Deceased Donor Bone Marrow Salvage and Processing - ABSTRACT
This program aims to develop a method for banking clinical-grade bone marrow from cadaveric donors
that can be deployed nationally to ameliorate shortages, provide bone marrow stockpiles as medical
countermeasures for nuclear threats, and support existing research approaches such as delayed immune
tolerance induction and transfusion of HIV-resistant stem cells.
We will adapt a method designed by our research team for procurement, processing, and banking bone
marrow from cadaveric vertebral bodies, which has been shown to produce high yields of hematopoietic stem
cells and other bone marrow cells from heart-beating donors. We have successfully transplanted bone marrow
from these sources in clinical trials, with no adverse patient reactions. Now we aim to make key modifications
to our method for deployment on a large scale, creating a protocol whereby organ procurement organizations
can routinely procure vertebral bodies from a large pool of donors and ship them successfully to a centralized
facility for processing, banking, and post-cryopreservation preparation for infusion. This will create a large supply
of bone marrow that can be used on-demand, off the shelf, complementing existing bone marrow donor registries
and cord blood banks.
The technical objectives of this Phase 1 feasibility study are to (1) develop a streamlined procurement
protocol allowing organ procurement organizations to ship recovered vertebral bodies to a centralized processing
facility, (2) test this optimized protocol for procurement from donors after cardiac death (DCDs) and non-organ
tissue donors, and (3) develop a protocol for washout of cryoprotectants at a centralized facility before shipment
to clinics. In Aim 1, we will optimize and streamline the existing bone marrow collection and processing protocol
for donors following brain death (DBDs), testing multiple preservation solutions for procurement and shipment of
donor vertebral body bone marrow. In Aim 2, we will validate that the optimized protocol determined in Aim 1 to
can be applied to donors following cardiac death (DCD) and non-organ tissue donors to determine the potential total
donor pool. In Aim 3, we will optimize post-cryopreservation processing to allow potential shipment of thawed, large
cell volume products to clinics after removal of all cryoprotective agents, testing a hollow fiber dialysis/filtration system
that prevents loss of cell yield as cryoprotectants are removed. The outcome of these aims will determine the most
effective system for procurement, processing and banking of cadaveric bone marrow for clinical use on a large scale.