Blood stem cell donation medical guidelines
Requirements for donating blood stem cells exist to protect your health and the health of transplant patients. Here are some guidelines to keep in mind.
Guidelines for donating blood stem cells aren’t the same as those for donating blood. The list below includes most, but not all, medical requirements. If you’re a match for a patient, we’ll discuss your health history further and arrange for a thorough physical exam.
If you’ve been diagnosed with HIV (AIDS), you can't donate. If you’re at risk for the HIV virus, your current medical status will be carefully evaluated. More information about HIV/AIDS and how it is transmitted may be found at the Department of Health and Human Services Centers for Disease Control and Prevention Website (Opens in a new tab).
If you suffer from common allergies to animals, the environment, medications, etc., you may be able to donate. If you have serious or life-threatening allergies to medications or latex, your health condition and allergies will need to be carefully evaluated.
In general, if you have mild to moderate osteoarthritis or degenerative arthritis, you may be able to donate. Mild to moderate arthritis is defined as having little impact on daily activities and is relieved by taking occasional medications. If you have arthritis affecting the spine, your condition will need to be carefully evaluated. If you have severe medical arthritic conditions such as rheumatoid, reactive, psoriatic or advanced stages of other types of arthritis, you will not be allowed to donate.
If you have asthma that is exercise-induced or is well-controlled and have had no attacks requiring oral (pill) or intravenous (IV) steroids or emergency care in the past 12 months, you may be able to donate. If you have asthma requiring regular/daily use of oral (pill) steroids, you won’t be allowed to donate.
Most diseases that may be defined as autoimmune disorders, such as multiple sclerosis, systemic lupus, chronic fatigue syndrome and fibromyalgia, will prevent you from donating blood stem cells. However, if you have a condition such as Hashimoto's or Graves' disease, you may be allowed to donate as long as the disease is well-controlled and you’re medically stable.
Common back problems such as sprains, strains and aches shouldn’t interfere with a blood stem cell donation. If you had a single back surgery more than 5 years ago and have no ongoing symptoms, you may be able to donate. If you have chronic/ongoing back pain (including persistent sciatica and/or numbness) requiring medical treatment (e.g., daily pain meds, physical therapy (PT), chiropractic treatments) you won’t be able to donate.
The following back-related issues must be carefully evaluated to determine whether you may donate:
- Single surgery 2-5 years ago
- Multiple surgeries, no matter how long since procedures
- History of fracture from an injury 2-5 years ago
- History of herniated, bulging or slipped disc in any location of the back
- Mild osteoarthritis involving the spine, neck or hip
- Diagnosis of scoliosis, if no history of surgery or if the rods/pins have been removed and you’re fully recovered
- Diagnosis of degenerative disc disease
If you have significant back problems and/or any questions regarding your medical condition, contact your donor representative.
If you have elevated blood pressure (hypertension), you may donate if your condition is well-controlled by medication or diet and if there’s no associated heart disease.
If you have breathing problems such as shortness of breath, sleep apnea and/or a history of chronic bronchitis, chronic obstructive pulmonary disease (COPD), emphysema, pneumonia, a pneumothorax, pulmonary emboli, etc., contact your donor representative.
If you have a history of precancerous cells, you’re able to donate. If you have had cured, local skin cancer (basal cell or squamous cell), you may also be able to donate. If you have healed melanoma in situ, skin cancer, cervical cancer in situ, breast cancer in situ or bladder cancer in situ, you’ll be able to donate. (In situ cancer is diagnosed at a very early stage [stage 0] and is specifically called "in situ.")
If you’ve been diagnosed and treated for a solid tumor type cancer and it has been more than 5 years since completion of treatment with no recurrence, you may be able to donate. If your treatment included chemotherapy and/or radiation therapy, you won’t be able to donate. If you’ve had any other form of cancer, you won’t be able to donate—no matter the length of time since treatment or recovery.
If you have a history of chemical dependency and/or mental health issues, you may be allowed to donate after careful evaluation of your current situation. In general, if you’ve completed chemical dependency treatment, it has been at least 6 months since therapy and you have no physical ailments that may put you at risk for donation, you may be able to donate.
If you have a condition such as attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), bipolar or manic-depressive disorder, or depression, you may be allowed to donate as long as the condition is well-controlled and you’re medically stable. Mental health conditions such as schizophrenia, schizoaffective disorder or delusional disorder will prevent you from donating blood stem cells.
It’s important that you’re committed and able to follow through with the donation process. Guidelines used to evaluate your current chemical dependency/mental health status are not meant to judge. They are meant to protect your safety and well-being and provide the best possible outcome for the patient.
