| | - Jane Turner
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.,Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Geoffrey R Hill
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.,Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,Bone Marrow Transplant Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - David Gottlieb
- Blood and Bone Marrow Transplant Unit, Westmead Hospital, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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3
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Zając-Spychała O, Pieczonka A, Barańska M, Wachowiak J. Long-Term Recipient Health-Related Quality of Life and Donor-Recipient Relationship following Sibling Pediatric Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2019; 26:401-406. [PMID: 31622770 DOI: 10.1016/j.bbmt.2019.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/03/2019] [Accepted: 10/08/2019] [Indexed: 01/13/2023]
Abstract
Despite the fact that the choice of donors and the number of sources of hematopoietic stem cells have increased, a sibling remains a preferred donor for allogeneic hematopoietic stem cell transplantation (HSCT). Transplant donation between siblings is a unique life experience that may have an impact on their future relationship. The aim of the study was to quantitatively measure the quality of life (QoL) in patients who underwent transplant and to describe the relationship between a recipient and a sibling donor after HSCT. We identified and invited 82 adults aged 18.0 to 38.7 years (median, 23.6) who underwent HSCT in our center and their sibling donors to participate in this survey. Forty-five patients (54.9%) and their siblings consented to take part in the study. The studied group consisted of 45 matched siblings donor (MSD)-HSCT recipients (19 women and 26 men) aged 18.0 to 36.2 (median, 28.5) years, who underwent MSD-HSCT at the age of 5.8 to 16.3 (median, 11.9) years, and their sibling donors aged 21.0 to 36.0 (median, 31.0) years, who were aged 11.2 to 20.2 (median, 15.5) years at bone marrow harvesting. For QoL and sibling relationship assessment, we used the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT) and the Adult Sibling Relationship Questionnaire (ASQR). Higher scores indicate better quality of life in each scale of the FACT-BMT and the more significant is the factor in a sibling relationship measured by the ASQR. The questionnaires were given to both subgroups, HSCT recipients and donors, and the results were compared with each other. The overall result of the FACT-BMT questionnaire was 117 ± 35.0. The highest QoL was found in the functional (25.0 ± 3.5) and social well-being (25.0 ± 3.5) subscales, whereas the worst was in the emotional well-being (18.0 ± 9.5) subscale. Statistically, the QoL score was not influenced by current age (P = .378), age at the moment of HSCT (P = .256), and sex (P = .117). Being a recipient or a donor of HSCT was not a significant factor associated with warmth (2.6 ± 0.5 versus 3.1 ± 0.5; P = .830) and conflict (2.0 ± 0.7 versus 2.1 ± 1.2; P = .886) within the sibling relationship, whereas recipients scored significantly lower in rivalry within the sibling relationship compared with HSCT donors (0.8 ± 0.3 versus 1.2 ± 0.2; P = .012). The FACT Treatment Outcome Index remained the only significant predictor of warmth in the sibling relationship between HSCT recipient and donor. QoL in adult patients after HSCT in childhood was good. Sibling donor-recipient relationship is unbalanced, with a higher level of rivalry presented among donors. Further multicenter studies based on a larger cohort of patients are necessary to assess all aspects of the sibling relationship after transplantation experience.
