Japan Marrow Donor Program to shorten wait for marrow transplants

Main Category: Stem Cell Research
Article Date: 08 May 2004 - 0:00 PDT

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The Japan Marrow Donor Program (JMDP), a foundation that promotes bone marrow transplants, has launched a project to shorten waiting periods.

Such transplants are one of the most effective treatments for leukemia and other diseases.

The number of operations that involved donors who were not blood relatives and were mediated by the JMDP's bone-marrow bank reached 5,489 in March after the first bone-marrow operation in 1993.

The number of people who have registered as donors has exceeded 186,000. But not all patients can receive the operation.

The annual number of bone marrow transplants has leveled off at more than 700, while the annual number of patients is between 1,500 and 1,700.

Many patients died while waiting for donors.

The JMDP started its project this fiscal year to restrict waiting periods to around 100 days and work toward improving coordination.

Last year, the median waiting period was 175 days, while the shortest was 60 days and the longest 3,740 days.

In the United States and Europe last year, the median waiting period was about 120 days.

One reason for the difference between Japan and other countries is that schedules for blood tests and bone marrow extractions delay the operation.

Although such schedules should be coordinated between the medical institution and the donor to ensure that the patient only has to wait for a short time, few facilities are flexible.

Procedures, including finalizing a donor's will, also are complex.

Some have criticized the JMDP for its bureaucratic nature, calling it inflexible and saying it takes an unnecessarily long time to process paperwork.

Another factor in the drop in transplants is that patients have more treatment options.

Transplanting cord blood stem cells from placenta and umbilical cords have the same effect as a bone-marrow transplant. The number of such transplants are increasing because a patient can be operated on within a week.

Last year, 588 cord blood stem cell transplants were conducted and have increased in number over the past six months, setting such a pace that they may outnumber bone marrow transplants for the year.

But Yoshihisa Kodera, a director of the JMDP and chief of the Japanese Red Cross Nagoya First Hospital's bone marrow transplant center, said, "Although some medical facilities have had success with cord blood stem cell transplants, I believe bone marrow transplants are more reliable in terms of safety and effectiveness."

The JMDP will review within its project how to secure cooperation with medical institutions and simplify its administrative procedures.

In June, the JMDP will introduce a quick course for patients on an experimental basis that will judge the urgency of each patient's case.

About 150 patients died within 150 days of their registration with the JMDP.

The JMDP aims to establish a system in which patients whose need is urgent can receive transplants within 70 to 90 days of their registration.

Similar systems already have been introduced in the United States and Europe.

Twelve years have passed since the JMDP was established, and the foundation has erased its chronic deficits from last year, stabilizing its financial situation.

Patients' financial burdens also have been reduced, partly due to an increase in government subsidies.

However, a large number of patients have voiced dissatisfaction over JMDP's organization. The foundation's future depends on the progress it makes toward putting patients' interests first.

The introduction of a shorter waiting period may be seen as unfair to some patients unless it is managed properly.

The JMDP must disclose information in full to promote an image of accountability that will gain people's trust.

Tatsuya Kimura Yomiuri Shimbun Staff Writer
From: http://www.yomiuri.co.jp/newse/20040508wo33.htm

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