Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 30.
doi: 10.1007/s11764-025-01887-1. Online ahead of print.

Decision-making experience for second donation in unrelated hematopoietic stem cell donors: a descriptive qualitative study

Hangting Li  1 , Lingxi Chen  2 , Dijiong Wu  1 , Jiayin Ruan  3 , Xiaolian Wu  4
Affiliations

Decision-making experience for second donation in unrelated hematopoietic stem cell donors: a descriptive qualitative study

Hangting Li et al. J Cancer Surviv. .

Abstract

Background: A second allogeneic hematopoietic stem cell transplantation (allo-HSCT) is often the most effective treatment option for patients experiencing graft failure or disease relapse following a first round of allo-HSCT. Unfortunately, the consent rate for second donation is insufficient to meet treatment needs worldwide. The purpose of this study was to provide a comprehensive understanding of the decision-making experience of unrelated donors when considering making a second donation. This research is essential as it could inform the development of interventions to improve the consent rate for second donation.

Design: This was a descriptive qualitative study that followed the COREQ checklist.

Methods: A total of 16 unrelated hematopoietic stem cell donors who completed a second donation were selected by purposive sampling and underwent semi-structured interviews between September and December 2023. Data were analyzed using conventional content analysis.

Results: Data analysis yielded four themes and 11 sub-themes: (1) initial reaction (unexpectedness, immediate consent); (2) locked-in dilemma (worried about the outcome of second donation, faced familial pressure, felt morally hijacked); (3) internal impetus (personal value of helping others, kinship tie, self-efficacy from the first donation, positive impact of the first donation), and (4) external reinforcement (pluralistic social support and societal influence).

Conclusions: To improve the consent rate for second donations, it is necessary to implement targeted education and comprehensive support encompassing personal, familial, and social aspects, while ensuring autonomy. Our analysis suggested that optimizing the first donation experience and fostering positive feedback beliefs are crucial factors when considering a second donation.

Implications for cancer survivors: By clarifying the decision-making experiences of unrelated donors, this research informs strategies to improve second donation consent rates. Enhanced donor retention directly expands life-saving options for patients with disease relapse or graft failure, potentially improving survival outcomes.

Keywords: Decision-making; Experience; Interview; Qualitative study; Second donation; Unrelated hematopoietic stem cell donor.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Similar articles

See all similar articles

References

    1. Chang YJ, Pei XY, Huang XJ. Haematopoietic stem-cell transplantation in China in the era of targeted therapies: current advances, challenges, and future directions. Lancet Haematol. 2022;9(12):e919-29. - PubMed
    1. Nagler A, Ngoya M, Galimard JE, et al. Longitudinal outcome over two decades of unrelated allogeneic stem cell transplantation for relapsed/refractory acute myeloid leukemia: an ALWP/EBMT analysis. Clin Cancer Res. 2022;28(19):4258–66. - PubMed
    1. Xie YX, Ma LM, Ren RR, et al. The impact of second-donor lymphocyte infusion on secondary graft failure after allogeneic hematopoietic stem cell transplantation through activation of Foxp3 and regulatory T cells [J]. Cytotherapy. 2022;24(9):923–30. - PubMed
    1. Kozanoglu I, Buyukkurt N, Asma S, et al. Is it possible to be a stem cell donor for the second time: a single-center report of 12 consecutive procedures [J]. Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, 2021.
    1. Panch S R, Logan B, Sees J A, et al. Shorter interdonation interval contributes to lower cell counts in subsequent stem cell donations [J]. Transplant Cell Ther. 2021;27(6): 503.e1-.e8.

LinkOut - more resources