The main misconceptions about bone marrow donation. Bone marrow donation: collection procedure, types and possible consequences How to donate bone marrow
(not to be confused with the spinal cord, which is part of the central nervous system [CNS]) is a soft, sponge-like tissue located inside the bones. Bone marrow contains hematopoietic or blood-forming stem cells, and small numbers of these cells are found in the umbilical cord and blood.
Stem cells, hematopoietic cells or bone marrow cells are the same thing, the only difference is in the collection methods. The same stem cells are taken from different sources: directly from the bone marrow (in the bones) or from the peripheral blood (through a vein).
Human blood cells - and any other warm-blooded organism - are constantly renewed. They are synthesized by the bone marrow - a reproductive system of complex structure located in the ribs and pelvic bones - one of the main organs of the hematopoietic apparatus and immunopoiesis (maturation of cells of the immune system). Once it loses its functions, the immune status drops sharply - this is fraught with death.
Without bone marrow, the process of formation and active activity of blood cells is impossible. If the bone marrow is damaged, it is unable to cope with its functions. Bone marrow pathology causes loss of control over accumulation throughout circulatory system still immature cells. Their excess suppresses the basic functions of mature cells.
stem cells or bone marrow is a complex and unique treatment method that prolongs people's lives, but this method can have serious consequences and complications, in principle, just like the absence of this when it is required.
This operation saved the lives of many patients; it is often performed in the treatment of both hematological diseases and oncological diseases, diseases of the blood and bone marrow, as well as some other malignant diseases (lymphoma, leukemia, etc.). Sometimes THC (hematopoietic stem cell transplantation) is performed experimentally for non-malignant and non-hematological diseases (for example, severe autoimmune or cardiovascular disease), the risk of fatal complications remains too high to expand the range of indications for the use of THC.
The main risks associated with stem cell or bone marrow transplantation occur during the healing of the bone marrow, such as rejection, or infection may endanger the patient's life.
A significant contribution to the development of stem cell transplantology was made by the team at the Fred Hutchinson Cancer Research Center in the 1950s–1970s, led by Edward Donnall Thomas. Thomas's research has shown that bone marrow cells given intravenously can repopulate the bone marrow and produce new blood cells. His work also reduced the likelihood of developing life-threatening graft-versus-host complications. In 1990, Edward Donnell Thomas, together with Joseph Edward Murray, who was involved in transplantation , received the Nobel Prize in Physiology or Medicine for their discoveries concerning “organ and cell transplantation in the treatment of human diseases.”
Depending on the source of bone marrow cells, a distinction is made between autologous transplantation (pre-prepared cells obtained from the patient himself) and allogeneic transplantation (from donors, including relatives). Syngeneic transplantation - a graft is transferred from one monozygotic twin to another. The procedure for obtaining bone marrow is called bone marrow harvesting, and is the same for all three types of transplants (autologous, allogeneic and syngeneic).
Selecting a bone marrow donor for a specific patient is a complex procedure, which is carried out on the principle of tissue compatibility between the donor and the recipient (recipient). The matching of blood groups according to the A0 system is not mandatory. If you are compatible, you will immediately be informed about the methods for collecting bone marrow or peripheral hematopoietic stem cells and the methods preferred for the patient.
Maximum compatibility among parents is 50%. The best chance of finding a donor is usually among the patient’s siblings: the probability of full compatibility with a brother or sister is 25%. If there are no siblings who are suitable for donation, then it is necessary to look for unrelated bone marrow donors. There may be exceptions with relatives, when none of them may be suitable for donation.
When performing an allogeneic transplant, an exchange occurs between the immune systems of the donor and the patient, which is an advantage. But when performing such a transplant, there is a risk of a mismatch of immune systems. The donor's immune system can have a negative impact on the recipient's body. There is a risk of damage to the liver, skin, bone marrow and .
This process is called graft-versus-host reaction. If such a reaction occurs, patients require treatment, since the lesions can cause problems or organ failure. When performing autologous transplantation, these risks are absent.
The largest registry, NMDP, with more than 6.5 million, is located in the United States. Germany provides the most donors among European countries (more than 5 million people are in the ZKRD register). In total, there are more than 25 million potential donors on the International Bone Marrow Donor Search.
