Donating bone marrow

While TV shows and movies have wildly exaggerated blood stem cell donation—especially bone marrow donation—as something scary, the reality is much less dramatic. 10% of donors are asked to donate bone marrow and there are several steps in the marrow donation process, all in place to ensure the donor and patient are the best match and that the donation process runs safely and smoothly.

Bone marrow is a soft tissue found inside bones; it contains blood stem cells. These blood stem cells can develop into a variety of different blood cells: red blood cells that carry oxygen, white blood cells that fight infection and platelets that make blood clots. Those new blood cells are then distributed throughout the body.

For many patients with blood cancers and other life-threatening disorders, a blood stem cell transplant from an unrelated donor is their best hope for survival. Blood stem cells can be donated in two ways: through peripheral blood stem cell (PBSC) donation or bone marrow donation.

Doctors may select bone marrow donation instead of PBSC for several reasons, including::

• When the patient is at risk for chronic graft-versus-host disease (GVHD), a complication sometimes seen in transplants that causes a donor’s blood stem cells to attack healthy cells in the patient. The chances of a patient contracting GVHD is lower with bone marrow transplants compared to PBSC.
• When the patient is a child. Pediatric patients undergoing an allogeneic transplant have higher survival rates using bone marrow than PBSC.

Because PBSC is the most common transplant method, only 10% of donors are asked to donate bone marrow. But for pediatric patients and those at a higher risk for GVHD, your decision to donate could be the life-saving cure they’ve been waiting for.

Get more information about the process and an overview of the timeline.

Bone marrow donation is a surgical procedure performed under anesthesia at a hospital. Here’s what to expect:

1. Confirming you’re the best match

• Complete a health history questionnaire
• Undergo additional testing to ensure the best match
• Attend an information session where you can ask questions and learn about the process
• Receive a physical exam and blood tests to ensure donation is safe for you

Throughout your journey, NMDP experts will guide and support you every step of the way. The entire donation process takes an average of 20 to 30 hours over 4 to 6 weeks (excluding travel). Learn more about how donors are matched with patients.

2. Preparing for donation

Most donors will need to travel to a hospital that participates in marrow collections since the procedure requires a surgical setting. While some medical tests and bloodwork can be done locally, travel is usually necessary for the actual donation.

NMDP covers all donation-related costs, including:

• Flights, hotels and meals
• Childcare, pet boarding and lost wages
• Travel expenses for a friend or family member to accompany you

The day before donation, you may have additional preoperative testing and consultation at the hospital. Your care team will provide all necessary details, ensuring you feel prepared and supported. Find out more about donor safety and support.

3. The day of donation

On donation day, you’ll arrive at the hospital in the morning. Your care team will walk you through final preparations, and your doctor will go over the procedure again.

• Anesthesia: Nearly all donors receive general anesthesia, meaning you’ll be completely unconscious during the procedure. Some donors may receive regional anesthesia (spinal or epidural), which numbs the lower part of the body while you remain aware. The medical team will determine the best option for you.
• The donation procedure: While under anesthesia, you will be positioned on your stomach, and doctors will use a sterile needle to withdraw liquid marrow from both sides of the back of your pelvic bone.
• Duration: The procedure typically takes 1 to 2 hours, depending on how much marrow is needed.
• After donation: Once the collection is complete, a medical courier will immediately transport your marrow to the patient’s location for transplant.

After the procedure, you’ll be taken to a recovery area, where medical staff will monitor you as you wake up. While most donors go home the same day, some hospitals plan for an overnight stay to ensure a smooth recovery. Your care team will ensure you are comfortable before discharge.

 

4. After your bone marrow donation

Recovery times vary, but most donors return to work, school, and daily activities within 2 to 7 days. Since marrow is collected from the pelvic bone, temporary soreness in the lower back or hips is common, as well as fatigue and mild nausea in the days following donation. These side effects typically resolve within a week, and your body naturally replaces the donated marrow within a few weeks.

To ensure a smooth recovery, NMDP will follow up with you regularly and provide guidance on resuming normal activities. Learn more about what happens after you donate.

Your choice to donate has the power to save a life. NMDP is committed to supporting you every step of the way.

At NMDP, your safety and well-being are our top priorities. We take every precaution to make sure donation is as safe as possible. However, like any medical procedure, bone marrow donation has some potential risks and side effects.

While nearly all donors experience some temporary side effects, serious complications are extremely rare (less than 1%). Most side effects resolve quickly, and the median time to full recovery is 20 days.

Common side effect post bone marrow donation

Side effects from anesthesia:

The risks of anesthesia during marrow donation are similar to those of any surgical procedure.

• General anesthesia: Some donors experience a sore throat (from the breathing tube), mild nausea, or vomiting.
• Regional anesthesia (spinal or epidural): This may cause a temporary drop in blood pressure or a headache after the procedure.

Side effects from the procedure itself:

Most donors report temporary side effects in the days following donation, including:

• Back or hip pain – 84%
• Fatigue – 61%
• Sore throat – 32%
• Muscle pain – 24%
• Temporary insomnia – 15%
• Headache – 14%
• Dizziness – 10%
• Loss of appetite – 10%
• Nausea – 9%

Most donors return to work, school, and normal activities within 2 to 7 days. However, full recovery varies from person to person. Your body naturally replenishes the donated marrow within a few weeks.

For more information on donor safety and support, learn how we protect donors.

Because bone marrow donation is more complex than donating blood, you likely have questions regarding preparation, recovery and the process itself. Staff at your donor center can answer many of your questions. However, you can find answers to frequently asked questions on our site.

Get answers