The Gift of Life – Part 2

In my previous post, The Gift of Life, I detailed the events surrounding my ongoing process of becoming a bone marrow donor. For this entry, I wanted to spend some time discussing the specifics of the process, in hopes of demystifying the concept of bone marrow donation and perhaps inspiring others to join the National Marrow Donation Program and potentially give their own gift of life.

In order to join, as I mentioned previously, all that is needed is a blood sample using the same techniques as you would for routine bloodwork. The vials are collected and analyzed, and your 6-marker screening information becomes accessible in the national database. Physicians around the world have access to this database, and search for potential matches for their patients in need of a transplant. Again, if you are a close match based on the screening, more vials of blood are drawn to complete the full 10-marker analysis.

Assuming you are a compatible match with the recipient, there are 2 possible ways to donate: Peripheral Blood Stem Cell (PBSC) donation, and Bone Marrow Transplant (BMT). Only the recipient’s physician can determine which procedure is most appropriate for that particular case.

In PBSC, the procedure is completely outpatient. For 5 days in a row the donor receives an injection of filgrastim, which is a medication that causes your bone marrow to release it’s immature blood cells, including stem cells, into the bloodstream. On the fifth day, the donor goes to a blood center to undergo apheresis, a process by which whole blood is drawn out of the body, run through a filter to remove the stem cells and then returned back into the body. The stem cells are then preserved and delivered to the recipient. During the time that the donor is receiving the medication, they may develop some bone aches, headache, muscle pain, or nausea, but these almost always stop shortly after the aphersis is complete.

In BMT, the donor is required to undergo minor surgery. Under either general or regional anesthesia, a hollow needle is inserted through the back into the iliac crest, one of the pelvic bones, and a syringe is used to draw out the bone marrow from that region. When sufficient marrow has been extracted, the procedure is over and the donor is moved to a recovery area to be monitored as the anesthesia wears off. Most donors go home the same day. Only 5-10% of the body’s marrow is removed during the procedure, and this replenishes itself in about 4-6 weeks. After the procedure most donors feel sore in their low back or pelvis and may require some assistance with walking or climbing stairs, but this resolves in a few days for almost all donors. The risks of the procedure are mostly related to the effects of anesthesia, and are very uncommon.

In both cases, the recipient’s insurance is responsible for all costs of donation, including an allowance for transportation costs to and from the hospital for appointments and procedures. Most employers are required by the state to provide paid time off for work missed due to donation, and in the event that this is not the case a reimbursement for lost wages is possible.

Of course, certain people are not able to be donors. In particular, patients with diseases such as HIV, hepatitis, or genetic blood disorders like sickle cell disease or thalassemia are not able to donate. Other circumstances may also preclude being a donor, and are mostly the same criteria that would prevent one from donating whole blood or blood products.

If you are interested in learning more about becoming a bone marrow donor, I would encourage you to visit marrow.org. For the cost of your time and a few days of achy pain, you could potentially save somebody’s life.