Hematopoietic cell transplants in resource-poor countries: challenges and opportunities

Area of Science:

• Hematology
• Transplant Medicine
• Global Health Equity

Background:

• Hematopoietic cell transplantation (HCT) activity is rising globally, predominantly in high-income nations.
• Resource-limited countries face significant barriers to HCT, including personnel shortages, infrastructure deficits, donor access challenges, drug unavailability, and high costs.

Approach:

• A comprehensive literature search was conducted focusing on HCT in resource-rich versus resource-poor settings.
• Key advancements potentially improving HCT accessibility in resource-limited environments were identified and analyzed.

Key Points:

• Outpatient transplantation models simplify logistics and reduce infrastructure needs.
• Graft storage at 4°C and less intensive pre-transplant conditioning regimens decrease complexity and cost.
• Utilizing generic drugs, simplifying donor identification and access, and fostering international collaborations are crucial strategies.

Conclusions:

• Despite identified challenges, several innovations show promise for expanding HCT in resource-poor countries.
• While current epidemiological data from resource-limited settings are scarce, a future increase in transplant rates is anticipated with the adoption of these advancements.