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Affiliation(s)
- Olga Zając-Spychała
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Anna Pieczonka
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Małgorzata Barańska
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
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4
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Zomerdijk N, Turner J, Hill GR, Gottlieb D. Adult related haematopoietic stem cell donor care: Views of Transplant Nurses. Eur J Oncol Nurs 2019; 41:56-63. [PMID: 31358258 DOI: 10.1016/j.ejon.2019.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 05/08/2019] [Accepted: 05/31/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE The objective of this mixed-methods study was to explore the experiences and perspectives of Transplant Nurses (TNs) in caring for related donors (RDs). METHOD In this mixed-methods study, both quantitative and qualitative data were collected from semi-structured interviews with seven TNs from two clinical hospitals. Closed and multiple-choice questions regarding the organisation of RD care were administered in addition to an in-depth exploration of TN experiences and perspectives of RD care. Interviews were audio-recorded, transcribed, and qualitative data was subjected to thematic analyses. RESULTS The analysis identified 5 themes relating to RD care: managing complex family dynamics and ambivalence; concerns about RD psychological adjustment; identifying and correcting RD misperceptions; limited guidelines and structured processes; limited training for the role and access to supervision. Five themes were identified describing the barriers to delivering RD care: RDs unwilling to express their concerns; language; time constraints; medical priority of clinicians; biomedical focus of TNs. All TNs agreed they would like additional training in the psychosocial management of RDs. TNs identified key areas for improvement, including psychosocial support and educational material. CONCLUSIONS Our results highlight the significant role of TNs in RD care, and underline issues specific to the current RD care environment. Lack of training for the role and limited guidelines addressing RD care management are key issues which may detrimentally affect RD care. The pivotal role of TNs must be acknowledged and supported by improving TN training and implementing clear guidelines for the management of RDs. The trial has been registered on the publicly accessible register: www.clinicaltrials.gov site with the identifier ACTRN12617000407392.
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Affiliation(s)
- Nienke Zomerdijk
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia; Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
| | - Jane Turner
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia; Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
| | - Geoffrey R Hill
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia; Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia; QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Fred Hutchinson Cancer Research Center, Sydney, NSW, Australia.
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5
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Gallo AM, Patil CL, Knafl KA, Angst DA, Rondelli D, Saraf SL. The experience of adults with sickle cell disease and their HLA-matched adult sibling donors after allogeneic hematopoietic stem cell transplantation. J Adv Nurs 2019; 75:2943-2951. [PMID: 31287187 DOI: 10.1111/jan.14152] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 04/18/2019] [Accepted: 05/29/2019] [Indexed: 01/25/2023]
Abstract
AIM To provide a rich description and in-depth understanding of the recipient-donor allogeneic hematopoietic stem cell transplantation experience. BACKGROUND A stem cell transplant has a high likelihood of improving symptoms of sickle cell disease in adults. While studies have reported the transplant experiences of recipients and donors with haematological malignancies, no published reports have examined the experience of both adult recipients with sickle cell disease and their donors. DESIGN Exploratory qualitative descriptive analysis. METHODS We conducted individual interviews with 13 recipients and donors (eight males, five females) representing five recipient-donor dyads and one recipient-donor triad from one Midwest transplant centre between August 2017-February 2018. Interviews were digitally audio-recorded, transcribed verbatim and analysed using conventional content analysis. FINDINGS Five themes were identified: the downward spiral and a second chance; getting the monster off my back; difficult and manageable; it was worth it; and relating to the healthcare team. CONCLUSIONS The results provide a description and insights into the complex nature of the stem cell transplant experience in sickle cell disease from the perspectives of both recipients and donors. IMPACT Health provider awareness of recipient-donor experiences can contribute to family-centred care that supports the health and quality of life for both recipients and donors. This understanding promotes high quality clinical care and improved communications by taking into account the knowledge, values and informed preferences of recipients and donors and contributes to improved decision-making and clinical care. Future research can assess family experiences that support informed choice for potential transplant candidates.
