Bone marrow donation is a life-saving medical procedure that provides healthy blood-forming cells to patients battling various diseases, including blood cancers like leukemia and lymphoma, and other blood disorders. These transplants offer a chance at recovery for individuals whose own bone marrow is not functioning properly. The ability of an individual to donate can offer a second chance at life for a patient in need.
This process relies on the generosity of volunteer donors, as finding a compatible match is often challenging. A successful transplant hinges on a close genetic match between the donor and the recipient, making a diverse and robust donor registry important. Understanding the requirements and procedures can help more people consider becoming a part of this effort.
Who Can Donate
Eligibility for bone marrow donation is determined by several factors, focusing on the donor’s age and overall health for safety. Individuals between 18 and 60 years old can register, though many registries prioritize recruiting donors aged 18 to 40 because younger donors often provide better outcomes for patients.
Donors must be in good general health, free from chronic illnesses, autoimmune disorders, and infectious diseases. Conditions like HIV, Hepatitis B or C, severe asthma requiring daily medication, and insulin-dependent diabetes prevent donation. These restrictions protect the donor from complications and prevent the transmission of diseases to the recipient.
Weight and Body Mass Index (BMI) are also considered, with a BMI under 40 for eligibility. Being underweight (BMI under 18.5) or obese (BMI over 40) can pose safety risks during donation. Other factors like recent major surgery, current pregnancy, or lifestyle choices can also temporarily or permanently disqualify a donor.
The Donation Procedures
Two main methods are used for bone marrow donation: Peripheral Blood Stem Cell (PBSC) donation and bone marrow donation (also known as bone marrow harvest). The choice of method depends on the patient’s physician’s determination for best transplant results. Approximately 90% of donations are PBSC donations.
For a PBSC donation, donors receive daily injections of granulocyte-colony stimulating factor (G-CSF) for four to five days before the procedure. This medication stimulates the bone marrow to produce and release blood stem cells into the bloodstream. The collection is an outpatient procedure called apheresis, where blood is drawn from one arm, processed by a machine to separate stem cells, and returned to the other arm. This process takes four to eight hours per session and may require one or two sessions over consecutive days to collect enough cells.
Bone marrow donation, in contrast, is a surgical procedure performed in a hospital setting under general or regional anesthesia. The donor is positioned on their stomach, and doctors use hollow needles to withdraw liquid marrow from the back of the pelvic bones. The procedure lasts one to two hours, with one to two pints of marrow collected, which is 10% of the body’s total marrow cells. Donors return home the same day or after an overnight stay.
Donor Safety and Recovery
The safety and well-being of the donor are monitored throughout the process. While both donation methods are safe, some temporary side effects are common. For PBSC donation, the G-CSF injections can cause flu-like symptoms, such as bone and muscle aches, fatigue, headaches, and a low-grade fever. These symptoms subside within 24 hours after the donation. During the apheresis procedure, donors may experience tingling around the mouth, fingers, and toes, or mild muscle cramps due to the anticoagulant used, which can be managed by adjusting the procedure or administering calcium.
Following a bone marrow donation, donors can expect soreness and bruising in the lower back or hips where the marrow was collected. Fatigue, mild nausea, and a sore throat from the breathing tube (if general anesthesia was used) are also common. Over-the-counter pain relievers can help manage discomfort. The median recovery time for PBSC donation is 7 days, while for bone marrow donation, it is 16 days. Most donors can return to work or school within a few days to a week, with full recovery occurring within a few weeks as the body replenishes the donated cells.
Becoming a Registered Donor
Individuals interested in becoming a bone marrow donor can join a national registry. The first step involves ordering a swab kit online or attending a donor drive. This kit contains cotton swabs used to collect cells from the inside of the cheek. The cheek swab provides a DNA sample that is analyzed to determine the donor’s human leukocyte antigen (HLA) type.
Once the HLA type is identified, this information is added to the national registry database. If a potential match is found for a patient in need, the registered donor will be contacted. Further testing, including blood samples, is conducted to confirm the detailed HLA match and assess the donor’s health thoroughly. It is important to note that joining one reputable registry is sufficient, as multiple registrations can cause confusion in the system.