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Unrelated donor (UD) attrition is a serious problem impacting patients awaiting a transplant. In 2011 we presented results from a study of 7541 UD showing that donor attrition at CT was 38.2% and significantly worse in women, ethnic minorities, non-blood donors and those being on the register longer.
Since then 3 significant changes have been made: the joining age was reduced to 16-30 (previously 18-40), the maximum BMI allowed for PBSC donors was increased from 35 to 40 and an improved tracing system for uncontactable donors was introduced.
The objective of this work was to assess the impact of these changes on the proportion of donors involved in the cancellation of requests.
METHODS
All CT requests made from Anthony Nolan in 2013 were reviewed, and outcomes documented. For each request, donor characteristics were documented.
RESULTS
In 2013, 4207 requests were performed; 56.8% were completed, while 37.7% were cancelled for donor reasons. The univariate analysis showed that longer duration on the register (p<0.001), not being a blood donor (p<0.001) and African, African-caribbean and Asian ethnicities (p<0.001) were associated with higher attrition rates.
Compared to our previous study we found similar attrition rates overall (38.2% to 37.7%; p=0.6). However there was a reduction in donor cancellations for medical reasons (30% to 14.8%; p < 0.001). Conversely, we found that the attrition rates due to emigration or travel had increased (7.9% to 13%; p<0.001).
CONCLUSION
In conclusion, although a similar rate of attrition was seen in donors overall, the reasons were different from our previous study. Two of the changes instituted are likely to have contributed (lowering joining age and increasing BMI). Further work must be done on understanding other factors associated with attrition, and collaborating with other international registries to permit access to donors who have moved to other countries.