Carta al editor
Authors: T. Maziarz, MD Richard 
Published: February 2020

As Director of the hematopoietic stem cell transplant program at the Oregon Health and Science University, I am very pleased to congratulate my friend and colleague, Dr Guillermo Ruiz Arguelles for achieving the important milestone in having performed their 1000thhematopoietic stem cell transplant procedure at Clinica Ruiz, in Puebla, Mexico.    To be honest, it is not Dr. Ruiz who is to be congratulated, but rather, the entire team and staff of the transplant program and as well, to the patients who have the benefit to be treated at this site.  These numbers are milestones, and milestones are important. The milestone may be the first patient ever treated within the transplant program.  Another milestone may be performing the first allogeneic transplant procedure in an established autologous transplant center and soon thereafter, the first cord blood or graft engineered allogeneic procedure.  What does the milestone of having reached 1000 transplants for patients in need, mean?  It indicates that a program is fully established and recognized for the services they provide.  No transplant program will reach these milestones, if they are not providing high level service to their patient recipients.  More importantly, what I feel that the milestone of 1000 transplant means, is that any patient who crosses the threshold can trust that there lives are in the hands of a very experienced and professional team.  It is not just the doctors.  It is the laboratory team members who handle the cellular products and the hematopathologists, who review complicated pathology specimens to provide accurate diagnoses.   It is the nursing staff who on a daily basis, dedicate their lives to the care of the patient and provide personal support that the patient needs when undergoing aggressive therapies.  When you reach 1000 transplants, there is nothing more confidence building to a patient than when a nurse can tell them that what they are going through is expected and that there is light at the end of the tunnel.  Of course, there are the physical therapists and the occupational therapists who assist in guiding patients back to their normal life.  And of course, there are social workers to address the non-medical issues and often the complex family interplay takes place when the patient needs a transplant procedure. These are the accomplishments and achievements of a program that reached and has performed 1000 transplants.  This milestone allows all to pause and reflect on the initiation of a program, the establishment a program, the continual expansion of a program, and to confirm that the program has matured.  It also allows one to reflect on its next milestones, t perhaps that of 2000 transplants performed and importantly, to be able to count the number of patients who have benefited and for whom a worse outcome would have been encountered, if you were not there.I applaud my professional colleagues and all of the care providers who assisted in gaining this important milestone. Congratulations to all, and l among others, look forward to following the success of your program at Clinica Ruiz, into the future.