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Affiliation(s)
- Agatha M Gallo
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Crystal L Patil
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Kathleen A Knafl
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Denise A Angst
- Advocate Aurora Health, Advocate Aurora Health Research Institute, Downers Grove, IL, USA
| | - Damiano Rondelli
- Department of Medicine, Division of Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA
| | - Santosh L Saraf
- Department of Medicine, Sickle Cell Center, University of Illinois at Chicago, Chicago, IL, USA
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6
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Zomerdijk N, Turner JM, Hill GR. Adult-related haematopoietic stem cell donor experiences and the provision of information and psychosocial support: A systematic literature review. Eur J Cancer Care (Engl) 2018; 28:e12932. [PMID: 30277290 DOI: 10.1111/ecc.12932] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 08/26/2018] [Accepted: 08/31/2018] [Indexed: 01/12/2023]
Abstract
For blood cancer patients, haematopoietic stem cells (HSC) donated by a relative can be lifesaving. However, related donors can face significant physical and psychosocial challenges. As the demand for adult-related HSC donors is increasing, it is important to review our understanding of adult-related HSC donors' need for and availability of information and psychosocial support with a view to identifying gaps in the literature. A systematic review of relevant studies (2000-2017) was conducted using five databases with supplementary hand searching. Sixteen studies involving 1,024 related HSC donors met the following criteria: English or Dutch language, peer-reviewed, sampled first-time-related HSC donors, ≥18 years, haematological malignancies, assessed psychosocial aspects, retrospective or prospective and with or without comparison group. Data were abstracted, and study quality was assessed using the PRISMA criteria. Studies contained limited information on the provision of information and psychosocial support. Most studies addressed pre-donation information, and none reported providing information or support to donors post-donation. Additionally, few studies formally assessed unmet needs. Recommendations include improved transparency of reporting for the availability, sources and timing of information and psychosocial support, and the identification of unmet needs to enable the development of educational and psychosocial interventions for this invaluable donor population.
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Affiliation(s)
- Nienke Zomerdijk
- Faculty of Medicine, Mental Health Centre, University of Queensland, Brisbane, Qld, Australia.,Royal Brisbane & Women's Hospital, Brisbane, Qld, Australia.,Bone Marrow Transplantation Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
| | - Jane M Turner
- Faculty of Medicine, Mental Health Centre, University of Queensland, Brisbane, Qld, Australia.,Royal Brisbane & Women's Hospital, Brisbane, Qld, Australia
| | - Geoffrey R Hill
- Faculty of Medicine, Mental Health Centre, University of Queensland, Brisbane, Qld, Australia.,Royal Brisbane & Women's Hospital, Brisbane, Qld, Australia.,Bone Marrow Transplantation Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
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7
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Polomeni A, Tardieu L, Ainaoui M, Andrianne C, Bancillon N, Chapel V, Chevallier N, Evrard S, Fournier I, Gargallo G, Godin S, Issarni D, Le Bars L, Renaud B, Yakoub-Agha I, Wallart A, De Bentzmann N. [Information booklet for related hematopoietic stem cell donors: Guidelines from the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)]. Bull Cancer 2017; 104:S71-S75. [PMID: 29126585 DOI: 10.1016/j.bulcan.2017.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/03/2017] [Accepted: 08/09/2017] [Indexed: 10/18/2022]
Abstract
Providing information to living donors is first and foremost a legal obligation as well as an ethical one, not to mention necessary to health care provision. It's been shown that quality of information concerning the procedure's practical aspects, scheduling of clinical tests and examinations, withdrawing stem cells for the donation, post-donation symptoms, and support provided by healthcare teams, directly impacts the donor's quality of experience. Taking this into consideration our group decided it was essential to create an informational support for donors in the form of a booklet to be provided in different hematopoietic stem cell transplant centers across France. In September 2016 in Lille, France, the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) organized the 7th allergenic hematopoietic stem cell transplantation clinical practices harmonization workshops. As part of these workshops, our group worked collectively to develop a basis of indispensable information to be included in the booklet and presented using clear and accessible language.
