Bone marrow donation is a medical procedure that provides healthy blood-forming hematopoietic stem cells to patients with life-threatening blood cancers and other disorders. These stem cells are capable of developing into all types of blood cells. The donated cells replace a patient’s unhealthy cells, allowing their body to generate a new, healthy blood and immune system. Understanding the steps involved in this process is the first step toward potentially giving a patient a second chance at life.
The First Step: Joining the Donor Registry
The journey begins with joining a national or international donor registry. Potential donors generally need to be between the ages of 18 and 60 and meet specific health criteria. Recruitment often focuses on those aged 18 to 35 because younger donor stem cells yield better patient outcomes. Joining requires simple online registration followed by providing a tissue sample, usually via a mailed cheek swab kit. This swab determines your Human Leukocyte Antigen (HLA) type, a complex set of proteins that must closely match the recipient’s for a successful transplant.
Your unique HLA type is entered into a confidential database, making you searchable as a potential match for patients worldwide. Joining the registry is a commitment to donate if you are identified as a match. Since matching is a rare and complex process, most people who register are never contacted, but keeping contact information current is vital.
Finding a match can take anywhere from a few weeks to many years after registration. If you are identified as a possible match, you will be contacted for further testing to confirm compatibility. While initial eligibility is based on general health guidelines, the commitment begins when a patient is found who needs your specific genetic profile.
Understanding the Two Donation Methods
Once confirmed as a genetic match, the patient’s physician determines the collection method based on the patient’s disease and treatment plan. There are two primary methods: Peripheral Blood Stem Cell (PBSC) donation and a traditional surgical bone marrow harvest. Approximately 90% of all donations today use the PBSC method, making it the most common procedure.
Peripheral Blood Stem Cell (PBSC) Donation
PBSC donation is a non-surgical, outpatient procedure similar to donating plasma or platelets, involving apheresis. For five days before the donation, the donor receives daily injections of filgrastim, a synthetic protein. Filgrastim stimulates the bone marrow to produce extra stem cells and release them into the bloodstream.
The apheresis procedure typically takes between four and eight hours and is usually completed in a single session. A second session is occasionally needed to collect the required cell dose. On the day of donation, blood is drawn from one arm, passed through a machine to filter out the stem cells, and returned to the body through the other arm.
Side effects from the filgrastim injections include temporary mild bone or muscle aches, headaches, and fatigue, which resolve shortly after the donation. This method is favored for its less invasive nature and quicker donor recovery time.
Surgical Bone Marrow Harvest
The second method is a traditional bone marrow harvest, a surgical procedure performed in a hospital under general or regional anesthesia. Doctors use hollow needles to withdraw liquid marrow directly from the back of the pelvic bone (posterior iliac crest). This procedure usually takes one to two hours, and the amount of marrow collected is typically less than 10% of the donor’s total marrow.
As a surgical procedure, it carries minor risks associated with anesthesia, such as a sore throat or temporary nausea. The donor may need to stay overnight for observation, and the collection site will be sore afterward. Recovery from the surgical harvest is generally longer than PBSC donation because the body needs time to replenish the removed liquid marrow.
Navigating the Pre-Donation Screening and Logistics
After being identified as a match, a comprehensive screening process ensures the donor’s health and safety. This phase involves confirmatory testing of a blood or cheek sample to verify the HLA match and rule out infectious diseases. Following confirmation, the donor undergoes a thorough physical examination, a detailed medical history review, and additional tests (like an EKG and chest X-ray) to ensure they are healthy enough to proceed.
This preparation includes an informed consent discussion with a medical team, explaining the specific procedure, potential side effects, and risks in detail. The entire process, from initial contact to donation, requires a time commitment of 20 to 30 hours spread over four to six weeks.
Logistical support covers all expenses, including travel, accommodation, and meals, as the donation typically occurs at a specialized collection center or hospital. The donor center staff coordinates all scheduling, working around the donor’s commitments while remaining mindful of the patient’s urgent medical timetable. Before scheduling the final procedure, the medical team confirms the donor has adequate time off work and a post-donation recovery plan. This structured process supports the donor, minimizing stress and logistical burden.
Donor Recovery and Post-Procedure Care
Recovery differs based on the donation method, but the body naturally replaces the donated cells within a few weeks for both procedures. For PBSC donors, side effects are usually mild, including fatigue, headache, and bone or muscle pain, resolving within a few days. Most PBSC donors return to normal activities within one to seven days.
Donors undergoing a surgical bone marrow harvest experience soreness, bruising, and stiffness in the lower back or hip area where the marrow was collected. Discomfort is managed with over-the-counter or prescription pain medication. While most surgical donors return to their normal routine within one to two weeks, the median time for full recovery is about 20 days.
In both cases, donors are advised to rest, hydrate, and gradually return to strenuous activities as tolerated. Follow-up care is standard, with the registry or medical team monitoring recovery progress. The body naturally replaces the donated liquid marrow within four to six weeks, and blood stem cells are typically replenished much faster.