In Russia, the number of donor registries is still small, and the donor base in them is extremely small; for this reason, almost all unrelated bone marrow transplantations in Russia are carried out from foreign donors. Although for representatives of some peoples of Russia, the likelihood of finding fully compatible donors in foreign registries is low due to genetic differences between nations. Unfortunately, the combined database of the Russian registry is not yet included in the international search system for hematopoietic stem cell donors, but it is precisely the cooperation of registries from different countries allows doctors to promptly find donors for those patients who were unable to find a genetically compatible pair in the national registry. But time to find a donor is a very limited resource. A lot depends on the diagnosis, condition at the time of transplantation and many other factors, but in any case, this is the last hope for patients awaiting transplantation, and the longer the recipient waits for his donor, the less chance of a cure remains.
Moreover, in Russia, in principle, there is no legislative framework for unrelated bone marrow donation. For example, according to international standards, the donor and recipient must remain anonymous for at least two years.
Bone marrow donation is not prohibited in Russia, but the law on donation says nothing about it. Secondly, in Russia there are no rules that would oblige registries to reimburse the costs of searching for donors - in Europe this system has long been worked out. There are cases when, after helping, a donor may be required to pay income tax. And, by the way, in essence the law that the donor and recipient should not know each other is not spelled out in Russian legislation.
Approximately 27% of the total number registered in the database are most often in demand. At the same time, 70% of patients who need a transplant do not undergo it due to the inability to find a compatible donor.
*More recently, domestic Insurance companies insure hematopoietic stem cell donors in case of complications.
Bone marrow donation and transplant procedure
When performing a transplant from the patient's own body, thorough treatment is undoubtedly required. For this reason, treatment will first be carried out in accordance with the plan approved by the doctors.
At the next stage, stem cells will be collected, followed by freezing and treatment with special medications. The dose of medication in such patients is higher. Typically, for a week after the collection of healthy stem cells, the patient receives high-dose drug therapy. Upon completion of treatment, the patient receives back healthy latent stem cells. Thanks to this approach, stem cells, cells that were damaged during treatment, begin to recover on their own.
Injecting frozen stem cells into a patient may result in the disease returning due to the introduction of diseased cells.
Under general or local (expressed in numbness of the lower body) anesthesia, a needle is inserted into the pelvic bone to collect bone marrow. The volume of bone marrow obtained depends on the patient’s body weight and the concentration of stem cells in the collected fluid. Basically, 1000-2000 ml of a mixture containing blood and brain is required.
The resulting bone marrow is processed to remove any remaining bone and blood. Sometimes added to bone marrow , after which it is frozen until the stem cells are needed. This method is called cryopreservation. Thanks to this method, stem cells can be stored for many years.
- The donor requires hospitalization for 1 day. The operation is performed under general anesthesia. Several punctures are made. The pelvic bones are pierced with special needles, and while the donor is under anesthesia, 4-5% of the total amount of hematopoietic stem cells is pumped out - they are in a liquid state. The procedure takes about 2 hours. Possible discomfort and pain may be felt after anesthesia. 2-3 days after you need to wear an adhesive plaster at the puncture site and see a doctor;
- Hospitalization is required for approximately a week. Over the course of 5 days, the donor is injected with a special drug that stimulates the active entry of bone marrow cells into the bloodstream. Then the donor is connected to the device for 5-6 hours. The blood is forced through the system and the bone marrow cells are separated.
For several days after the procedure, the donor may experience swelling and induration at the sites where the material was collected. During this period, the donor may feel nausea, fatigue, and cramps in the hands. Over the course of several weeks, the donor's body will restore the lost bone marrow; however, the recovery period is individual for each person.
The person may feel weak , quite noticeable pain in the pelvic bones and aches in the . Pain after the procedure is usually relieved with conventional anesthetics; immunocorrectors that restore the functions of the immune system will help speed up the rehabilitation process. You should only take them if your doctor has prescribed them for you. In some cases it is recommended therapy with complexes containing a group of B vitamins. Sometimes doctors may prohibit taking painkillers for a short time so as not to change the function of the brain matter.
In the case when hematopoietic stem cells are isolated from the blood: no anesthesia, only a donor chair and several hours without much movement. Externally, this procedure is similar to a procedure, for example, plateletpheresis - it is familiar to many blood donors. This method of sampling requires a little preparation. The release of hematopoietic cells into the peripheral blood is stimulated with a special drug. During these 4-5 days you can feel symptoms: body aches, headache. Such pain can be relieved with conventional analgesics.
IMPORTANT! Only organically healthy people aged 18 to 55 years, weighing more than 50 kg, can become donors of hematopoietic stem cells. In this case, there should be no hereditary or organic diseases, only then will the future donor be entered into the database.
The following diseases and conditions are direct contraindications to bone marrow donation:
- history of AIDS and -infection;
- tuberculosis;
- ;
- ;
- autoimmune diseases;
- oncological processes;
- ;
- poor tolerance to anesthesia;
- ;
- organic disorders of the central nervous system;
- ;
- lactation.