If you’re called to donate blood stem cells, you may not be able to donate if you show signs of a serious cold or flu at the time of donation. If you’ve been called as a donor, it’s important that you contact your donor representative if you develop cold or flu symptoms. Symptoms such as a fever greater than 100 F, a productive cough, sore throat, headache(s), etc., need to be carefully evaluated.
If you have a history of depression that’s stable and well-controlled, you may be able to donate. Contact your donor representative to discuss any other mental health conditions.
If your diabetes is well-controlled, you may be allowed to donate after careful evaluation of your current health status. In general, if your diabetes is well-controlled by either diet or oral (pill) medications, you may be able to donate. If you require insulin or any injected medications to treat diabetes or if you have diabetes-related serious health issues such as kidney, heart or eye disease, you won’t be able to donate. If you have questions regarding your diabetes, contact your donor representative.
If you have epilepsy, you may be able to donate after careful evaluation of your seizure history. Certain situations may be associated with developing epilepsy.
In general, if you have heart disease, you can’t donate. This includes a prior heart attack, any history of angioplasty, cardiac bypass surgery, heart valve replacement surgery or pacemakers. However, some heart conditions such as well-controlled irregular heartbeats (arrhythmias), mitral valve prolapse or successful cardiac ablation don’t necessarily prevent donation. Your situation will be evaluated on an individual basis.
If you have a history of a stroke, a transient ischemic attack (TIA), an intracranial hemorrhage (epidural, subdural, subarachnoid) or other significant brain injury or surgery in the brain—even if currently recovered and without symptoms—you aren’t able to donate.
You may donate if you have a history of fully recovered documented hepatitis A. If you’ve received a vaccine to prevent hepatitis, you’ll also be permitted to donate.
If you have any of the following, you’ll be carefully evaluated to determine if you can donate:
- History of, or at risk for, hepatitis B or C
- History of hepatitis or yellow jaundice (age 11 or older) without a known cause
- Close or intimate contact with someone with active hepatitis in the past year
If you have questions regarding hepatitis and donation, contact your donor representative.
More information about hepatitis and how it’s transmitted may be found at the Department of Health and Human Services Centers for Disease Control and Prevention Website (Opens in a new tab).
If you’ve been injured, hospitalized and/or had surgery in the past year, you may be able to donate after careful evaluation of your experience and recovery. Medical conditions that require surgery, hospitalization or treatment in an emergency room setting must be evaluated to protect your safety and provide the best possible outcome for the patient.
If you’ve received a common immunization, you may donate. Receiving an investigational vaccine in the past year, however, must be evaluated. Some immunizations (such as smallpox) will require assessment if you’re selected as a potential donor.
If you have serious kidney problems such as polycystic kidney disease and are over 40 years old or chronic glomerulonephritis (any age), you won’t be able to donate. If you’ve had a kidney removed due to disease, you may not be able to donate. However, if you donated a kidney to another person and are now fully recovered from that surgery, you may donate. You’re able to donate if you have a history of kidney stones.
If you have a serious liver disease such as hepatitis B, hepatitis C or Wilson disease, you aren’t able to donate.
You can donate if you have Gilbert's syndrome.
If you’ve fully recovered from a tick-borne disease, such as Lyme disease, ehrlichiosis, human anaplasmosis or Rocky Mountain spotted fever, you’ll be able to donate. However, if you have chronic Lyme disease, you won’t be able to donate. The other tick-borne diseases mentioned aren’t believed to have chronic forms in humans.
Treatment with some medications may affect your ability to donate. Most often it isn’t the actual drug itself but the condition requiring the medication that would determine your suitability. Some medications may prevent you from undergoing one type of donation procedure, such as bone marrow donation, but not the other, peripheral blood stem cell (PBSC) donation. If you’re currently taking medication(s), you may want to contact your donor representative to discuss the medication(s) and/or underlying condition.
If you’ve received human tissues, such as bone (including bone powder for dental procedures), ligaments, tendons, skin or corneas, you may be allowed to donate, depending on the reason for the procedure.
If you received any of the following types of transplants, you won’t be able to donate:
- Human organs such as heart, lung, liver or kidney
- Peripheral blood stem cells
- Xenotransplant (live tissues from animals)
If you’ve had ear or body piercing in the past year, you may be able to donate if non-shared instruments were used. The use of shared non-sterile needles/instruments requires evaluation for possible signs/symptoms of infection for 12 months from the date of the piercing.
Blood stem cells can’t be collected at any time during pregnancy. If you’re pregnant (or attempting to become pregnant), you must be temporarily deferred from donating until fully recovered from the delivery.
