More collections than ever before

The demand for transplant material from Switzerland continued unabated in 2020, with the number of procedures performed to collect blood stem cells for unrelated recipients reaching a new high. Swiss Transfusion SRC was able to continue providing all of its services during the Covid-19 pandemic, thanks largely to the blood transfusion centres, which remained open.

When a person listed in the Swiss Registry comes up as a possible donor, Swiss Transfusion SRC arranges for confirmatory typing to verify their HLA markers. In 2020, confirmatory typing was performed for 258 individuals (2019: 273). Confirmatory typing activities continued even during the several weeks of lockdown; blood collection was possible in the blood transfusion centres at all times. Swiss Transfusion SRC is prepared to carry out part of the confirmatory typing procedure electronically, using a digital health check, should this become necessary during a future phase of lockdown.

In 2020, 70 procedures were performed to collect blood stem cells for unrelated recipients; 9 more than were performed in 2019 (61). This nearly 15 per cent increase brought this figure to a new high. One of the procedures was a secondary collection, i.e., one person returned to donate a second time. 11 of the donations collected were for patients in Switzerland, substantially more than had been the case in previous years (2019: 4).

From the search to the provision

Swiss Transfusion SRC searches for suitable donors for patients in Switzerland and throughout the world. In 2020, it received 235 search requests from Swiss transplant centres, compared to 247 in 2019.

Once a donor has been definitively identified, arrangements must be made to get their blood stem cells to the patient at the right time. Swiss Transfusion SRC coordinates between the collection and transplant centres and is responsible for seeing that the transplant material arrives precisely on schedule. This includes arranging the transport of transplant material donated for Swiss patients by unrelated donors, the vast majority of whom do not live in Switzerland.

The Covid-19 pandemic had a major impact on transport conditions. Air traffic was interrupted for some time; quarantine regulations were in force. Special permits had to be obtained, e.g., for quarantine exceptions, and special transport arrangements had to be made. By drawing on its wide network of partners, Swiss Transfusion SRC was able to deliver all the material collected for transplantation to patients in Switzerland. The organisation received a special grant from the Corona emergency fund of the Swiss Red Cross to cover the additional transport costs, which in some cases were very much higher.

In 2020, Swiss Transfusion SRC received a total of around 360 WorkUp Requests, i.e. orders to initiate transplants for patients in Switzerland or collections from Swiss donors. During the Covid-19 pandemic, the organisation also provided hospitals with additional assistance with the coordination of donations from related donors. This service is normally requested very rarely. Due to the transport restrictions, though, Swiss Transfusion SRC was called in six times to arrange for the transport of transplant material from related donors in 2020.

To minimise the risks posed by the possibility of transport delays and the infection of donors with Covid-19 infections, the transplant centres in Switzerland and around the world waited until the transplant material arrived at the centre before conditioning their patients. This required the transplant material to be frozen in liquid nitrogen, either directly in the collection centre or in the transplant centre after successful transport. However, this process, known as cryopreservation, can impair the efficacy of the transplant material.

Transplant procedures in Switzerland

A total of 290 transplant procedures (2019: 264) were performed in Switzerland in 2020 with related (136) and unrelated (154) donors. There was one more unrelated transplant procedure performed in 2020 than in 2019 (153). The numbers of haploidentical transplants remained stable.

Cellular therapies

Thus far, therapies using genetically modified CAR T cell therapies have been approved only for use in cases of a very few groups of patients with specific forms of leukaemia in Switzerland. Swiss Transfusion SRC is responsible for managing the data for the ongoing therapies.

In 2020, Swiss Transfusion SRC and the scientific-medical body Swiss Blood Stem Cell Transplantation and Cellular Therapy (SBST) jointly drew up a plan for the collection of data with which to evaluate the efficacy, practicality and cost-effectiveness of CAR T-cell therapies. The Federal Office of Public Health will use these data when it considers whether health insurance should continue to bear the costs of these products. Under current provisions, these costs will only be covered through the end of 2022.