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Affiliation(s)
- Alice Polomeni
- Assistance publique-Hôpitaux de Paris, hôpital Saint-Antoine, service d'hématologie et de thérapie cellulaire, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - Laure Tardieu
- Centre hospitalier Dupuytren, service d'hématologie, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France
| | - Malika Ainaoui
- CHRU de Lille, service des maladies du sang, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
| | - Christelle Andrianne
- Centre hospitalier universitaire de Liège, domaine universitaire du Sart-Tilman, hématologie clinique, B35, 4000 Liège, Belgique
| | - Nelly Bancillon
- CHU d'Angers, service des maladies du sang, 49033 Angers cedex 2, France
| | - Valerie Chapel
- Centre hospitalier de Lyon Sud, hématologie secteur 1 G, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - Nathalie Chevallier
- CHRU de Strasbourg, unité de greffe de moelle osseuse, 1, avenue Molière, 67098 Strasbourg, France
| | - Solène Evrard
- CHU de Rennes, hématologie clinique, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - Isabelle Fournier
- CHRU hôpital Sud, service des maladies du sang, BP 3009, 80030 Amiens cedex, France
| | - Guillaume Gargallo
- G.H. du Haut-Levêque, service des maladies du sang, avenue de Magellan, 33604 Pessac, France
| | - Sandrine Godin
- CHRU de Lille, hôpital Jeanne-de-Flandre, service hématologie pédiatrique, avenue Eugen-Avinée, 59037 Lille, France
| | - Dominique Issarni
- Hôtel dieu CHU, service d'hématologie clinique, place Alexis-Ricordeaux, 44035 Nantes cedex 01, France
| | - Laetitia Le Bars
- CHU de Rennes, hématologie clinique, 2, rue Henri-Le-Guilloux, 35000 Rennes, France
| | - Barbara Renaud
- CHRU de Montpellier-site Saint-Éloi, département d'hématologie et de thérapie cellulaire, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - Ibrahim Yakoub-Agha
- CHU de Lille, LIRIC Inserm U995, université de Lille 2, 59000 Lille, France.
| | - Anne Wallart
- CHRU de Lille, service des maladies du sang, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
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Kisch AM, Forsberg A. The Core of Sibling Stem Cell Donation - A Grounded Theory Study. Open Nurs J 2017; 11:73-83. [PMID: 28839511 PMCID: PMC5543621 DOI: 10.2174/1874434601711010073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 05/05/2017] [Accepted: 05/23/2017] [Indexed: 11/22/2022] Open
Abstract
Background: There is a lack of theoretical framework supporting stem cell transplant nurses in their assessment, judgment and caring interventions of sibling stem cell donors. Objective: The purpose of this study was to explore sibling stem cell donors’ main concerns and how they deal with them before and after donation. Method: Ten healthy sibling donors, 5 men and 5 women, with a median age of 54 years were included in this study when they were due to donate stem cells to a brother or sister. Data were collected prospectively on three occasions (before the donation and three and twelve months after it) through in-depth interviews, which were recorded and transcribed verbatim for analysis by the Grounded Theory method according to Charmaz. Results: This study describes the efforts of the ten donors to fulfil their duty as a sibling by doing what they considered necessary in order to help. Their efforts were summarised in a process wherein the grounded theory generated three main categories; Prepare, Promote and Preserve. A clear path of transition leading to fulfilment is evident, starting before the donation and continuing for one year afterwards. Conclusions: Being a sibling stem cell donor means doing what you have to do to fulfil your duty and if possible, saving the life of a seriously ill brother or sister. The relationship between the siblings is strengthened by the donation process. Sibling stem cell donation appears to be about fulfilment and the theoretical framework may support clinicians in their evaluation and support of donors.
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Affiliation(s)
- Annika M Kisch
- Department of Haematology, Skåne University hospital, Lund, Sweden
| | - Anna Forsberg
- Lund University, Inst of Health Sciences and Department of Thoracic Surgery, Skåne University Hospital, Lund, Sweden
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9
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Polomeni A, Bompoint C, Gomez A, Brissot E, Ruggeri A, Belhocine R, Mohty M. Current practices for screening, consent and care of related donors in France: Haematopoietic stem cell transplantation coordinator nurses’ perceptions. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12612] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2016] [Indexed: 01/15/2023]
Affiliation(s)
- A. Polomeni
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
| | - C. Bompoint
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
| | - A. Gomez
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
| | - E. Brissot
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
| | - A. Ruggeri
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
| | - R. Belhocine
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
| | - M. Mohty
- Service d'Hématologie Clinique et thérapie cellulaire; Hôpital Saint Antoine; Assistance Publique-Hôpitaux de Paris; Paris France
