In this video, Dr. Sunil Bhat provides an in-depth overview of bone marrow transplantation as a potential cure for thalassemia ...

part-4-what-are-the-different-types-of-donors-how-do-we-choose-a-donor-amp-who-is-an-ideal-donor

Part 4 | What Are the Different Types of Donors, How Do We Choose a Donor &amp; Who is an Ideal Donor?

[Music] Hello friends uh my name is Dr Sunil but I'm the director and clinical lead of periodic Hematology Oncology and board M transplantation at the Naran H Bangalore now I have been doing this series of small videos with you and discussing the various aspects of talisia and talisia care now to today's video I'm going to be discussing um bone merrow transplant and thalis measure as bone transplant Thal measure is a very very big topic uh I'm going to be dividing it into few components and today's component is going to be on what are the different types of donors which can be used for transplantation and how we can choose which is the better and which is the the ideal donor to be used now before we get into that you know um we know that for bone neur transplantation in talisia major uh is probably the only practical Curative option at this point of time although as we all know that gene therapy is another potential Curative option it has been approved abroad but it's very expensive and at this point of time not available for our patients in India so I'll Focus my discussion on bone transplant being a Curative and practical option for our patient now what happens with bone marrow transplantation is that we want to destroy the bone marrow of the patient who got Thim measure and replace it by a healthy bone marrow from a healthy donor right so this healthy bone marrow from the healthy donor goes and stays in the bone marrow of this patient and leads to normal blood production so the aim of bone marrow transplant is to replace the defective marrow and give the opportunity for this patient to manufacture normal blood so that they not dependent on transfusion from outside so the first important aspect is to who can be a donor right now all of us come up with something called as CH typing and we get actually typing from our parents we get half from the mother and half from the father it's like our fingerprint like all of us with a unique fingerprint we also come with a unique actually typing so between the patient and the donor we have to match them on something called as H typing and as I said it comes from the parents hence the chances of H typing matching is more between siblings so the chances your brother or sister can match you is more than anyone else in the world right so what is this chance the chance of EX typing matching siblings is around 25 to 30% so that means if 10 patients are there and these 10 patients all of them have one one sibling who can donate for them there's a two or three patients will have a full H typing match sibling in this 10 patients so that's how it works now the so what we do need to do is H typing between the patient and the potential donors right this H typing is done by two different ways one is called as low resol typing some called as high resoltion typing now low res typing it is good enough when you match patient and The Sibling but if you to match anyone who is not a sibling like a mother father Uncle Auntie other family members or even unrelated donors you need to do something called as high resolution H typing low is not good enough so these are two typ H typing and mostly in today's world today's days we do high typing for all of them even for siblings we do H typing because readily available and is one short process and we don't have to repeat it again and again so that is one now the second myth is there that from a patient and the donor there should be having same blood groups it's not important patients and donor blood group can be anything you don't need to have same blood gr between the patient the donor but they need to have same H typing which I was discussing with you just now so H typing is important blood group is not important that's number one number two is that what are the various types of donors which can be used for transplantation the first I explained you already and that is something called as mased sibling donor that means patients brother or sister who does not have talisia can be a donor if they're actually typing with the patient that is the one type of donor second can be matched family donor that means anywhere else in the family like like mother father Uncle Auntie or anyone else who's related to you in the family has got the same H typing as the patient has got that is called as match related full match related donor family donor so this is one type of donor that is a full matched family donor whether sibling or non- sibling if we do not have this as an option then the second option we look at is something called as unrelated donor that means anywhere in India abroad does anyone have a full match donor a full match H typing with our patient and how do we do that we do that from Registries there are unrelated donor Registries both in India and abroad where we can take the typing of the patient send it to the registry and tell them is any full match donor for our patient now there are various Registries which are available in India there's something called as dri registry there is a dkms bmst registry there's MDR registry in India and there are various reg abroad there's a registry in us there's a registry in UK there's a regist in Germany and various other registries and we can have access to all these Registries and see there anyone in world is matching this patient which is called as 10 by 10 match so that's second type of transplant called as unrelated donor transplant fully match third type of transplant which can be done especially these days is something call as hpal transplantation that means half match donor so patients always have biological parents as half matches right and if the siblings are not a full match they may be a half match also so practically when we use a half match donor we have donor for practically every patient because half match donors are available actually in all the patient families that can also be a type of donor and that's called as half match donor transplantation or hyal transplantation that came another type of donor there's another type of transplantation which used to do before and now we are not doing it as frequently that's called as Cod blood transplantation that mean you take the Cod blood from unrelated donor Cod blood registry and use that as a Cod blood trans which is somebody else's Cod blood stored in some registry in some cod blood bank now Cod blood Bank unrelated C blood transplants have reduced in number because outcomes of hyperal transplantation have improved over a period of time and hence we these days do not use cod Bloods as a source of stem cells from unrelated donors we still use cod Bloods from related donors if they siblings or CS are stored we can still use them but usually the other ones we do not use nowadays very frequently so these are the different types of transplants which can be done in thalin major so first I said matched family donor which can be sibling or non- sibling chances of that finings about 25 30% matched unrelated donor 10 by 10 match from unrelated donor registry chances of finding a full 10 by 10 match donor is around 10 to 20% third is H transplantation using one of the parents or other siblings as a donor and that is something called as Happ transplantation and as I said practically everyone will have a donor available for transplantation and the last one is called as Cod blood transplantation using Cod blood as a stem of stem cells and that can other typee of transplantation which can be used so these are the various types of donors which can be used for transplantation and every patient will have to look at what options they have available and based on the best option available for them we will we will suggest or take them for that kind of transplant so that was the first you know uh section I want to cover on transplantation based on the donut type thank you very much [Music]

Dr.

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