You're a Match: A Donor's Online Guide to Donation

You have been identified as a possible donor for a patient who seeks a marrow or peripheral blood stem cell (PBSC) transplant. When you joined the NMDP Registry, you agreed to consider donating cells from your marrow or blood to possibly help any patient in the world who may benefit from a transplant. You gave a blood or tissue sample when you joined. That sample was tested to determine your tissue type, and the test results were listed on the NMDP Registry

Ron, PBSC donor (top left) with his mother, Dion (top right) and his father, Ron Sr. (bottom right).

Now, a doctor searching the registry has identified you as a possible match for a patient who seeks a transplant.

If you agree to donate, blood-forming cells collected from your marrow or bloodstream (which are PBSCs) will be transplanted into the patient to replace his or her marrow. A marrow or PBSC transplant can often help patients with leukemia, lymphoma, sickle cell disease and other life-threatening diseases live longer, healthier lives.

A transplant requires carefully matching the tissue type of the donor and the patient. Because tissue type is inherited, a patient’s brother or sister usually has the best chance of matching. If a match cannot be found within the patient’s family, the search is started to find an unrelated donor, like you. For more information about becoming a donor, reference pages 9-19  of the donor work up book.

• Complete a Health History Screening Questionnaire: page 10
  
• Learn more about the process: pages 12-19
  
• Make an informed decision about donating: pages 10-11
  

Peripheral blood stem cell (PBSC) donation is one way to collect blood-forming cells for transplant. The same blood-forming cells (sometimes called blood stem cells) found in marrow are also found in the circulating (peripheral) blood. The donation will take place in a hospital or apheresis center with experience collecting PBSCs for Be The Match.

In order to be able to donate enough PBSCs for a transplant, more of the cells need to be moved out of the marrow and into the bloodstream. One proven way to move cells from the marrow into the bloodstream is by taking filgrastim (Neupogen^®), a drug given by injection each day for five days before the PBSC donation. Filgrastim is commonly used to treat cancer patients to boost their blood cell counts.

Donating PBSCs is done through a standard process called apheresis. During apheresis, a needle will be placed into each of your arms.

Blood will be removed from a vein in one arm and passed through tubing into a blood cell separator machine. The blood is spun at high speed and the cells separate into layers.

The machine collects PBSCs, some platelets and some white blood cells. Plasma and red blood cells are returned to your body through the other arm while the PBSC are put into a collection bag. All the tubing used in the machine is sterile and used only once for your donation.

For more information about PBSC Donation, reference pages 23-29 of the donor work up book.

Donation of PBSC

Marrow donation is a surgical procedure that takes place in a hospital operating room. You will be given either general or regional anesthesia to block the pain. Typically, the hospital stay is from early morning to late afternoon, or occasionally overnight for observation. The donation will take place in a hospital that is experienced and participates in marrow collections for Be The Match.

In most cases, the hospital will schedule a same-day admission and discharge for your marrow donation procedure. Some hospitals routinely plan for an overnight hospital stay. Your donor center representative will guide you through the process and will be available the day of your marrow donation. If you have a specific concern about your hospital stay—your symptoms, your comfort, your privacy or some other issue—tell the hospital staff. They want to make your marrow donation procedure as comfortable as possible. Also, please be aware that delays may occur.

During the marrow donation, you will be lying on your stomach. While the donation varies slightly from hospital to hospital, generally, the doctors make several small incisions through the skin over the back of the pelvic bones.

The incisions are less than one-fourth inch long and do not require stitches. The doctor will insert a special hollow needle through these incisions over the rear of the pelvic bone. A syringe is attached to the needle to draw out the marrow.

The amount of marrow donated is only a fraction of the body’s total marrow. The amount donated does not weaken your own immune system. The marrow naturally replaces itself within a few weeks.

For more information about Marrow Donation, reference pages 33-38 of the donor work up book.

During marrow donation, marrow is collected from both sides of your pelvic bone.

Step 1: Patient's doctor asks for a preliminary search of the registry

In a preliminary search, the patient’s human leukocyte antigen (HLA) tissue type is compared to the HLA types of millions of Be The Match Registry members like you. HLA are proteins—or markers—found on most cells in the body. The immune system uses these markers to recognize which cells belong in the body and which do not. A close HLA match between patient and donor is the most important factor in selecting a donor for a patient.

Step 2: Patient's doctor reviews the preliminary search results

The doctor receives a list of potential donors and cord blood units that may be a match for the patient. These early results may show many or few potential matches. Further testing is needed to find out which, if any, of the potential donors or cord blood units are the closest possible match for the patient.

Step 3: If the patient is not already at a transplant center, his or her doctor will refer the patient to one

At the transplant center, the transplant team will evaluate the patient’s health, disease stage and other factors to decide if transplant is a good treatment option for the patient. Many patients have significant travel to their transplant center due to the need for specialized transplant care. Some patients and their caregivers even need to relocate for the duration of their transplant so they are closer to their transplant center.

Step 4: Patient’s transplant center asks for additional testing of one or more potential donors

Further testing is needed to find out whether potential donors or cord blood units listed on the preliminary search results are suitable matches for the patient. A transplant center may test several potential donors or cord blood units to find the closest match for the patient. If a potential donor appears to be a good match, he or she must be contacted to be sure he or she is healthy, willing and able to donate.

Step 5: Transplant doctor selects a suitable donor

You are at this step. The transplant doctor has selected you as a potential donor for the patient. If you agree to donate, you will undergo tests to ensure that you do not have an infection or disease that could be passed on to the patient through the transplant. The tests also make sure donating will not be too risky for you.

For more information about the patient experience, reference pages 55-61 of the donor work up book.

—Kyle, transplant recipient