INTRODUCTION

The selection of a donor is a critical element contributing to the success of a hematopoietic cell transplant (HCT). There are several possible sources for these cells:

• An identical twin (syngeneic, HLA identical)
• A sibling, relative, or unrelated donor (allogeneic, which can be HLA identical, haploidentical, or mismatched)
• The patient (autologous, HLA identical)
• Umbilical cord blood (allogeneic, which can be HLA identical, haploidentical, or mismatched)

This topic will provide an overview of the general issues involved in donor selection for HCT [1,2]. The decision as to which donor source to utilize depends to a large degree upon the clinical situation and the approaches employed at the individual transplant center. (See "Sources of hematopoietic stem cells".)

GENERAL CONSIDERATIONS

Transplant donors must be in generally good health without other comorbid conditions. The donor must have a performance status that will permit the safe collection of the cells, either by bone marrow (BM) or peripheral blood progenitor cell (PBPC) collection [3,4]. (See "Sources of hematopoietic stem cells".)

Thus, the donor must have adequate cardiac, pulmonary, hepatic, and renal function. If being considered for BM collection, the donor must be able to tolerate anesthesia (either general or regional). Pediatric donors are only utilized for autologous collection or donation to siblings. Donors with ongoing malignancies or a history of a malignant condition other than minor skin cancers (eg, basal cell carcinomas) are generally excluded from further consideration. For sibling donors with a history of a malignant condition, a five-year disease-free period without recurrence is usually considered adequate for subsequent collection.