If you’ve been called as a match and are currently breastfeeding, you may want to contact your donor representative to discuss your options.
If you’re currently pregnant or planning on becoming pregnant, you may want to consider donating umbilical cord blood after your baby is born. To see if this is an option at your hospital, see Where to Donate Cord Blood.
If you have or have had a sexually transmitted disease such as herpes, HPV, chlamydia or syphilis, you may be able to donate. Your case will be evaluated on an individual basis.
If you received a tattoo in the past year, your current medical status will be carefully evaluated for possible signs/symptoms of infection.
You may be able to donate regardless of where you’ve traveled. If you’re selected as a potential donor, recent travel to areas at risk for infections such as malaria or mad cow disease will be evaluated.
You may be able to donate if you have a history of a positive Mantoux (PPD) test. You may be able to donate if you’ve completed treatment for TB, if it has been more than 2 years and you have a clear chest x-ray. If you’ve had active pulmonary tuberculosis (TB) within the last 2 years, your current health status will require careful evaluation.
Weight guidelines
If you’re called to donate, you’ll complete a health screening and physical exam before moving forward with donation. Medical guidelines for cell therapy product donation (such as peripheral blood stem cells and bone marrow), including BMI (body mass index), will be assessed to determine donation eligibility.
BMI is calculated using your weight and height. You may not be able to donate if your BMI (both underweight and overweight) presents a safety risk to either you or the patient. While we don’t have a guideline table listing minimum weight criteria, if you’re extremely underweight for your height, your current health status will require careful evaluation.
To find out the maximum weight (in pounds) for a given height (in feet and inches), see the chart below.
Height Weight 4'10" 215 4'11" 222 5'0" 230 5'1" 238 5'2" 246 5'3" 254 5'4" 262 5'5" 270 5'6" 278 5'7" 287 5'8" 295 5'9" 304 5'10" 313 5'11" 322 6'0" 331 6'1" 340 6'2" 350 6'3" 359 6'4" 369 6'5" 379 6'6" 389 6'7" 399 6'8" 410 6'9" 420 6'10" 430
Age guidelines
NMDPSM is focused on recruiting younger people because medical research shows that blood stem cells from those donors provide the greatest chance for transplant success and long-term survival. Therefore, individuals over 40 are not able to join the registry. Likewise, anyone under 18 is unable to donate because donation is a medical procedure requiring informed consent, which minors are unable to give. And because it’s a voluntary procedure, parents/guardians can’t sign a release or give consent on their behalf. If you’re under 18, however, you can sign up for the pre-registry (Opens in a new tab); you’ll be contacted about joining the registry when you turn 18. These age limits aren’t meant to discriminate. Rather, they’re in place for the best outcomes, health and safety of both the donor and patient.
Once you’re a member, you’ll remain on the registry until the age of 61, unless you request removal (Opens in a new tab). While doctors frequently prefer younger donors to increase the odds of transplant success, there are times when donors between the ages of 40 and 60 are asked to donate.
If you identify as LGBTQIA+, there are no restrictions on joining the NMDP RegistrySM. If you’re called to donate, you’ll be asked to fill out a health history questionnaire and may be asked about your sexual activity, but your answers wouldn’t preclude you from donating.
Once a member of the NMDP Registry, you may opt in to be a potential donor for NMDP BioTherapiesSM. This is the part of NMDP that supports organizations that are creating next-generation cell and gene therapies.
Our cell and gene therapy partners are regulated by the Food and Drug Administration (FDA) and, depending on the therapy being made, may also be regulated by international requirements. A single donation from one person can potentially be manufactured into many doses that are given to different patients all over the world. That means the regulations and requirements may be different than those for blood stem cell transplants. Men who have had sex with men in the past 5 years or women who have had sex with a man who has had sex with a man in the past 5 years may not be able to donate to NMDP BioTherapies.
The decision to donate can feel overwhelming at times. While we’re here to walk you through every step of the process, you may have some questions as you make your decision. Here are a few of the most frequently asked ones.
Matching a patient
Doctors look for a donor who matches their patient's tissue type, specifically their human leukocyte antigen (HLA) type. HLAs are genes that code for proteins—or markers—found on most cells in your body. Your immune system uses these markers to recognize which cells belong in your body and which do not. The closer the match between the patient's HLA and yours, the better for the patient.
We can’t predict the likelihood that an individual member will donate because there are so many HLA types. And as the diversity of the population increases, more unique HLA types are being created, making full matches harder to find. However, new research and clinical trials from NMDP through our research collaboration CIBMTR® are making it possible for patients to have a successful transplant even when paired with a donor who isn’t a full match. This initiative, called Donor for All, means more transplants for patients and more opportunities for NMDP Registry members to donate!
