Steps of PBSC donation
If you’re called as a match for a patient, there are several steps you’ll need to follow before donating peripheral blood stem cells to make sure the procedure is safe for both you and the patient.
From registering (Opens in a new tab) to matching with a patient to donating, NMDPSM is by your side. After you’ve agreed to move forward with donation, we’ll help you:
- Complete a health history questionnaire
- Move through additional testing to make sure you’re the best match
- Get your questions answered in a detailed information session
- Undergo a physical exam and give blood samples to ensure it’s safe for you to donate
Throughout your journey, you’ll have a team of NMDP experts working with you to answer any questions and make sure you’re set up for a successful donation. The entire donation process takes an average of 20 to 30 hours spread out over 4 to 6 weeks, excluding travel.
While bloodwork and medical appointments can usually be done locally, most donors have to travel for donation. NMDP pays for all travel and donation-related costs, including things like childcare, pet boarding and lost wages. We’ll also pay for a friend or family member to travel with you to donation.
90% of donors are asked to donate peripheral blood stem cells (PBSC); that procedure is detailed below. The other 10% percent are asked to provide bone marrow. The patient's doctor chooses the donation method that’s best for the patient.
How do you donate peripheral blood stem cells?
If you’re asked to donate peripheral blood stem cells (PBSC), you’ll go to an experienced collection center or outpatient hospital facility, where donation is done via a nonsurgical procedure called apheresis.
With locations across the country, including our NMDP Collection Centers, we will work to schedule your donation day at the location that is best for you and the patient.
For 5 days leading up to donation, you’ll be given injections of a drug called filgrastim or an FDA-approved similar. The purpose of the filgrastim injections is to stimulate the bone marrow to make more blood-forming cells and move them from the marrow into the bloodstream so they can be collected by apheresis.
On donation day, you can expect to arrive at the collection site early. You’ll usually receive the last injection of filgrastim and then have your complete blood cell count taken to make sure that enough stem cells have mobilized from the bone marrow out into the blood. Then you’ll be set up on the apheresis machine.
During apheresis, a needle will be placed in each of your arms. Blood will be removed from a vein in one arm and passed through tubing into a blood cell separator machine. (If you don’t have suitable arm veins, a central venous line may need to be placed instead. A central line is a sterile tube that’s inserted into one of the larger veins: the femoral vein, internal jugular vein or subclavian vein. The blood is removed and returned through different lumens, or tubes, connected to the central line.)
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 PBSCs are put into a collection bag. All the tubing used in the machine is sterile and used only once for your donation.
This process is similar to donating plasma or platelets but can take 4 to 8 hours. While donating, donors can watch movies or shows, read, use their phones, hang out with their companion or nap.
Once the process is complete, you’ll be checked out to make sure all is well. You’ll have the IVs removed and be monitored for a short period of time before being released. Find out more about what happens after you donate.
90% of all PBSC donations are completed in one apheresis session, which may take up to 8 hours. The remaining 10% of donations are completed in two apheresis sessions, which will take 4 to 6 hours each.
How someone reacts to donation varies from person to person. There are donors who report feeling only a little discomfort, while others say that donation was more painful than they thought it would be. During the days leading up to it, when receiving shots of filgrastim, some donors experience headaches or bone or muscle pain. After donation, donors may experience bruising at the site where the IV was placed or fatigue.
Recovery times vary depending on the individual and the type of donation, but donors can usually go back to work, school and most other activities within 1 to 7 days. Your blood stem cells return to normal levels within a few weeks. NMDP guides you though what to expect after donation to ensure your recovery is a smooth one, help you express your experience and remain involved.
Peripheral blood stem cell donation risks and side effects
No medical procedure is without risk, but fewer than 1% of PBSC donors experience a serious side effect from the donation process.
You may be curious about any risks related to receiving filgrastim in advance of donation. We've studied the risk of long-term complications from filgrastim, and there is no increased risk compared to donors not given filgrastim.
As mentioned above, PBSC donation may require placement of a central line if you don’t have suitable arm veins. Based on our experience, 13% of women and 2% of men require central line placement. The risk of serious complications from use of a central line is small. A central line will be placed only with your consent after you’ve received information about the possible risks.
Donors may also experience immediate side effects from donation. Those could include headaches or bone and muscle pain, similar to a cold or the flu, for several days before collection. These are side effects of the filgrastim injections and disappear shortly after donation. Other common side effects are nausea, trouble sleeping and tiredness.
During donation, some donors experience tingling around the mouth, fingers and toes and mild muscle cramps. This is caused by the anticoagulant (blood thinner) used in the apheresis procedure. These symptoms are easily treated with calcium replacement or by slowing down the procedure. Other common side effects include bruising at the needle site, chills and a decrease in the blood platelet count.