The race for stem cells

Over the past 25 years, the South African Bone Marrow Registry (SABMR) – the only registry in South Africa that supports an active unrelated donor match and transplant programme – has helped save the lives of hundreds of patients with life-threatening blood diseases.

Currently, approximately 30 times a year, couriers travel to fetch stem cells from anonymous overseas donors, delivering them to South African patients awaiting bone marrow transplants.

Timing is everything when a patient needs a bone marrow transplant to survive and the journey of stem cells for transplant is planned like a military operation.

From searching for the right tissue match – finding someone in the general public who is like an identical twin – to coordinating the collection and delivery of stem cells, the SABMR leaves nothing to chance.

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The first hurdle: Finding a matching donor 

The SABMR’s mission is to find matching unrelated bone marrow donors for critically ill South Africans who need a transplant to live but who do not have a match in their family. This represents the majority of patients – over 70% – living with disorders or illnesses such as leukaemia. Stem cell transplants can help patients recover from these serious maladies and live a long and healthy life.

Since the chance of finding a matching donor for a patient is approximately one in 100 000, identifying a suitable match is a complex process that can take weeks, or even months, to find. With only close to 74 000 registered donors in South Africa, the SABMR has partnered with donor registries in 56 countries worldwide to increase the chance of finding the perfect match for local patients.

“I was ecstatic and relieved when I heard the news that an international donor had been found” – Andrew Melck (27)

Diagnosed with leukaemia at 25

Andrew Melck (27) is a representation of the 70% of patients who rely on finding a match from an unrelated donor.

Melck was diagnosed with leukaemia in September 2015. The SABMR conducted a search across local and international databases but a match was not found in South Africa. Just two months after Andrew’s diagnosis, the SABMR found a 10/10 match on the German database.

“The thought that a donor may not be found is one that slowly wears down your energy and emotions, leaving you open to worry and frustration. I was ecstatic and relieved when I heard the news that an international donor had been found,” says Melck.

Andrew Melck with Dr Darren Green at the 2016 WPBTS Donor Awards.

The second hurdle: transporting the stem cells to the patient 

Once a match is found, the SABMR coordinates the transport of the collected cells to the patient’s bedside in a transplant centre in South Africa.

The bag of life-saving stem cell fluid – live human tissue – must be transported by a personal courier and arrive within 72 hours of the start of collection in order to remain effective for transplant.

It is kept in a small, cool, temperature-monitored hamper and closely watched to ensure its safety. Couriers may not take alcohol or sleeping pills on the plane and must keep the container within sight at all times, taking it with them wherever they go.

SABMR Assistant Harvest Coordinator, Jane Ward, is a seasoned courier who knows the importance of delivering stem cells on time.

“As couriers, we are told that we can only pick up the hamper at a certain time, since harvesting of the cells needs to take place and necessary blood counts need to be done. The timing of these processes can often be tight,” explains Ward.

On one occasion, while travelling from Sheffield, England to Manchester Airport to catch her connecting flight to Heathrow Airport, Ward found herself in a taxi stuck in traffic for more than an hour. Of his own free will, the taxi driver decided to risk getting points deducted from his driver’s licence to get Jane and the cells to the airport on time. Upon arriving at the airport, and with less than an hour until boarding time, Jane needed to make her way through security. The hamper carrying the cells cannot be X-rayed as this can destroy the cells. Thus, in order to prevent this, couriers have to be prepared and follow strict security protocol. After waiting for more than 20 minutes while the security manager verified her documents, Jane boarded the flight with minutes to spare.

Despite the challenges presented by international collections, most courier trips are uneventful. The moment the stem cells reach the transplant centre, couriers are met with the feeling of relief and satisfaction that their job is done.

“It is a great privilege to be a part of potentially giving someone a second chance at life,” says Ward.

The SABMR’s role in helping save the lives of patients in need of a bone marrow transplant is an intricate one that is carried out with the utmost care. The selfless acts of couriers like Jane bring hope to patients like Andrew for a second lease on life.

“Words can’t describe the gratitude one has for the people involved in providing you with a chance of survival,” says Melck, “On a mission to deliver the cells from the unselfish donor, the courier takes part in a race against time and is often faced with immense challenges. Their determination saves lives and we, as patients, are eternally grateful for this.”

For more information on the South African Bone Marrow Registry (SABMR), visit www.sabmr.co.za

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