Being younger also increases your chances of matching. Research shows cells from younger donors lead to better long-term survival for patients after transplant, and doctors request donors in the 18 to 35 age group nearly 80% of the time.
If you match a patient, you’ll undergo more testing to see if you’re the best possible match for the patient. We may ask for another cheek swab or a blood sample, or we may be able to use a stored sample.
If the patient's doctor selects you as the best donor for the patient, we’ll schedule an information session so you can learn more about the donation process, risks and side effects. Though almost all patient information is confidential, we can share the patient's age, gender and disease with you. At that time, we can also confirm the type of donation the patient's doctor has requested—either bone marrow or peripheral blood stem cells (PBSC), collected from the circulating blood.
Deciding to donate
Donating is always voluntary, and you have the right to change your mind at any time. If you decide you don’t want to donate, let us know right away. We’ll need to continue the search for another donor, and delays can be life-threatening for the patient.
Donating bone marrow is a surgical procedure done at a hospital. While the donor is under anesthesia, doctors use needles to withdraw liquid marrow from the back of the pelvic bone.
PBSC donation is a nonsurgical procedure done at an outpatient clinic. PBSC donors receive daily injections of a drug called filgrastim or an FDA-approved similar for 5 days leading up to donation to increase the number of blood-forming cells in the bloodstream. Then, using a process called apheresis, a donor's blood is removed through a needle in one arm and passed through a machine that separates out the blood-forming cells (aka blood stem cells). The remaining blood is returned to the donor through the other arm.
When you join the registry, you agree to donate by whichever method is needed for the patient you are matching. Once you’re chosen as a donor, you’ll find out which method will be used either when you’re first contacted or at the donor information session that happens later. The patient's doctor chooses the method that’s best for the patient.
- Donors never pay to donate and are never paid to donate. We cover all costs related to donation, including:
- medical expenses
- donation itself
- travel expenses such as hotel, air and ground transportation, and meals for you and a companion
- childcare
- pet care
- lost wages
Becoming a donor requires a time commitment. Before you donate, there are several steps you’ll go through to make sure you’re the best donor for the patient. These include an information session to provide resources to help you make your decision, as well as appointments for additional blood tests and a physical exam.
Donation itself typically takes 1 day, but the time commitment for the entire donation experience for either bone marrow or PBSC—finding out you’re a match, undergoing additional testing, preparing to donate, donating—is 20 to 30 hours spread out over a four-to-six week period, excluding travel. Most donors will travel during the donation process, which could include air travel and staying overnight in a hotel.
We have extensive contacts with health care organizations and medical professionals who are experts in blood cell donations and medical care. We’ll work with them to help find care for complications related to donation.
If you’re on the NMDP Registry and you donated through NMDP, you’ll be covered by a donor life, disability and medical insurance policy for complications directly related to the donation.
Donating bone marrow
Marrow donation is a surgical procedure that takes place in an operating room. The donation will be scheduled at a hospital that partners with NMDP. In some cases, the hospital may be near your home. In other cases, you may be asked to travel. We’ll guide you through the process and be available the day of your donation.
- Hospital stay: You’ll arrive at the hospital outpatient facility early on the day of the donation and stay there until late afternoon, although some hospitals routinely plan for an overnight stay.
- Anesthesia: You’ll be given anesthesia to block any pain during the procedure. If general anesthesia is used, you’ll be unconscious during the donation. If you receive regional anesthesia (either spinal or epidural), medication will block sensation in the affected area, but you’ll remain aware of your surroundings. General anesthesia is used for about 96% of NMDP marrow donors. The average time under anesthesia is less than 2 hours.
- Donation: During marrow donation, you’ll 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 less than ¼-inch long and don’t require stitches.
- Recovery: Hospital staff will watch you closely until the anesthesia wears off and continue to monitor your condition afterwards. Most donors go home the same day or the next morning. After you leave the hospital, we’ll contact you on a regular basis to ask about your physical condition and any side effects you may be experiencing.
Marrow donation is primarily done under general anesthesia, so the donor experiences no pain during the collection procedure.
Discomfort and side effects vary from person to person. Most marrow donors experience some side effects after donation. Common side effects include:
- Back or hip pain
- Fatigue
- Muscle pain
- Headache
- Bruising at the incision site
Some donors said the experience was more painful than they expected; others said it was less painful. Some donors describe the pain as similar to achy hip bones or falling on their butt. Others say it feels more like a strained muscle in the back. The ache may last a few days to several weeks.