Temporary contraindications have different durations depending on the cause. The most common prohibitions are:
- deletion (10 days),
- tattooing, and even acupuncture treatment (1 year),
- , flu, (1 month from the moment of recovery),
- (5 days),
- abortion (6 months),
- period of pregnancy and lactation (1 year after birth, 3 months after the end of lactation).
What are the possible side effects of bone marrow transplantation?
The removal of such a substance is, however, considered an operation, and any surgical intervention that is performed in a hospital setting may be accompanied by complications.
The most common and dangerous complication of bone marrow transplantation is graft-versus-host disease (GVHD).
The main risk of treatment is increased cataract (clouding of the eye crystal), secondary cancer and damage to the liver, kidneys, lungs and/or heart. The risk of possible complications and their severity depend on many factors and should be discussed with your doctor in advance. The patient must be under constant medical supervision and in sterile conditions, contacts should be limited, and the patient may need psychological therapy. Treatment and rehabilitation can take quite a long time, but the attitude must remain positive, and the help of loved ones is extremely important. It can take up to a year for the new bone marrow to start functioning like its own. Patients should remain in contact with the hospital during this time to ensure any infections or complications that may develop are detected early. The prospect of returning to a full, healthy life after a transplant is worth all the effort.
Awareness of donor-recipient responsibility
The procedure is quite painful for both the donor and the recipient. Therefore, there is always the possibility that the donor will want to refuse the procedure.
It may also happen that a person donated blood, he is included in the national register, but then, due to some circumstances, he decided to refuse the procedure.
Remember that you can always say “no” at any stage - while a repeat compatibility study is underway, during the collection of your own material, even before the operation itself. This procedure is completely voluntary, free of charge and anonymous, no one should force you to undergo it. Therefore, when giving consent to a transplant, it is important to be aware in advance of all the consequences, both for yourself and for the person receiving help.
If you refuse to give your material at a stage when the patient has already undergone all the preparatory procedures, then you are actually endangering the life of the recipient. Since he has already undergone chemotherapy and radiation, the person’s own hematopoietic and immune systems have already been destroyed. He may not have another chance.
Bone marrow donation is a fairly popular procedure in modern medicine, used by people who need a specific organ transplant. There are a lot of such people: from the smallest to the elderly. For example, if leukemia or another similar disease develops, a bone marrow transplant is required, and a donor must be found for this procedure. Who can become one and, most importantly, are there any consequences of taking the bone marrow?
Who can apply to be a donor
What is a "bone marrow donor"
This concept refers to a person who, through inpatient collection, donates a small part of his bone substance for subsequent administration to another person. A similar semi-liquid substance is localized in the bones of the body and ensures the production of blood cells. This is necessary for transplantation from a healthy to a sick person in the event of the development of leukemia, tumors, aplastic anemia, or genetic diseases.
How to become a bone marrow donor
Special registers of applicants for donation are being created, which every healthy person can enter by signing a special agreement. The age of a potential donor is limited: from 18-50 years.
After a person has been added to the register, it will be necessary to wait until he is bone matter will be needed for transplantation.
It is possible to determine whether a substance is suitable for a particular person in case of another disease by comparing combinations of genes after taking biomaterial from a potential donor and the patient. After confirming compatibility, a person must finally decide whether he is ready to be a donor.
In some cases, the donor may refuse to undergo such surgery, even if he is suitable for such a procedure in all respects. This may be due to some significant reasons, for example - bad general state health at the time of the need for collection, lack of time on the day of the operation, fear of possible complications or pain that may arise.
Bone marrow donation is a voluntary procedure. That is why a person who has agreed to hold it in the future can refuse it at any time. But the donor must understand that by refusing he is putting his life at risk.
How much do they pay for bone marrow donation?
This procedure is considered free and anonymous in each country.
Under what circumstances is a person not suitable for donation?
Contraindications for bone marrow donation can be either absolute or relative. The following can be called absolute:
Temporary contraindications with a period of prohibition on taking the substance after recovery include the following:
- blood transfusion – 6 months;
- surgical interventions, including artificial interruption pregnancy – from six months;
- tattoo – procedure, acupuncture treatment – year;
- development of malaria – three years;
- development of acute respiratory infection – a month;
- inflammatory process in the body of an acute or chronic course - a month;
- development of VSD (vegetative-vascular dystonia) – month;
- some vaccinations - from ten days (vaccination against hepatitis B, tetanus, diphtheria, cholera) to a month (vaccination against plague, tetanus, rabies);
- pregnancy period – a year after birth;
- menstruation - five days after the end.
