The bone marrow transplant at Ruby Hall Clinic has been doing transplant for over 7 years.

a dedicated centre was found in July 2008. The Transplant Centre at Ruby Hall Clinic was ofcially inaugurated later in 2011 by Prof Reuven Or who heads the transplant program at Hadassah University, Jerusalem, Israel. ! Since inception over 190 transplants have been done.! Over 60 transplant for Thalassaemia and Hemoglobinopathy have been done. We have done related and unrelated transplants for all indication. We were the rst centre to have haploidentical transplant for people without donor. Haploidentical means partially matched family donor for patients without fully matched donor. This has helped patients with no hope of transplant because unrelated bone marrow stem cell transplant is not available due to cost(35-40lakhs) or because of fear of GVHD(transplanted cells attacking the patient which can also kill the patient) to undergo Haplo-identical transplant( 12 to 15 lakhs). Ruby Hall Clinic has setup various tests like Mixed Lymphocyte Cytotoxicity and Panel reactive Antibodies for Haplo-identical transplant. This was done as Dr Vijay Ramanan requested Dr Nita Munshi for the same. Dr Munshi obiliged and took lots of hardwork, pain to standardise these tests. ! These tests are available at best centres in the world like M.D Anderson, Texas.! The rst successful Cord blood stem cell transplant for Thalassaemia and Sickle cell disease has been done at ruby Hall Clinic.! Our activities has received international attention with Dr Eliane Gluckman(First person to do unrelated cord blood transplant in the world in early 1980's) part of Eurocord to contibute our data of cord blood transplant and Haploidentical transplant to a prestigious International survey including the largest registries in the world. CIBMTR is centre for International Bone Marrow Transplant Registry and handles over 70000 transplant per year. EBMTR is European Bone Marrow Transplant Registry handling over 40000 transplants per year. Eurocord is the premier agency for all cord blood transplants in Europe. These registries cover over 1.2 lakh transplant per year. India does just around 1000 transplant per year. So this recognition is signicant as Ruby Hall Clinic is the only Transplant centre in Asia, Middle-east, Africa to be recognised. Only second transplant centre in the WORLD outside Europe and USA.! In Sickle cell disease there is change of normal hemoglobin to hemoglobin Sickle. This leads to change in shape of RBC from normal saucer to one like Sickle. The saucer shape leads to exibilty of RBC in micro-circulation like at tips of nger, feet, organs like lung, brain etc. In a patient with Sickle cell disease this leads to RBC getting struck in various organs in time of stress like dehydration, fever, infection, exercise, low oxygen concentration. This is called crisis and is lifethreatening. Transplant is offered to patients who have either 3 or more life-threatening incidents or stroke or any family member's death due to sickle cell disease.! The transplant for Sickle cell disease is very difcult due to alloimmunisation which is rampant in Sickle cell disease as compared to thalassaemia. It means there is very high chance that the stem cell transplanted may be rejected by patients body because of development of antibodies in patients body. We have come to the conclusion that HbF or fetal Haemoglobin increases in patients after cord blood transplant and this leads to decrease in Sickle Hemoglobin. This decrease leads to reduction of Sickling Crisis and reduction of deaths.! The work that has been done at Ruby Hall Clinic, Pune has put transplant in India on international scene. Its important for all the transplant programme to have their data published with international registries as it indirectly reects the quality of work being done. !