The donation process

Once you have been chosen as the best matched donor for the patient, you have already completed several blood tests and your compatibility to the donor has been confirmed.

The patient’s physician informs the donor registry about his donor selection and the donor registry schedules an extensive medical check of the donor, which will take place approximately four weeks before the collection date. The medical check will be performed in the collection center and may take 3-5 hours. Additional waiting time should be calculated because of the nature of the different physical examinations.

The medical check is needed to ensure that donation is safe for the donor and to reduce potential risks for the recipient. 

Detailed information about the donation, potential risks and side-effects will be given to the donor.

If possible, we will arrange the medical check and the collection in our collection center in Birkenfeld because we would like to personally look after and guide the donor through the physical examinations and the following donation.

(Please just click on the headlines to read the full text) The steps of the medical check

  1. The potential donor needs to complete a detailed health histrory questionnaire.
  2. Information about the different steps of the medical check.
  3. Collection of additional blood samples for further testing: Bloodvcount , liver markers/liver function, HIV (AIDS), hepatitis, and many more. We will provide a copy of these test results for the donor, abnormalities will be discussed and additional test will be ordered if necessary.
  4. Extensive physical examinations by a physician from the collection center, including an electrocardiogram and ultrasound of the adomen. Additional exams like x-rays of the lung may be added to exclude a pulmonary disease.
  5. Detailed information session about the two methods of donation.
  6. Extensive conversation with the responsible physician in which all the questions will be answered and the schedule of the procedure and possible side effects and risks of the stem cell donation will be explained.
It takes 7-10 days after the medical check until the donor receives additional information about the realization of the collection. The dates for the collection will be discussed and confirmed.

There are two methods to donate stem cells:
  1. The collection of stem cells from the peripheral blood.
The stem cell collection from the peripheral blood is. The stem cells are collected from the venous blood of the donor. First the amount of stem cells in the bloodstream needs to be increased. To achieve this increase, the donor is given small injections of G-CSF (a natural protein) under the skin. The administration takes place every morning and evening approximately four days, a hospital stay is not necessary. The actual collection is called stem cell apheresis or harvesting. The blood is removed through a needle from the donor’s arm and is passed through the cell separator which collects the stem cells. The remaining blood is returned to the donor through a needle in the other arm.
If possible we will arrange for a collection in a collection center close to the donor’s place of residence.
A hospital stay is not necessary, but in some cases a second collection may take place on the following day.

 
  1. The collection of stem cells from the bone marrow
The collection of the stem cells from the bone marrow is a surgical procedure that takes place at a hospital and is being performed under general anesthesia and an inpatient stay is necessary. Special hollow sterile needles are used to withdraw approximately 800 – 1500 ml liquid marrow from the large crest of the donor’s pelvic bone. The collection takes approximately one hour.

The punctuation of the pelvic bone might lead to a blood loss and an autologous blood donation before the procedure might be recommended. This blood is stored and may be returned to the donor after the collection. The marrow replaces itself completely within a few weeks.

The transplant physician states the preferred source of stem cells for the patient. The physician’s choice is usually based on the recipient’s disease, the current health status and on the opinion about what source offers the most promising outcome. Donors will be counselled on both donation methods. A general consent for both methods would be favourable for the patient but the final decision is up to the donor. The donor registry will discuss the donor’s decision with the transplant center.

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