Bone sampling: procedure progress
How is bone marrow collected from a donor?
This procedure is performed in the operating room using general anesthesia. The latter is recommended to minimize the occurrence of discomfort during surgery.
Where do they get bone marrow for transplantation?
During anesthesia, the doctor inserts a needle into the thigh bone or pelvic iliac bone. It is in these bones that bone matter is concentrated in large quantities. No skin incisions are required during sampling.
How much bone marrow will need to be taken in a given case?
It depends on the height and weight of the donor, as well as on the concentration of his cells in the taken mass. In most cases, the required volume of liquid is 900-2000 ml.
Is it painful to take bone marrow?
After the end of general anesthesia, the donor begins to experience discomfort in the places where the doctor made punctures to collect fluid. The nature of the pain syndrome is similar to the discomfort after a strong fall on the hip area. This pain can be eliminated with the help of painkillers. After the necessary fluid is collected, the donor (namely, the next day) is discharged from the hospital.
Is it dangerous to be a bone marrow donor?
It is impossible to answer unequivocally. The removal of such a substance is, however, considered an operation, and any surgical intervention that is performed in a hospital setting may be accompanied by complications.
The percentage of the possibility of negative consequences occurring can be determined taking into account the condition general health donor and whether there are any associated complicating factors.
Based on the above, we can identify some complications that may arise after the procedure for collecting the corresponding substance from the bones:
- bleeding;
- infection.
There are also some complicating factors that, when exposed, can cause negative consequences after the operation:
- disruption of the functioning of the heart and blood vessels;
- penetration of infections into the area where the sampling was carried out;
- penetration of infections into the blood;
- if there was radiation treatment in the area where the sampling was carried out;
- if severe stage osteoporosis occurs in the body.
To prevent possible bleeding after bone marrow collection, those donors who simultaneously take medicines with a blood-thinning effect, it is recommended to stop using them for a period determined by your doctor. A small amount of blood may flow from the site of needle insertion and sampling for some time. This is normal.
The day after surgery, the donor can lead his usual lifestyle, but it is still recommended to monitor his general health.
If the following warning symptoms begin to occur, you should immediately visit your doctor and notify him about them:
- general malaise, fever and chills are symptoms of infection of the body;
- swelling, pain syndrome with increasing character at the puncture site;
- the skin at the puncture site turned red, and fluid began to secrete in the same place;
- nausea and vomiting occurred;
- a rash appeared all over the body;
- joint pain syndrome;
- feeling of lack of air, cough and pain in the heart area.
In most cases, the percentage of possible negative consequences is quite low, because during the surgical intervention and puncture, large vessels and important internal organs are not affected. After just a few days, the discomfort in the area of the fence disappears.
The bone marrow recovers approximately two weeks after surgery. For the donor, this period will not bring much discomfort, but for the person who will be injected with the donor substance, this is salvation.
Red bone marrow in the body of any of us is involved in the process of blood renewal. If for some reason its work was disrupted, this will lead to complex and serious diseases, the number of which is steadily growing. Thus, a person has an urgent need for a bone marrow transplant, which in turn creates a huge demand for donors. This process is quite difficult as it is necessary to find the right person. It is worth noting that a healthy person can make money from this. It is worth knowing only that And in this publication we will talk about this topic in details.
Types of bone marrow transplant
Previously, this procedure was not practiced, but currently bone marrow transplantation is used to improve survival in cases of leukemia, treatment, aplastic anemia, lymphoma, myeloma, ovarian, and breast cancer. The main task of any donor is to donate his hematopoietic stem cells, which later become precursors in the event of the emergence of all other blood components. For transplantation of the latter, there are two main types of procedures - autologous and allogeneic transplantation.
Allogeneic transplantation.
This type involves taking bone marrow from a donor who will best suit the genetic patient. Basically, this person becomes a close relative of the patient. This method of transplantation from a donor comes in two types:
Syngeneni. This procedure is performed on an identical twin. Autologous bone marrow transplantation from this donor is absolutely compatible, which in turn completely eliminates the occurrence of an immune conflict.
In the second option, the donor is a healthy relative. And the effectiveness of this procedure will depend entirely on the compatibility of bone marrow tissue in percentage terms. The most ideal is 100% match. But if the compatibility turns out to be very low, then the transplant may be rejected by the body, which will be perceived by the latter as a tumor cell. In addition, there is haploidentical transplantation. In this case the match will be 50%. This procedure is carried out from a person who has no family connection. These conditions are not the most successful, since they have a fairly high risk of various complications.
Autologous.
