Bone Marrow / Stem Cells
Bone marrow is the tissue that could be regarded as the factory for the production of red cells to carry oxygen, white cells to fight infection and platelets to prevent bleeding.
Every year thousands of individuals with blood diseases such as leukaemia, marrow failure or aplasia, and inherited metabolic and immune deficiency syndromes reach a stage where only this procedure offers a chance of cure.
Most bone marrow transplants are complete by the donor donating Peripheral Blood Stem Cell (PBSC). This donation is a nonsurgical procedure similar to donating blood and will be described in more detail below.
Every healthy person between 18 and 45 can be a donor. “Tissue-types” are inherited characteristics, used in matching donors and patients. The likelihood, therefore, of finding a suitable volunteer will be considerably greater within the same ethnic background.
Family members, particularly brothers and sisters are generally most suitable. However, due to the average family size, only about 30% of patients have a compatible sibling.
In the same way as red cell blood groups exist, so white cells can be categorised into groups known as “tissue-types”. There are many possible tissue types that exist, so finding the correct match depends upon having a very large register of volunteer donors.
Unfortunately, the field of bone marrow transplantation is complex and a number of patients are not cured despite the best medical care. However, increasing numbers of successful transplants are being carried out using matched unrelated donors. Donors offer the only hope of a future to patients whose disease would almost certainly otherwise prove fatal.
Regarding Peripheral Blood Stem Cell (PBSC) donation, for days before the procedure the donor is given a drug that stimulates the production of blood stem cells. ON the day of donation the donor will go to a donation centre and be connected to a machine called an apheresis machine, also called a cell separator. Blood is taken from the donors arm into the machine and then returned to the patients other arm.
Inside the machine, only the blood-forming cells are collected and the remaining blood is returned to the donor’s other arm. One or two collections on consecutive days, each lasting 4-6 hours, may be required. Overnight hospitalisation is not usually necessary. A general anaesthetic is also not required for the procedure. Where appropriate, Peripheral Blood Stem Cells can be equally efficient and comparable to bone marrow for the recipient and are much less trouble for the donor.
Donating actual bone marrow is a more complicated procedure for the donor which is not often used.
Actual bone marrow donation is a surgical procedure that takes place in an operating room under anaesthetic. The can be either general anaesthetic or regional anaesthetic (either spinal or epidural) depending on the circumstance,
During the marrow donation, you will be lying on your stomach. While the donation varies slightly from hospital to hospital, generally, the doctors use special, hollow needles to withdraw liquid marrow (where blood-forming cells are made) from both sides of the back of the pelvic bone. The incisions are small and do not require stitches.
Hospital staff will watch you closely until the anaesthetic wears off, and continue to monitor your condition afterwards. Most donors go home the same day or the
The amount of actual bone marrow donated will not weaken your own body or immune system. Most donors are back to their usual routine in a few days, and your marrow naturally replaces itself within four to six weeks.
The risk of side effects of anesthesia during marrow donation is similar to that during any other surgical procedure.
All the necessary precautions to ensure the safety and well-being of the donor are taken.
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Q? I WANT TO REGISTER AS A DONOR, WHAT DO I DO?
You will be listed on our database as a potential donor. When a need arises, we will contact you to be tested. This will require a small blood sample taken and sent to a laboratory for tissue-typing.
Alternately, you may also wish to have the test straight away and be placed on an international computer registry. In the event of a possible match, you will be asked to provide further blood samples to help select the donor matches best for a particular recipient.
Q? SUPPOSE I DECIDE AGAINST BEING A DONOR?
You have the right to withdraw your offer at any time and you would be supported in your decision by Life2Life and the transplant team.