Bone marrow donation

Overview

Bone marrow donation, or bone marrow harvesting, is a procedure used to obtain blood-forming stem cells for transplants. It begins with a donor’s agreement and involves healthcare providers using large hollow needles to extract bone marrow from the donor’s pelvic bones. The process is not painful and can potentially cure individuals with blood cancer or blood disorders. While anyone can volunteer to donate, all donors must meet specific health requirements.

Bone marrow donation is one of three ways healthcare providers obtain healthy stem cells. Most stem cell transplants involve peripheral stem cell or cord blood transplants. Peripheral stem cells are immature stem cells found in the bloodstream, while cord blood comes from umbilical cords. People who have recently given birth can choose to donate their umbilical cord blood. Those in need can receive donated bone marrow from family members (related donors) or from people they don’t know (unrelated donors).

Reasons for undergoing the procedure

Your bone marrow is the soft, spongy tissue found in the center of some bones, responsible for producing over 200 billion new blood cells daily, including red blood cells, white blood cells, and platelets. Bone marrow transplants can be life-saving for individuals with certain diseases, such as aplastic anemia or blood cancers like non-Hodgkin lymphoma. In these transplants, healthy stem cells from donor bone marrow replace the unhealthy bone marrow of the patient. Each year, approximately 18,000 people are diagnosed with bone marrow diseases that could potentially be cured by a bone marrow or other stem cell transplant.

Finding a suitable donor match is a significant challenge. The best match involves a healthy donor with human leukocyte antigens (HLA) closely matching those of the patient. HLAs are blood proteins identified through blood tests in a process called HLA typing. Providers compare these proteins to evaluate donor stem cells for antigen matches, with higher numbers of matching antigens increasing the likelihood of successful blood cell production. About 30% of patients find matching donors within their immediate family, while the remaining 70% depend on finding matching donors outside their close family circle.

Risk

Most donors recover completely after donating bone marrow. However, it is important to remember that bone marrow donation is a surgical procedure and carries potential risks, including:

  • Reaction to anesthesia
  • Nerve or muscle damage
  • Infection
  • Hip injury at the needle insertion site

Procedure

You could not be eligible to donate bone marrow for a number of reasons. Individuals sixty years of age and above, for instance, are unable to donate. The age limit is set by transplant organizations because many persons experience medical issues as they age that may prevent them from being eligible to donate. The following medical issues exclude potential donors:

  • Autoimmune diseases that affecting your entire body.
  • Bleeding disorders (such as hemophilia or deep vein thrombosis).
  • Brain injury.
  • Cancer patient who are undergoing chemotherapy or radiation therapy or who had history cancer treatment within the past five years.
  • Chronic back, hip, or spine discomfort, if you’re taking medicine for it.
  • Chronic Lyme disease.
  • Diabetic patient who are taking insulin.
  • Heart disease.
  • Hepatitis B or C.
  • HIV/AIDs.
  • Kidney disease.
  • Severe arthritis such as rheumatoid arthritis.

These are only a handful of the reasons you could not be eligible to donate bone marrow. Speak with a healthcare provider if you wish to donate bone marrow but are unsure if you will be eligible. They can look at your medical history and the recommended course of action.

Before the procedure

Your total health will be evaluated by healthcare providers. They will advise you on how to get ready for general anesthesia. To make sure you are able to donate bone marrow, they could recommend the following test.

  • Blood tests:
    • Complete blood count (CBC).
    • Comprehensive metabolic panel (CMP).
    • Pregnancy test.
    • Prothrombin time test (PTT). To measures how quick is your blood to form a clot.
  • Infectious disease tests:
    • Chickenpox (varicella).
    • Cytomegalovirus (CMV). To check for herpes virus.
    • Epstein-Barr virus (EBV).
    • Hepatitis.
    • HIV/AIDS.
    • Human T-cell lymphotropic virus Type 1 and Type 2. Your immune system’s T cells, which are white blood cells, are affected by these viruses.
    • Syphilis
    • Toxoplasmosis.
  • Imaging test:
    • Chest X-ray.
    • Electrocardiogram, to monitor the function of the heart.

During the procedure

The patient will be taken to an operating room and given general anesthesia. They will lie on their stomach, and healthcare providers will insert a tube in their throat to assist with breathing. A special needle will be placed through the skin into the narrow cavity of the hipbone, as hipbones contain the most marrow and the largest number of healthy stem cells. The healthcare provider may need to insert the needle several times to collect enough bone marrow.

The collection process involves retrieving about 1 to 2 pints of liquid bone marrow, which is approximately 10% of all marrow cells. The entire bone marrow donation procedure, also known as a bone marrow harvest, typically takes about an hour. In some cases, healthcare providers may also take red blood cells during the procedure, which will be returned to the patient in the recovery room.

After the procedure

After donating bone marrow, you’ll be taken to the recovery room where you’ll need to stay for about an hour. During this time, a recovery room nurse will assist you in waking up and will check your vital signs — blood pressure and pulse — every 15 minutes until they are stable. The nurse will also monitor the bandage on your hip for any signs of unusual or excessive bleeding. You’ll have an intravenous (IV) tube in your arm, and if red blood cells were taken during the procedure, the IV will deliver them back to you. The nurse will remove the IV once you can tolerate fluids and will encourage you to take deep breaths, cough, and change positions to aid in your recovery from anesthesia.

Immediately after donating bone marrow, you may experience several side effects. You may feel tired and weak, and your throat might be sore and dry due to the breathing tube used during the procedure. Nausea is also a common side effect, and you might need assistance if you need to go to the bathroom. Once you’ve sufficiently recovered from the procedure, you’ll be able to go home, but you won’t be able to drive yourself.

Outcome

Most donors can return to work or resume normal activities after resting for a few days, though complete recovery from donating bone marrow may take a few weeks. During your recovery, you may experience side effects such as aching or soreness in your lower back and hips, and you might have bruises. Healthcare providers may recommend over-the-counter pain medication to alleviate discomfort. Some donors may feel weak or have difficulty walking for several days post-procedure, in which case iron supplements may be advised to help restore normal red blood cell levels. Your healthcare provider will monitor your red blood cell levels and inform you if continued supplementation is necessary.

It is important to contact a healthcare provider if you experience symptoms that could indicate an infection, such as fever or tenderness and redness at the needle insertion site on your hip. Keeping an eye on these symptoms and seeking medical advice when necessary will help ensure a smooth recovery process.