Donations in high demand

Donations from Switzerland continued to be in high demand in 2021, though requests for transplant material from unrelated donors in Switzerland did not quite reach the record set in 2020.

When someone listed in the Swiss Registry comes up as a possible donor, Swiss Transfusion SRC arranges for confirmatory typing to verify that person’s tissue markers. In 2021, confirmatory typing was performed for 274 individuals (2020: 258). Confirmatory typing and blood collection was possible at the Swiss blood transfusion centres at all times during the second year of the coronavirus pandemic.

Procedures were performed to collect blood stem cells from Swiss donors for unrelated recipients 65 times in 2021, five less than in 2020 (70). One of these procedures was a secondary collection ( i.e., one person returned to donate a second time). Three of the procedures were performed to collect donations destined for patients in Switzerland, significantly fewer than in previous years (2020: 11). Seven cord blood units from Switzerland were used in transplant procedures, another increase (2020: 4). These, taken together with the units from collection procedures, bring the total number of units delivered to a record high.

From the search to the provision

Swiss Transfusion SRC searches for suitable donors for patients in Switzerland. In 2021, the organisation received 246 search requests from Swiss transplant centres, up from 235 in 2020.

Once a final decision on the donor has been taken, steps must be taken to ensure that their blood stem cells reach the patient at just the right time. Swiss Transfusion SRC works with the collection and transplant centres to coordinate this process and is responsible for ensuring that the transplant material is delivered precisely on schedule. This includes arranging for the transport of transplant material destined for Swiss patients collected from unrelated donors who, in the vast majority of cases, do not live in Switzerland.

The Covid-19 pandemic having made it clear that open borders and transport conditions cannot be taken for granted, Swiss Transfusion SRC carefully reviewed and adjusted its existing relationships with courier services. In the future, working with an additional service provider will make it easier to ensure that blood stem cells make it all the way through to the last leg of their journey, i.e. from the airport to the transplant centre, even in the event of border closures, as having multiple service providers will make it possible to assign individual tasks to the appropriate provider. This will make it possible to ensure the transport of transplant material for patients in Switzerland quickly, using trusted partner companies, even during a crisis.

In 2021, Swiss Transfusion SRC received a total of 397 «work-up requests», meaning requests to initiate the process to obtain transplant material for patients in Switzerland or to collect transplant material from donors in Switzerland. This is over 100 more requests than Swiss Transfusion SRC received just five years earlier. Not all work-ups ultimately lead to a collection procedure: the procedure may not get the greenlight after the donor’s medical examination, for instance. This was the case more often in the past two years due to Covid-19.

Transplant procedures in Switzerland

A total of 283 transplant procedures were performed in Switzerland in 2021 (2020:290), with related (127) and unrelated (158) donors. The number of unrelated donor transplants was up by four compared to 2020 (154).

In 2021, 94 patients underwent CAR T-cell therapy in Switzerland (2020: 67). CAR T-cell therapy is a type of treatment involving the modification of immune cells through genetic engineering so that they will recognise and attack cancer cells. The patient’s own immune cells (T-cells) are taken from their blood, changed in the laboratory and then infused back into the patient.

Increase in family-member testing

Swiss Transfusion SRC is not involved in the testing (tissue-typing) of family members when the patient and the family member are in Switzerland. The situation is different if either the patient or the family member lives abroad. In such cases, Swiss Transfusion SRC can step in to support and coordinate family-member testing. In particular, it provides information to the relevant parties and coordinates the collection of a blood sample and its transport to the relevant laboratory for testing to determine HLA-antigens (tissue-markers).

Swiss Transfusion SRC has noted an increase in these cases in the last two years. Travel restrictions were one of the main reasons for this, above all during the lockdown.

Similarly, Swiss Transfusion SRC received more requests to coordinate in cases in which either the transplant patient or the matched related donor lived in another country. There were seven such cases in 2020 and five in 2021, compared to an average of two per year in the past.

Auxin: shaping the future together

«Auxin» is the name of a project that was launched to review and optimise existing processes, tools and methods. The project aims at a comprehensive analysis and redesign of the value-creation chain of core processes in the SBSC division. All processes are subject to a structured analysis to identify “waste” and will be continuously optimised in collaboration with the employees. The main focus in the project is on setting up an IT system that will be capable of supporting the staff in their activities across the entire work process in the medium term, and on maximising “value creation” (customer process). In parallel with this work, a process orientation is being initiated on multiple levels throughout the entire organisation. The project also promotes the organisation’s cultural development and encompasses the development of a process management system.

The baseline analysis and the conceptual design of the target processes were completed in 2021. The second phase involves the assessment of a tool for use in implementing the evaluated requirements.