CORD BLOOD BANKING AND TRANSPLANT IN EUROPE

Allogeneic haematopoietic stem cell transplantation (HSCT) has been used to treat thousands of patients, adults and children, with life-threatening haemato-logical diseases. The principal limitations of allogeneic bone marrow transplantation are the lack of suitable HLA-matched donors and the complications of graft-versus-host disease associated with HLA disparities. In the absence of a suitable HLA identical sibling donor, alternative donors such as mismatched related or matched unrelated donors are searched. In these transplants, major and minor histocompatibility differences are often unrecognised by current matching tests, explaining the relatively high frequency of post transplant complications, graft failure, graft-versus-host disease and delayed immune reconstitution. The description of new more sensitive techniques of typing by molecular biology and has decreased the probability of finding a fully matched donor. Despite a bone marrow donor registry which contains more than 4 millions bone marrow donors world-wide, some patients cannot be transplanted because of the lack of an HLA identical donor.