Having signed up as a bone marrow donor, there are still many questions unanswered on what exactly happens when someone is found to be a matching donor for a patient. We asked Dr Yvonne Loh, blood stem cell transplant physician, to give you a simple overview of the most frequent questions our donors ask about being what actually happens during a bone marrow donation.
So what will actually happen if I’m identified as a match?
First of all, we will call you and arrange a time to collect a small blood sample which we will use for “Verification Typing”. This will confirm that you are indeed a suitable match for the patient.
If the doctor selects you as a donor, the next stage is what we call “Donor Workup”. This includes a full physical examination to make sure that you are fit and healthy to donate and during that session the doctor will share more about the donation process including any risks and side effects. You will also be informed if the transplant doctor has requested for either a bone marrow or cells collected from the blood – Peripheral Blood Stem Cell (PBSC) donation. If the transplant doctor has no preference, then you will be able to choose the method you prefer.
Can you explain more about the donation process?
There are two methods of donating bone marrow:
Traditional Bone Marrow Donation is a short procedure done under General Anaesthesia and bone marrow is extracted from the pelvic bone. Usually the donor will be admitted to hospital the evening before and discharged the day after donation when the effects of the anaesthetic have worn off.
Peripheral Blood Stem Cell (PBSC) Donation is an outpatient procedure and the donor is given a small injection of filgrastim – or GCSF – every day for five days. This is a naturally occurring chemical which stimulates production of the bone marrow cells (blood stem cells) which then spill out into the bloodstream where they can be collected through a blood-donation like procedure. The difference is that once the blood is collected, it goes through an aphaeresis machine which removes ONLY the blood stem cells and everything else is returned to the donor. This procedure usually takes 6-7 hours as an outpatient and immediately afterwards the donor is free to leave.
Which is the best method?
Neither method is better than the other although the default for most donor centres today is to harvest blood stem cells using the PBSC method which cuts out the need for a General Anaesthetic. If the donor has a preference, we would try to accommodate that unless the transplant centre specifically makes a request based on the patient’s medical condition.
Are there any side effects?
For the traditional Bone Marrow harvest, there is always some risk associated from a General Anaesthesia but from the actual harvest procedure, serious side effects are very uncommon. As only 5% of the donor’s bone marrow is collected, feedback from our donors usually suggests the after-effect is similar to having a sports “tackle” and they are a little stiff for a couple of days.
With a PBSC harvest, some people experience headaches and / or heaviness to the limbs rather similar to a flu-like ache during the 5 days of hormone injections. This is usually relieved through taking a simple painkiller and in almost all cases, these stop immediately upon collection. Again, serious side effects are very unusual.
What can I expect after I have made the donation?
After a traditional Bone Marrow harvest is completed, most said they would be back at work or studies a day or two after making their donation.
Sometimes a PBSC collection may require two days, but it is an outpatient procedure and the donor does not stay in hospital. After the collection is complete, usually the donor is free to go home or back to work and the bone marrow or blood-forming cells will be back to their normal levels within two to four weeks.
Do I have a choice as to which procedure I prefer?
Sometimes, the transplant doctors will allow you to state a preference and we do try our best to support your preferred method of donation. However, depending on the patient’s condition, the doctor may recommend the procedure that would best aid in the patient’s outcome.
Are there any follow up examinations?
Yes, you will be looked after every step of the way. There will be follow-up sessions scheduled after donation – usually at least one week and one year after your donation. Once the doctor signs off after your last visit, you will not need to return for any subsequent follow-ups. All costs incurred will be covered by the BMDP including any required medicines in the unlikely instance that any treatment is required.
Do I need to incur any costs?
No, you do not need to pay for anything. Any out of pocket expenses will be reimbursed to you including travel expenses as well as any loss of earnings that may result from your donation.
Do you inform my employer that I am a donor?
Yes, we will definitely communicate with any relevant person or individual depending on the donor’s needs. Usually employers are very supportive and willing to support any donors through giving additional leave as necessary to cover the various appointments. We will also talk with other members of the donor’s family if this would be helpful in reassuring them of the procedures involved.