In the field of allogeneic stem cell transplantation, the choice between fresh and frozen grafts has always been a topic of discussion. However, with the ongoing COVID-19 pandemic, this debate has gained even more significance. The EBMT Infectious Diseases Working Party (IDWP) and Cellular Therapy & Immunobiology Working Party (CTIWP) have recently provided insights and practices regarding this comparison during these challenging times.
Allogeneic stem cell transplantation is a procedure in which healthy stem cells from a donor are transplanted into a patient with a hematological disorder. These stem cells can be obtained from various sources, including bone marrow, peripheral blood, or umbilical cord blood. Traditionally, fresh grafts have been preferred due to their immediate availability and potential for better engraftment. However, frozen grafts have gained popularity in recent years due to their increased flexibility and reduced risk of infectious complications.
During the COVID-19 pandemic, the safety of both patients and healthcare professionals is of utmost importance. The IDWP and CTIWP have recommended several measures to minimize the risk of viral transmission during allogeneic stem cell transplantation. These measures include pre-transplant screening of donors and recipients for COVID-19, implementing strict infection control protocols, and considering the use of frozen grafts whenever feasible.
One of the main advantages of frozen grafts is the ability to perform thorough donor screening and testing for COVID-19 before transplantation. This ensures that potentially infected donors are identified and their grafts are not used, thus reducing the risk of viral transmission to the recipient. In contrast, fresh grafts may not allow sufficient time for comprehensive testing, increasing the chances of inadvertent transmission.
Furthermore, frozen grafts can be stored for extended periods, allowing for better coordination between donors and recipients. This is particularly important during a pandemic when travel restrictions and quarantine measures may disrupt the timely availability of fresh grafts. Frozen grafts can be transported and stored in specialized facilities, ensuring their viability and availability when needed.
Another advantage of frozen grafts is the reduced risk of infectious complications. Fresh grafts are typically collected from donors shortly before transplantation, increasing the chances of bacterial or viral contamination. In contrast, frozen grafts undergo a rigorous process of cryopreservation, which effectively eliminates most pathogens. This is especially relevant during the COVID-19 pandemic, as it reduces the risk of transmitting the virus from the donor to the recipient.
However, it is important to note that frozen grafts may have some disadvantages as well. The cryopreservation process can lead to a decrease in cell viability and functionality, potentially affecting engraftment and overall transplant outcomes. Additionally, the logistics of freezing, storing, and thawing grafts require specialized facilities and expertise, which may not be readily available in all transplant centers.
In conclusion, the comparison between fresh and frozen grafts for allogeneic stem cell transplantation has gained significant attention during the COVID-19 pandemic. The insights and practices provided by the EBMT Infectious Diseases Working Party and Cellular Therapy & Immunobiology Working Party highlight the advantages of frozen grafts in terms of donor screening, availability, and reduced risk of infectious complications. However, it is essential to consider the potential drawbacks of frozen grafts, such as decreased cell viability and logistical challenges. Ultimately, the choice between fresh and frozen grafts should be made on a case-by-case basis, taking into account the specific circumstances and resources available at each transplant center.
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- Source Link: https://platohealth.ai/fresh-or-frozen-grafts-for-allogeneic-stem-cell-transplantation-conceptual-considerations-and-a-survey-on-the-practice-during-the-covid-19-pandemic-from-the-ebmt-infectious-diseases-working-party-id/