We take all the necessary precautions to ensure your safety and well-being. However, no medical procedure is risk-free. Almost all bone marrow donors experience some side effects, but they resolve quickly, and very few donors have long-term or lingering health issues. A small percentage (just under 1%), however, experience a serious complication due to anesthesia or damage to bone, nerve or muscle in their hip region.
The amount of marrow donated will not weaken your own body or immune system. The average amount of marrow and blood donated is about one quart, less if the patient is a baby or child. This is only a fraction of your total marrow. Most donors are back to their usual routine in a few days, and your marrow naturally replaces itself within 4 to 6 weeks.
Marrow donation is a surgical procedure that takes place in an operating room. The donation will be scheduled at a hospital that works with the NMDP. In some cases, the hospital may be near your home. In other cases, you may be asked to travel.
Donating PBSC
Peripheral blood stem cell (PBSC) donation is one of three ways to collect blood stem cells for transplantation. The other two ways are bone marrow donation and umbilical cord blood donation. A blood stem cell transplant can help cure or treat more than 75 diseases.
PBSC donation is a nonsurgical procedure that’s done in an outpatient clinic.
For 5 days leading up to donation, you’ll receive injections of filgrastim or an FDA-approved similar, which increases the number of blood-forming cells in your bloodstream. The first injection will be given at a donor center or medical clinic. You can receive injections on days two, three and four at your place of work, your home, at a donor center or at a medical clinic. On the fifth day, you’ll receive your final dose of filgrastim right before donating.
PBSC donation is done through a process called apheresis, which is similar to donating plasma or platelets. A needle will be placed in each of your arms, and blood will be removed from a vein in one arm and passed through tubing into a blood cell separator machine.
The machine collects blood stem cells, platelets and some white blood cells. Plasma and red blood cells are returned to your body through the other arm. All the tubing used in the machine is sterile and is used only once for your donation. Most donations take place on one day and last 4 to 8 hours. If you’re asked to donate over the course of 2 days, each collection will take 4 to 6 hours.
On donation day, your NMDP representative will help you feel at ease. They’ll aid you in getting as comfortable as possible—with pillows, snacks and entertainment. You’ll also have a team of medical professionals ready to provide you with a high standard of care to answer your questions and ensure your donation goes smoothly and safely.
You should dress in layers of loose-fitting clothing like sweatpants and t-shirts.
You’ll be seated in a reclining chair. We’ll offer you pillows and blankets to keep you comfortable. You should expect to have minimal mobility of both arms during the donation process.
We encourage you to eat breakfast before you arrive on donation day, unless otherwise informed. If requested, we can provide lunch for you and your companion. Your meals are reimbursable, so be sure to save your receipts. Snacks and refreshments will be provided throughout your donation.
Yes, your companion can stay with you on collection day. NMDP collection centers may change their policies based on current public health guidelines and regulations. Your NMDP representative will inform you of the latest guidelines.
Donors may experience symptoms such as but not limited to, 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. Less than 1% (0.6%) of donors experience serious side effects from filgrastim.
The PBSC donation procedure can also have side effects. 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.
No medical procedure is without risk, but fewer than 1% of PBSC donors experience a serious side effect from the donation process.
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.
After your donation, a volunteer courier will deliver your blood stem cells to your recipient. Your healthy stem cells will replace their entire blood and immune system—it’s pretty incredible!
Learning about the patient
Updates about and contact with your recipient is dependent on whether their transplant center is in the U.S. or international.
If it’s in the U.S., your donor center should be able to give you a brief update about your recipient's condition at four intervals: 9, 12, 18 and 30 months after transplant. During the first year after transplant, you'll also be able to communicate anonymously with your recipient. After that, if both parties are willing, you can have direct contact with your recipient—which could include meeting them in person.
If the patient’s transplant center is outside the U.S., you’ll need to follow their regulations for contact between donors and recipients. Some countries prohibit updates or contact at any time, while others allow it after a specified waiting period. Your donor representative should be able to provide more guidance.
While transplantation is a life-saving therapy, not all recipients survive. Sometimes a patient's body can’t withstand the pretransplant chemotherapy and radiation. Sometimes health complications occur after the transplant. But for many recipients, a transplant is successful and their best or only option. Your gift gives them hope and a second chance at life.
Other ways to help patients
Your impact isn’t limited to whether you donate. If you’re unable to join the registry or become a donor, there are many other opportunities to offer support and care for patients with blood cancers or disorders. You’re a valuable part of our mission to save lives through cell therapy, no matter how you contribute.
Ready to join?
Be a part of our donor registry and give hope to those in need.