Academy
Highlights from the 9th WBMT workshop in Mongolia
Enkhchimeg Lkhagva
National Center for Transfusion Medicine, Mongolia
Mickey Koh
St George's hospital and Medical School, London, UK
Nina Worel
Medical University of Vienna, Vienna, Austria
In June 2025, the 9th Workshop of the Worldwide Network for Blood and Marrow Transplantation (WBMT), held in Ulaanbaatar, Mongolia, brought together over 60 regional and international experts to explore the essential pillars of hematopoietic stem cell transplantation (HSCT).
A Dedicated Session on Transfusion Support
On 27 June 2025, during the 9th WBMT Workshop, a dedicated joint WBMT and ISBT (International Society of Blood Transfusion) session titled “Transfusion Services for HSCT Centers” convened transfusion medicine and transplant experts from around the world. This collaborative session, co-chaired by Nina Worel (Austria) and
Enkhchimeg Lkhagva (Mongolia), was part of a broader initiative to strengthen blood services supporting HSCT. Enkhchimeg Lkhagva from National Center for Transfusion Medicine of Mongolia delivered an informative presentation on the current status of Mongolian transfusion services, highlighting national efforts to ensure safe and effective blood transfusion and component therapy. Her report outlined recent progress in service accessibility and safety, while also identifying challenges in supporting HSCT patients.
Blood component therapy is available in Mongolia including leukocyte depleted packed red cells and single donor platelet concentrates and both products can be irradiated to support transplant recipients. Upon request, platelet concentrates can also be pathogen-reduced using Intercept technology. However, one major public health problem in Mongolia is the high prevalence of hepatitis B (appr. 9%), C (appr. 9%), and D virus infections. The country has one of the highest prevalences of dual and triple infections in the world (1). Therefore, scaling up screening of blood donors is of utmost importance to provide safe blood products and avoid disease transmission.
9th WBTM participants
Nina Worel presented on international recommendations for blood transfusion including guidelines for transfusion in the context of HSCT support, thereby providing a framework for harmonizing local practices with global standards (2, 3). This presentation focused primarily on packed red blood cells and platelet concentrates. In addition to the need for leukocyte reduction, irradiation, and the advantages of pathogen-reduced platelet concentrates, transfusion policy - which blood type should be used in the different phases of HSCT - was also an important topic in the situation of blood type mismatched/incompatible allogeneic transplantation. Finally, challenges such as passenger lymphocyte syndrome, pure red cell aplasia, and platelet refractoriness were also addressed.
Interactive Roundtable on Transfusion Practices
An engaging roundtable discussion moderated by Professor Mickey Koh (UK) explored strategies in blood product screening and the management of alloantibodies in HSCT.
Panelists included: • Bishesh Poudyal (Nepal) • Mohiuddin Khan (Bangladesh) • Alimaa Tuya (Mongolia) • Nina Worel (Austria) • Hind Alhumidan (Saudi Arabia)
The panelists exchanged practical insights on compatibility testing, screening strategies, alloimmunization, and transfusion strategies, underscoring the critical importance of transfusion infrastructure in successful transplantation outcomes. Professor Koh congratulated the Mongolian transfusion services on being able to provide 100% of its blood supply based on voluntary non-remunerated donors, saying that this was a major milestone in achieving and maintaining blood safety.
The panel agreed and emphasized the essential infrastructure required for safe and effective transfusion practices, especially in the context of HSCT. Key challenges such as antibody screening, resource limitations, and standardizing protocols were addressed. Importantly, Dr. Ouyngerel, a leading figure in the national HSCT field and an honored professor in the Mongolian medical profession expressed her sincere appreciation for the dedicated efforts of the Mongolian blood transfusion service. She recognized their ongoing collaboration, commitment to quality, and the vital role of the national blood system in advancing transplantation services. Her words reinforced the significance of a strong transfusion foundation in achieving clinical excellence in HSCT.
Nina Worel
Enkhchimeg Lkhagva
Synergy Between Transfusion and Transplantation
The workshop underscored the indispensable role of transfusion services throughout the transplant process. From pre-conditioning to post-transplant care and the management of complications such as graft-versus-host disease (GvHD) and relapse, transfusion support is integral to patient outcomes.
Effective transfusion protocols not only reduce infection risks but also significantly enhance the feasibility and success of HSCT programs, particularly in low- and middle-income countries. The importance of integrating transfusion services into broader quality management and accreditation frameworks for HSCT centers was also emphasized.
Mickey Koh
Dr. Ouyndelger
Looking Ahead: Building Capacity and Collaboration
The collaboration between WBMT and ISBT for this joint session has set a strong precedent for future events. Participants unanimously agreed that strengthening transfusion services through targeted training, infrastructure development, and international cooperation is essential for expanding access to safe and effective HSCT worldwide.
References
1. Davaalkham Dambadarjaa, Otgonbayar Radnaa , Ser-Od Khuyag, Oyu-Erdene Shagdarsuren, Uranbaigali Enkhbayar, Yerkyebulan Mukhtar, et al. Hepatitis B, C, and D Virus Infection among Population Aged 10–64 Years in Mongolia: Baseline Survey Data of a Nationwide Cancer Cohort Study. Vaccines (Basel). 2022 Nov 14;10(11):1928. doi: 10.3390/vaccines10111928
2. EBMT Handbook 2024 https://www.ebmt.org/sites/default/files/2024-04/978-3-031-44080-9.pdf
3. Guide to the preparation, use and quality assurance of blood components. https://freepub.edqm.eu/publications/PUBSD-240/detail