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Anthias C, O'Donnell PV, Kiefer DM, Yared J, Norkin M, Anderlini P, Savani BN, Diaz MA, Bitan M, Halter JP, Logan BR, Switzer GE, Pulsipher MA, Confer DL, Shaw BE. European Group for Blood and Marrow Transplantation Centers with FACT-JACIE Accreditation Have Significantly Better Compliance with Related Donor Care Standards. Biol Blood Marrow Transplant 2015; 22:514-9. [PMID: 26597079 DOI: 10.1016/j.bbmt.2015.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 11/10/2015] [Indexed: 10/22/2022]
Abstract
Previous studies have identified healthcare practices that may place undue pressure on related donors (RDs) of hematopoietic cell products and an increase in serious adverse events associated with morbidities in this population. As a result, specific requirements to safeguard RD health have been introduced to Foundation for the Accreditation of Cellular Therapy/The Joint Accreditation Committee ISCT and EBMT (FACT-JACIE) Standards, but the impact of accreditation on RD care has not previously been evaluated. A survey of transplant program directors of European Group for Blood and Marrow Transplantation member centers was conducted by the Donor Health and Safety Working Committee of the Center for International Blood and Marrow Transplant Research to test the hypothesis that RD care in FACT-JACIE accredited centers is more closely aligned with international consensus donor care recommendations than RD care delivered in centers without accreditation. Responses were received from 39% of 304 centers. Our results show that practice in accredited centers was much closer to recommended standards as compared with nonaccredited centers. Specifically, a higher percentage of accredited centers use eligibility criteria to assess RDs (93% versus 78%; P = .02), and a lower percentage have a single physician simultaneously responsible for an RD and their recipient (14% versus 35%; P = .008). In contrast, where regulatory standards do not exist, both accredited and nonaccredited centers fell short of accepted best practice. These results raise concerns that despite improvements in care, current practice can place undue pressure on donors and may increase the risk of donation-associated adverse events. We recommend measures to address these issues through enhancement of regulatory standards as well as national initiatives to standardize RD care.
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Affiliation(s)
- Chloe Anthias
- Anthony Nolan Research Institute, London, United Kingdom.
| | | | - Deidre M Kiefer
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - Jean Yared
- Department of Medicine, Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Maxim Norkin
- Division of Hematology/Oncology, University of Florida, Florida College of Medicine, Gainesville, FL, USA
| | - Paolo Anderlini
- The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Bipin N Savani
- Division of Hematology/Oncology, Vanderbilt Medical Center, Nashville, TN, USA
| | - Miguel A Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | | | - Joerg P Halter
- Department of Haematology, University Hospital Basel, Switzerland
| | - Brent R Logan
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Galen E Switzer
- University of Pittsburgh, VA Medical Healthcare System, Pittsburgh, PA, USA
| | - Michael A Pulsipher
- Children's Hospital of Los Angeles, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Dennis L Confer
- National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - Bronwen E Shaw
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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11
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Being a haematopoietic stem cell donor for a sick sibling: Adult donors' experiences prior to donation. Eur J Oncol Nurs 2015; 19:529-35. [PMID: 25813531 DOI: 10.1016/j.ejon.2015.02.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 02/23/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is a lack of knowledge about sibling stem cell donors' experiences pre-donation and the waiting period before the donation might have been long. The donors and their corresponding sibling recipients were simultaneously included in two different interview studies. The results from the recipient study have been presented in a separate paper. PURPOSE The aim was to explore the experiences of being a stem cell donor for a sibling, prior to donation. METHOD Ten adult sibling donors were interviewed prior to stem cell donation. The interviews were digitally recorded, transcribed verbatim and subjected to qualitative content analysis. RESULTS The main theme Being a cog in a big wheel describes the complex process of being a sibling donor prior to donation, covering a mixture of emotions and thoughts. The four subthemes Being available, Being anxious, Being concerned and Being obliged cover the various experiences. The sibling donors' experiences are influenced by the quality of the relationship with the sick sibling. CONCLUSIONS Sibling stem cell donors go through a complex process once they have accidentally got involved in. They have been asked to become a donor; it was not a voluntary choice. In caring for sibling stem cell donors the nurses should be aware of the complexity of the process they experience and take into consideration their personal situation and needs. Providing optimal care for both sibling donors and their corresponding recipients is a challenge, and further improvement and exploration are needed.
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