HLA Typing and Donor Matching for Bone Marrow Transplant in India

When a newborn baby is born, from the placental side of the cord, 25 ml of stem cells are collected and go to a public bank or a private bank, and later, if you want to do a transplant, you can use that unit. You can do it for any condition, but in India we don't prefer cord blood transplants because there are quite a number of issues with them — that's why we prefer adult donor transplants over a cord blood unit.

There is no role of bone marrow transplant in prostate cancer — none, and no research on it either. On registries: the biggest bank is in Germany, the second biggest in the US, but there are many other banks in other parts of the world — there isn't even a single bank in Africa. That's one of the reasons transplants aren't happening in Africa, other than South Africa and some in Benin City, Nigeria. All of you need to come together and have your own registry, so that if somebody requires stem cells, you have your own bank — you people have to come out with the solution.

That's a very good question, but there is no role of bone marrow transplant in cerebral palsy. There are researches going on about whether transplant helps for cerebral palsy, but we don't have an answer in black and white — at the present moment there is no indication for doing a transplant for cerebral palsy.

Sooner is better — it is better to do a transplant early — but we have done transplants even for adults. I showed a picture of a Nigerian person, Mr. Buhari, whose transplant was done at the age of 34, and he's doing well.

For a matched sibling donor transplant, roughly it is around $25,000 for the transplant; for a half-match transplant it is around $35,000. For accommodation and other logistics you need $10,000 more — so roughly $35,000 for a full match and $45,000 for a half match. The stay is around three months.

HLA typing is the tissue matching test used to determine whether a potential donor is compatible with a sickle cell patient. It is performed on the patient and all available siblings as the first step in planning a transplant.

There is a 25 to 30% chance that any given sibling will be a full match to the patient.

Yes. Fortis has in-house high resolution HLA typing, which allows the team to identify quickly whether a sibling is a full match without sending samples to an external laboratory.

India has its own registry, called DATRI, though for sickle cell disease the more commonly used path when no sibling match exists is haploidentical transplant using a parent.