Similarities and Differences Between Allogeneic Hematopoietic Cell and Organ Transplantation and What We Can Learn From Each Other to Guide Global Health Strategy.

Overview

BACKGROUND: Allogeneic hematopoietic cell transplantation (HCT) and solid organ transplantation (SOT) have evolved into successful, curative treatments for many severe congenital and acquired diseases. Both use medical products of human origin and should therefore have overarching regulatory frameworks. Both require critical decisions about donor selection, donor/recipient matching, immunosuppression, and long-term care, all tasks best performed by a trained, highly specialized multidisciplinary team. Both need committed institutions and governmental support for their success. Whereas the main barrier for performing SOT is the lack of suitable organs, access to a transplant center is the main limitation for HCT, which remains a highly specialized, complex, resource-intensive, and costly medical procedure. METHODS AND RESULTS: Here, we describe the main indications for HCT and SOT, their similarities and differences regarding donor selection, treatment prior to transplant, intensity and duration of immunosuppression after transplantation, their main complications, and consequences of donation for living donors. CONCLUSIONS: Strategies to improve worldwide access to HCT and SOT are discussed, as well as future developments in this highly innovative field of medicine.