Fostering Donations, Saving LivesBy Rodrigo Brugada | Fri, 08/06/2021 - 15:07
Q: How has the stem cell transplant panorama changed in Mexico, especially considering the pandemic and changes regarding INSABI?
A: Generally, only 30 percent of those who need a stem cell transplant are able to get one from their family. The other 70 percent must find a genetically compatible person. Be The Match® México is the most diverse registry of potential bone marrow donors. Our mission is to find genetic matches around the world to provide life-saving opportunities for patients with blood diseases in need of a transplant. We seek to diversify and increase the number of donors in Mexico to ensure match opportunities. Currently, Be the Match has facilitated 29 transplants in the country, seven were from a Mexican donor to a Mexican patient. We have also received donations from 71 people in the country.
The pandemic changed the dynamics of registering with Be The Match® México. Previously, we would carry out mass registration events at races, corporations and universities, among others. We would give talks about the donation process, register potential donors and take oral samples from them to be included in our global database. Due to the health emergency, we made these education and sample collection processes virtual. For sample collection, potential donors need to pre-register on our website and we send them a sample collection kit. The donor pays nothing; we cover all expenses. If a match is found anywhere in the world, we contact them to start the donation process.
Q: How do you motivate more people to donate given the complexities of the procedures and associated fears?
A: There are always myths surrounding this subject. We provide accurate information about this process and the impact it can have. At the end of the day, we are talking about saving a life.
We first provide information about the process. There are two main ways to donate stem cells. The first requires peripheral blood and is quite similar to donating platelets. It takes about four to six hours. The second is through a bone marrow aspirate, which is a surgical procedure that requires anesthesia. The risks involved are very low: there is a 0.2 percent complication rate and is related with the anesthesia. The donor does not pay for anything. We pay all the related expenses to protect the donor and expedite the transportation of these cells.
Q: How do you provide integral care to donors and patients, particularly regarding the mental health impacts of transplants and immunosuppressive therapy?
A: Many of the patients are children. We accompany them by complementing the information given by the doctors about their disease and what the donation process will involve. This is followed by the match process and the transplant. Finally, we accompany them after the transplant with the necessary treatments and necessary follow-ups. Our main focus is to make it easier to find a donor and get the cells to the transplant center. We can also channel them to other organizations to provide other kinds of support, including emotional support.
As for the donor, they are examined to ensure they are in good health to make the donation and to prevent the transmission of certain diseases through the transplant process. We then proceed to collection in private centers. We cover all expenses, including the mobilization of the donor to the hospital, if necessary.
Q: How have your research efforts strengthened transplants nationally and internationally? What role does bioinformatics play in this process?
A: We provide specialized software to the transplant centers to facilitate the worldwide match query. This allows us to perform a preliminary search and estimate how many donors there may be. We do high-resolution genetic and immunological matching analysis to compare genetic markers and estimate the level of compatibility between a potential donor and the recipient, trying to maintain at least an 80 percent compatibility level.
Q: What role does Mexico play in the biotherapies field and what growth opportunities are there in the country?
A: The biotherapies filed operates mainly in the US and seeks to advance the scientific knowledge of stem cells and their therapeutic applications. One example is tissue regeneration, which could bring important advances for medical science and for people’s health. It is important to democratize these therapies worldwide.
In Mexico and Latin America, the need for transplants is quite large. Mexico requires approximately 2,000 transplants per year but the percentage covered is very low. Transplants from unrelated donors are not common but Be The Match® México has helped raise awareness. Mexico has served as a spearhead for the region and has provided advances for transplants in Latin America. Our goal is to grow in Latin America to make it easier for people in the region to come to Mexico, either to donate or to receive a transplant.
Q: How do you work in collaboration with hospitals and civil associations to ensure care is given where it is needed?
A: We have a network of 15 hospitals, which helps us to perform transplants and collect donated cells. We seek to add hospitals to this network to offer more benefits and to make it easier to perform these procedures. We also provide training to physicians and residents to further their medical educational opportunities. Furthermore, we run campaigns to promote donation and research opportunities.
Be The Match® México also works with other nonprofit associations to provide a comprehensive approach and support in the post-transplant process. We also provide medical centers with financial assistance of up to US$20,000 for operating expenses related to donor activation, cell collection, and for genetic and immunological typing studies for patients and their families. The goal is to remove the barrier of time and money for the patient.
Q: Given the high costs associated with transplants, how do you manage finances to ensure the process and follow-up is as affordable as possible?
A: In public hospitals, transplants are free of charge. In private centers, the cost can vary between MX$1 million (US$50,000) and MX$3 million (US$150,000). The work that Be The Match® México does, particularly because of the import-export process, costs approximately MX$1 million (US$50,000) and we cover up to 40 percent of it. In addition, we cover the costs of genetic analysis, which costs approximately MX$150,000 (US$7,500).
Q: What regulatory constraints must Mexico address to ensure a higher rate of donations?
A: The public health systems should cover all pre-transplant processes to facilitate transplantation. The same goes for private insurance companies, which should expand their coverage. The processing of paperwork needs to be faster and COFEPRIS has supported us with this component. In Mexico, COFEPRIS is in charge of issuing permits for the importation and exportation of stem cells. The donor and recipient hospital are in charge of processing these permits but we help them with these processes.
Be The Match® México is a nonprofit organization that seeks to help patients with blood diseases by connecting them with bone marrow donors.