Bone marrow is a soft, spongy tissue found inside bones like the hip and thigh. It produces various blood components: red blood cells (oxygen), white blood cells (infection), and platelets (clotting). When diseases such as leukemia, lymphoma, or sickle cell anemia impair this production, a transplant of healthy bone marrow or blood stem cells can offer a chance for recovery.
Becoming a Donor
Individuals interested in donating bone marrow or blood stem cells can join a donor registry. Eligibility requires donors to be 18-60 years old and in good overall health; younger donors (18-44) are preferred for better transplant success. The initial step involves a cheek swab to determine the individual’s Human Leukocyte Antigen (HLA) type, a protein match crucial for a successful transplant. If a potential match is identified, further blood tests confirm the HLA match and assess the donor’s overall health, including organ function.
Peripheral Blood Stem Cell Donation
Peripheral Blood Stem Cell (PBSC) donation is the more common method, accounting for about 80% to 90% of donations. This procedure involves a preparation phase where the donor receives daily injections of filgrastim (G-CSF) for four to five days. Filgrastim stimulates the bone marrow to produce and release more hematopoietic stem cells into the bloodstream. Common side effects include headache, bone and muscle aches, fatigue, and flu-like symptoms, which typically resolve within a few days after the last injection.
The collection process is called apheresis, a non-surgical procedure similar to donating plasma. Blood is drawn from a vein in one arm and passed through a machine that separates and collects the blood-forming stem cells, platelets, and some white blood cells. The remaining blood components, including red blood cells and plasma, are then returned to the donor through a vein in the other arm. The tubing used in the machine is sterile and single-use.
A PBSC donation session typically lasts four to eight hours. Some donors may require multiple sessions, sometimes spanning two days, to collect enough stem cells. Donors can engage in activities like reading or watching movies during the process. Most donors return to normal activities within a day or two.
Bone Marrow Donation (Surgical)
Traditional bone marrow donation, a less common but important method, is a surgical procedure performed in an operating room, accounting for about 10% of donations. It is conducted under general or regional anesthesia, ensuring the donor feels no pain during collection. General anesthesia is used in about 96% of cases, lasting less than two hours. Regional anesthesia, such as a spinal or epidural, blocks sensation in the lower body while the donor remains awake.
During the procedure, the donor lies on their stomach. Sterile needles are inserted through small incisions into the back of the pelvic bone (iliac crest). Liquid marrow, rich in blood-forming cells, is withdrawn from both sides of the pelvic bone, usually collecting one to two pints, representing about 10% of the donor’s total marrow cells. The incisions made for collection do not require stitches.
After the collection, donors are moved to a recovery room for monitoring as the anesthesia wears off. While some donors may be discharged the same day, an overnight hospital stay is often planned for full recovery and to manage post-procedure discomfort. Donors commonly experience soreness or aching in the lower back and hips, similar to a strained muscle, along with fatigue.
Recovery and Post-Donation Care
Recovery times vary, but most donors return to their usual activities within days to weeks. Following a PBSC donation, most individuals feel fully recovered within one to two days, though mild flu-like symptoms, muscle aches, or headaches may persist for days. Bruising at the needle sites is common due to temporary low platelet levels, which typically normalize within days.
For surgical bone marrow donation, donors might experience soreness, stiffness, or bruising in the lower back and hips for several days to a couple of weeks. Fatigue is a common side effect and can last for a few weeks as the body regenerates the donated marrow. To aid recovery, donors are advised to rest, stay hydrated, and manage pain with over-the-counter medications like paracetamol, avoiding ibuprofen or aspirin for a few days post-donation due to blood clotting interference. The body naturally regenerates donated stem cells within weeks (PBSC) or four to six weeks (surgical).