We have a potential transplant scheduled this month using a marrow collected from a donor with Sickle Trait. Unfortunately, the donor and recipient are ABO Incompatible and the marrow will require red cell depletion. Does anyone have experience using ficoll to deplete sickle trait red cells from bone marrow? Please share as I have concerns about the nucleated cell recovery during this process and am trying to convince transplant team to pick a different donor.

You could try to do it by dilution. If you prepare a buffy coat of the bone marrow and then add a full unit of O Neg RBC's and then repeat the buffy coat procedure, you should be able to end up with less than 30cc's of incompatible RBC's (if you are really good or if you add more RBC's you can get it down under 10cc). At that point you will have reduced the number of mismatched red cells below the point that it will cause any significant reaction.

If you know how many RBC's you end up with in your buffy coats then you can calculate the volume of RBC's to add back in order to get the desired final volume of incompatible RBC's.

It may not be as elegant as a ficoll procedure, but it has the virtue of preserving more of the MNC's. It also does not require any additional equipment, training or skill. We did this on a number of BMT patients years ago with uniform success.

Edited May 9, 201213 yr by JEMarti
Added clarifying information