Bone Marrow Transplant

Becoming a Bone Marrow Donor

People who have been identified as a match for bone marrow donation (HLA matched) will be scheduled for an evaluation by a bone marrow transplant physician. Although donating marrow generally poses no danger to the donor, the general anesthesia used during the procedure poses some risks. For this reason the donor undergoes a careful medical evaluation to ensure that he or she is in good health. This will include a physical examination and a medical history. The donor will also be screened for a variety of medical conditions using blood tests, a chest X-ray and an EKG. If the donor is evaluated as a good candidate, the harvest will be scheduled.

Those who are called upon to serve as bone marrow donors undergo a medical procedure called a bone marrow harvest. It is a surgical procedure that typically requires one overnight stay in the hospital. On the morning of the harvest, the donor is taken to the operating room and given general anesthesia. This is so the donor will feel no discomfort while the bone marrow is being harvested. The bone marrow transplant physician will withdraw the bone marrow from the pelvic bones (the posterior iliac crests). Afterwards, the donor may feel some soreness in the hip area where the bone marrow was withdrawn. This soreness can usually be relieved by taking oral medications like Tylenol.

For most donors, the opportunity to give a person, especially a loved one, a second chance at life is very exciting. Keep in mind, however, that not all transplants are successful. News of an unsuccessful transplant can be very hard on a donor who's made a substantial physical and emotional investment in saving another person's life. Donors can only be guaranteed that they'll give the patient a future. Whether that future is two months, two years, or a lifetime cannot be predicted with certainty.

Being a Peripheral Blood Stem Cell Donor

If the donor is a match after HLA typing, he or she is scheduled for a medical history and a physical evaluation by a bone marrow transplant physician. If the donor is a good candidate, he or she is scheduled for a peripheral blood stem cell collection.

Peripheral blood stem cells are obtained through a process called apheresis, which separates blood into its different components. The procedure involves inserting a needle into each arm. Blood is drawn from a vein in the arm and circulated through a cell-separating machine. This machine collects the stem cells and returns the remaining blood cells to a vein in the other arm. Stem cells collected by apheresis are frozen by a process called cryopreservation.

Before and during apheresis the donor receives daily injections containing Granulocyte Colony Stimulating Factor (G-CSF) to help stimulate the bone marrow to make new stem cells. The drug is injected under the skin using a small needle. The most common side effect of this medication is bone aches due to the stimulation of the bone marrow.

Apheresis typically takes about five hours to complete and may be repeated the next day to collect the number of stem cells needed for the recipient.

Apheresis is a painless procedure. Some people occasionally experience lightheadedness, coldness, numbness around the lips or cramping in the hands during the collection. These are temporary symptoms and are easily managed.

The bone marrow transplant physician will decide whether the donor will be a bone marrow or a peripheral blood stem cell donor based on the needs of the recipient.

Volunteering to be a Bone Marrow or Stem Cell Donor

People who are interested in being a volunteer donor for an unrelated patient, can find more information at the "National Marrow Donor Program" Web site.