The Gift of Life – Part 3by Sajid Surve, DO | October 15, 2008
Last month I underwent the bone marrow harvest which I had discussed in the previous two Gift of Life articles (Part 1 and Part 2). In the time preceding the harvest, I met with the doctors at Long Island Jewish Medical Center to have the preliminary screening tests, which were rigorous. Testing included a huge gamut of bloodwork for everything ranging from anemia to HIV, as well as an EKG, chest x-ray, and routine physical examination. The National Marrow Donor Program and entire medical team were fantastic every step of the way, and everything was anticipated and accounted for before I got there. Many of the technicians and various other support staff whom I encountered were excited to learn that I was a bone marrow donor. Most of them were also on the registry, and stated that they hoped they would be called some day to donate as well.
The hospital took care of all the arrangements for registering for surgery. On the day of the procedure, I was driven to the hospital with my wife, and walked right into the surgical check-in area. I waited in the waiting area until my time slot came, and then was placed on a stretcher and brought into the operating room. I met up with my doctor again, and spoke with the anesthesiologist who discussed the procedure in detail. Because I had to be face down for the procedure to grant access to my pelvis, I needed to be under general anesthesia with a breathing tube to make sure my lungs stayed inflated. An IV line was started, and they delivered the propofol to knock me out.
I don’t remember anything subsequently except waking up in the recovery room. I had a large bandage on my back, and I was ever-so-slightly sore when I moved around. The bigger problem was that I couldn’t speak well, and my lip was a little roughed up from the breathing tube. Still, I came around quickly, and left the hospital with my wife about an hour after waking up. Over the next two to three days the pain and stiffness in my back went from about a 2 out of 10, down to a 1, and then to just discomfort if I stayed in one position longer than a half hour or so. I was on strict voice rest for one week because of the breathing tube, then went back to normal speaking. I also developed some mild fatigue, which subsided about 10 days post-op. The only residual I have from the procedure is a small scar about the size of a head of a pin on each pelvic bone in the back. All in all, I would say that I came through the procedure well.
On the recipient’s end, things are a little more interesting. Once I was cleared for surgery, the recipient underwent intense chemotherapy and radiation to destroy all the bone marrow in his body. For that short window until my marrow arrived, the recipient did not have an immune system. As soon as the marrow was harvested from me, it was handed to a courier who rushed to the airport and was flown to wherever the recipient is (I’m not allowed to know due to international health information privacy laws), and he received the marrow through an IV. The marrow is smart enough to automatically take hold inside the recipient’s bones, and hopefully begin producing a new immune system, specifically my immune system, inside his body.
Part of that huge panel of bloodwork taken initially was a DNA screen to identify how many base pairs of “junk” DNA were present on the ends of my chromosomes. This number is a unique identifier for each individual, like a fingerprint. The same screen was done to the recipient. Once the new marrow starts producing red and white blood cells in the recipient, a blood sample will be taken and analyzed utilizing the same screen. If my number comes up, then the transplant was a success. If his number, or a combination of his and my numbers come up, then the transplant is a failure. What that means is that if the transplant takes hold, the recipient will be cured of leukemia, and will essentially have my blood flowing through his veins. That explains why the screening process was so rigorous.
Again, due to international health information privacy laws, I’m not allowed to find out if the marrow donation was a success or not. The only way I can get an update is if the recipient’s family goes out of their way to specifically request that I receive an update. All I can do is hope for the best, and know that if things don’t work out, at least that boy exhausted every possible avenue for treatment. Thank you to all of you for your support through this process. I definitely appreciate it.
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