Below is the process in which bone marrow or more appropriately the stem cells created in the bone marrow are collected from a donor who may save the life of another
Mark Marston Saving a Life by having the Extraction:
What happens at a marrow donor registration drive?
During the screening, you must complete registration forms and provide some basic demographic and health data. A simple cheek swab sample will be taken and this will be sent to the National Registry to be entered into the national database. From the time you show up until you are completely finished, the whole process takes less than 20 minutes.
If I register, what are the chances that I may be called to donate?
Less than 1% of the people we tested have ever been contacted. If your Human Leukocyte Antigen Tissue Type (which equates to your genetic human fingerprint) matches a patient, the registry’s regional donor center will contact you and ask if you are willing to proceed with additional blood tests. You will have a physical exam and be given more information about the donor process. If you are indeed a match, you will be counseled on the process involved in donating stem cells by a center coordinator.
How do you donate bone marrow if you are a donor match?
Stem cells can be collected in one of two different ways. Traditionally, bone marrow has been the source of stem cells for donation. However, some donors may be asked to donate stem cells from the peripheral blood instead of the marrow. This decision lies with the transplant physician. It is not the choice of the donor.
When you donate marrow, it is removed with a surgical needle from the back of your pelvic bone. All marrow donors are given either general or regional anesthesia. Usually, four to eight tiny incisions are made in the pelvic area. These incisions are so small that stitches are not necessary. The procedure lasts between 45 and 90 minutes. Marrow is constantly regenerating itself and is replaced within several weeks.
For a donation of peripheral blood stem cells, the donor receives one injection of Filgrastim each day for four to five days. Filgrastim is a drug that increases the number of stem cells released from the bone marrow into the blood stream. The stem cells are collected from the blood stream through a process called aphaeresis. During aphaeresis, which is done at a blood center or a hospital, your blood is removed through a sterile needle placed in a vein in one arm and passed through an aphaeresis machine that separates out the stem cells. The remaining blood, minus the stem cells, is returned through a sterile needle placed in a vein in the other arm.
Does the donor have to travel?
The donor does not need to go to the patient’s location. The donation procedure is done locally to where the donor lives. Several days prior to the donation, the patient is typically treated with radiation and chemotherapy. This conditioning eradicates the patient’s diseased immune system, and the patient is kept in protective isolation to prevent infection. The donor’s stem cells are given intravenously to the recipient.
The stem cells migrate through the circulatory system to the hollow cavities of the bones. If all goes well, the stem cells engraft within a few weeks and begin to manufacture healthy blood cells, giving the patient a second chance at life!
Does it hurt? (see above chart)
The collection site will feel as though you had bruised yourself in the lower back. The procedure does not preclude you from going about your daily routine, and the soreness diminishes over time. Most people go back to work in a day or two.
Does it cost me anything?
The answer is no. The collection procedure is paid for by the patient or the patient’s insurance company. You are left with the knowledge that you helped to save a life.
Do my donated stem cells replenish themselves?
Yes. Stem cells or marrow regenerates within a few weeks. The donation does not curtail your daily activities. You can also donate again in the future if you wish. Marrow, unlike solid organs, is a gift of life that keeps on giving.
What are the risks?
Anesthesia is the risk most commonly associated with bone marrow donation. The procedure must be done using a local or general anesthetic. The risk is extremely minimal, and thousands of collections have been performed worldwide.
If I can’t donate my stem cells is there something else I can do to help?
Bone Marrow Donor Eligibility Criteria
Donors must be between 18 and 55 years of age and healthy. Donors are asked to share personal information such as age, address, telephone number and a brief clinical history. This information is private but is included in the DKMS database. To measure compatibility characteristics, donors must agree to take a blood test. A small amount is kept in the lab for future testing.
For umbilical cord donations, any healthy, pregnant woman who has a normal vaginal delivery is eligible to donate cord blood stem cells.
Donors must not suffer from any of the following:
AIDS: If you have HIV or are at risk for HIV (AIDS), you cannot become a marrow donor.
Asthma: Serious asthma (poorly controlled, requiring hospitalization, etc) is not acceptable.
Back (neck or spine) problems: Back problems (sprains, strains and aches) are common and usually will not interfere with marrow donation. However, serious back problems, particularly those requiring surgery, may be a cause for deferral. If you have significant back problems, consult us.
Blood pressure: Elevated blood pressure (hypertension) is acceptable if controlled by salt restriction or medication.
Cancer: Cured local skin cancer (only simple basal cell or squamous cell) is acceptable. Cervical cancer in situ is acceptable. All other forms of cancer are unacceptable.
Diabetes: Medication-dependent diabetes is not acceptable. Diabetes controlled by diet is acceptable.
Epilepsy: More than one seizure in the past year or multiple seizures are not acceptable. Epilepsy controlled with medication, when there has been no more than one seizure in the past year, is acceptable.
Heart disease: Prior heart attack, bypass surgery or other heart disease is not acceptable. Mitral valve prolapse that does not require medication or restrictions is acceptable. Irregular heartbeat not requiring medication is acceptable.
Hepatitis: Hepatitis B surface antigen is not acceptable. Hepatitis C antibody is not acceptable. Any other hepatitis history must be evaluated early in the actual search process. Hepatitis vaccine is acceptable.
Lyme disease: Asymptomatic Lyme disease is acceptable if the donor has been treated successfully with antibiotics.
Chronic Lyme disease is unacceptable.
Malaria: If you had malaria more than three years ago, you are still eligible to be a marrow donor. If you finished a full course of antimalarial drugs more than six months ago, you are also eligible to donate your marrow.
Obesity: Body Mass Index is used to evaluate weight. Donors may be deferred if obesity presents donation risk.
Organ or tissue transplant: Heart, lung, kidney, bone or other organ or tissue transplant recipients are deferred.
Sexually transmitted diseases: Any history of sexual transmitted diseases must be evaluated early in the actual search process.
Tuberculosis: If you have had active pulmonary tuberculosis within the last two years, you are not eligible to be a marrow donor.
Source: Puget Sound Blood Center (Donating Bone Marrow)
Peripheral blood stem cell donors cannot donate if they have:
• A history of inflammatory eye disease (iritis, episcleritis)
• A history or risk factors for deep vein thrombosis or pulmonary embolism are taking lithium
• A platelet count lower than 150,000 ml
The following are temporary reasons a donor may not be able to donate:
• Marrow cannot be collected at any time during pregnancy. After giving birth and once you have stopped breastfeeding, you can become a donor again.
• Anticoagulant or anti-platelet treatments (with aspirin, persatine or similar medicines), depending on the length of these treatments.
• There are many other disorders not included in the above lists that may make it difficult to donate (including possible allergies to anaesthetics and inherited enzyme deficiencies). All candidates should find out about their own particular case prior to registration.