Bone marrow donation is a medical procedure that helps save lives, and a common concern for potential donors is the associated risks. The possibility of dying from bone marrow donation is extremely rare. The process is safe for healthy individuals who undergo thorough evaluation before donation.
Understanding Bone Marrow Donation
Bone marrow donation involves collecting healthy blood-forming cells for patients who need a transplant, and there are two primary methods. Traditional bone marrow donation, often called bone marrow harvest, is a surgical procedure. A surgeon uses needles to extract liquid bone marrow from the back of the donor’s pelvic bone (iliac crest). Donors receive general or local anesthesia during the procedure. This method does not involve the spinal cord.
The more common method, peripheral blood stem cell (PBSC) donation, accounts for over 85% of all donations. This outpatient procedure does not require surgery. For five days before the donation, the donor receives injections of a drug called filgrastim, which stimulates the bone marrow to produce more blood stem cells and release them into the bloodstream. On the day of donation, blood is drawn from one arm, passed through a machine that separates the stem cells, and the remaining blood is returned to the other arm. This process, called apheresis, typically takes several hours.
Evaluating the Risks of Donation
Bone marrow donation is a safe procedure, but it carries rare risks. The overall mortality rate for donors is very low. A study analyzing over 51,000 donations reported five donor fatalities, an incidence of approximately 0.98 per 10,000 donations. Another analysis focusing specifically on traditional bone marrow donations found only one fatal event out of nearly 28,000 procedures. Serious complications from either donation method are uncommon, occurring in less than 1% of cases for bone marrow donation and around 0.56% for PBSC donation.
For traditional bone marrow donation, risks are primarily associated with the anesthetic itself. Common side effects include a sore throat from the breathing tube, nausea, vomiting, or muscle aches. More serious, but rare, complications of general anesthesia include allergic reactions or accidental awareness during surgery. Beyond anesthesia, specific procedural risks include pain at the hip bone where the marrow is collected, which is temporary. Rare potential complications also include minor infections, excessive bleeding, or nerve irritation.
PBSC donation introduces risks related to the filgrastim injections. Donors frequently experience temporary side effects such as bone pain, headaches, and flu-like symptoms including fatigue or muscle aches. These symptoms subside once the injections are stopped. In very rare cases, filgrastim can lead to more severe complications, such as splenic rupture (estimated risk of 1 in 5,000 to 1 in 10,000 donations) or acute respiratory distress syndrome. Serious allergic reactions to filgrastim are uncommon (about 1 in 1,000 to 1 in 10,000 cases), and there is no evidence suggesting an increased risk of blood cancers in healthy donors due to G-CSF use.
Ensuring Donor Safety
Before any donation, prospective bone marrow donors undergo a comprehensive screening process to ensure their safety and suitability. This rigorous evaluation includes a detailed medical history review, a thorough physical examination, and various blood tests. These tests include human leukocyte antigen (HLA) typing, which is crucial for matching the donor to the patient, as well as screenings for infectious diseases like HIV and Hepatitis. Further assessments, such as chest X-rays and electrocardiograms, may also be conducted to evaluate overall health.
Potential donors must meet strict eligibility criteria regarding their age, general health, and medical conditions. If deemed suitable, the medical team provides extensive information about the donation process and potential risks, ensuring the donor can make an informed decision. Throughout the procedure, donors are continuously monitored by trained medical professionals. These measures ensure the high safety record of bone marrow donation.
Post-Donation Recovery
After donating bone marrow, donors experience common, temporary side effects. For those who undergo traditional bone marrow harvest, soreness or pain in the lower back or hips is expected, along with fatigue and mild nausea. These symptoms resolve within a week. PBSC donors experience bone pain, headaches, and fatigue due to the filgrastim injections, but these effects subside quickly once the medication is stopped.
The recovery timeline varies depending on the donation method. PBSC donors recover faster, with a median recovery time of about seven days, and many feel normal within a few days. They can return to work, school, and most daily activities within one to seven days. For traditional bone marrow donors, the median recovery time is slightly longer, around 16 to 20 days, though most can resume light activities within two to seven days. The body replenishes the donated bone marrow and stem cells within a few weeks (typically four to six weeks), and long-term health is not affected.