Living Blood & Marrow Donation
Patients receive blood and marrow transplants from living donors who have undergone tests for the closest possible tissue match. Generally the best chance to find a perfect match is with a sibling. If a suitable related donor is not available, an acceptable donor match may be found through the National Marrow Donor Program.
The procedure to collect donated bone marrow or stem cells is called the harvest. This is a surgical procedure that takes place in the operating room. On the day of the harvest, the donor is admitted to the hospital and given anesthesia. Once the donor is anesthetized, the surgeon inserts a needle into the donor’s rear hipbone where a large quantity of bone marrow is located. He or she extracts the bone marrow – a thick red liquid – with a needle and syringe. The harvested bone marrow is then processed to remove impurities and either taken directly to the receiving patient or stored for later use.
While the donor may have several skin punctures during the harvest, there are no surgical incisions requiring stitches. After the harvest, a sterile dressing is applied and the donor is moved to a recovery area where he or she can be closely monitored until the anesthesia wears off. Donors usually receive an infusion of their own blood after the harvest. The donor may return home that day or stay overnight in the hospital if necessary.
Following the harvest, donors may feel some discomfort in their lower back for several days. This can usually be controlled with acetaminophen. Some donors also feel fatigued after the harvest. Most are able to resume normal activities within a few days.
Peripheral Blood Stem Cell (PBSC) Donation
Blood stem cells can be collected from the blood stream without general anesthesia. This procedure is called a stem cell harvest, or peripheral blood stem cell harvest.
Prior to the harvest, donors receive daily injections of filgrastim for three to five days. Filgrastim (also called G-CSF or Neupogen) is a manmade version of protein that occurs naturally in the body. It causes blood stem cells to move out of the bone marrow into the bloodstream.
During the harvest, the donor has needles inserted into each arm. Blood passes through one of the needles into a tube that is connected to an apheresis machine. This machine removes the stem cells and returns the remaining blood back to the donor via a tube connected to the needle in the other arm. The procedure takes three to four hours and two sessions may be required.
The stem cell harvest is relatively painless and generally without lasting side effects.