This procedure consists of freezing previously collected healthy human stem cells and then injecting them into the patient after chemotherapy. If the procedure is carried out successfully, the person’s immune system will begin to quickly recover and the process of hematopoiesis will return to normal. This type of transplantation contains indications in case of remission of the disease, or if the disease has not affected the human bone marrow:
1. For breast or ovarian cancer.
2. For a brain tumor.
3. For non-Hodgkin's lymphoma.
4. With lymphogranulomata.
How to become a donor
Well, the time has come to find out how to become a bone marrow donor for money in Moscow. These tips can also be useful to other city residents. To be included in the bone marrow donor register, a person must be at least 18 and no more than 50 years old. Other requirements for the donor: absence of malaria, hepatitis B and C, tuberculosis, cancer, HIV, diabetes.
In order for a person to be included in the database, he needs to donate nine milliliters of his blood for typing and provide personal information about himself, as well as draw up an agreement to be included in the register. In the event that a person’s HLA type is completely compatible with any patient, he will need to undergo additional studies. First he will need to give his consent. This is required by law. Many people are interested in what it costs to pay donors. In most countries, this type of activity is free, anonymous and gratuitous. Based on this, you cannot sell your own stem cells. They can only be donated.
Who can be a donor
A potential donor is selected according to one of 4 options. They are all different from each other, but pursue a common goal - the maximum degree of compatibility.
The following are suitable for bone marrow transplantation:
- I am sick myself. His disease should be in remission or not affect the bone marrow. The stem cells are processed and frozen.
- Identical twin. Basically, relatives belonging to this type have 100% compatibility.
- Family member. The patient's relatives have a high degree of compatibility. The patient's sister and brothers can also become donors.
A person who is not a relative of the patient. There is a bone marrow donor bank in Russia. - Among the large number of donors registered in this bank, there may be those who are completely compatible with the patient. These registers are also available in the USA, Germany, Israel, etc.
How is bone marrow harvested?
Bone marrow is collected in the operating room. The patient is under general anesthesia at this moment in order to minimize the likelihood of reducing the patient’s discomfort and injury. A special needle with a limiter is inserted into the iliac or femoral pelvic bone, where the largest amount of the required material is contained. Basically, in order to obtain the required amount of fluid, repeated punctures are made. There is no need to cut or sew the fabric. The entire procedure is performed using a syringe and needle. The required amount of donor bone marrow will depend on the concentration of stem cells in the resulting substance and the size of the patient. Basically, a set of 950-2000 ml of bone marrow and blood is produced. You may get the impression that this is a very large volume, but it is worth noting that it will amount to only 2% of the volume. total number substances in the human body. Full recovery of such a loss can occur after four weeks.
Currently, donors are offered an apheresis procedure. First, the person is given the necessary drugs to stimulate the release of bone marrow into the blood. Then a procedure similar to donating plasma is performed. Blood is drawn from one arm of the donor, and using special equipment, the stem cells are isolated from the other components. The liquid purified in this way, from the bone marrow, returns to the donor’s body through a vein on his other arm.
How is the transplant performed?
Before undergoing a bone marrow transfer procedure, the patient must undergo an intensive course of chemotherapy, i.e. radical radiation, which is necessary to be able to destroy the diseased bone marrow. Next, the procedure for transplanting pluripotent SCs is performed using an intravenous drip. The process will take about one hour. Donor cells, entering the patient’s bloodstream, begin to take root. In order to speed up the procedure, doctors use means that can stimulate the functioning of the hematopoietic organ.
Consequences for the donor
Any person who wants to become a bone marrow donor definitely wants to know about the consequences of the operation. Medical workers claim that the risks of this procedure are minimized. They are mainly associated with the characteristics of the human body’s reaction to anesthesia, or to the insertion of a surgical needle. Sometimes, infection occurred at the puncture sites. After this procedure, the donor may experience the following for some time: side effects:
1. bone pain.
2. discomfort at the puncture site.
3. muscle pain.
4. nausea.
5. headache.
6. increased fatigue.
Contraindications
Before becoming a bone marrow donor and undergoing the necessary medical examination, you must first carefully study the list of contraindications. They, as a rule, may overlap with points related to the prohibition of blood donation, for example:
1. tuberculosis.
2. donor's age is more than 55 or less than 18 years.
3. hepatitis C and B.
4. mental disorders.
5. malaria.
6. autoimmune diseases;
7. cancer.
8. presence of HIV.
In the human body, red bone marrow performs the function of renewing blood. Disturbances in its functioning lead to serious diseases, the number of which is constantly growing. Thus, the need for a transplant of this element of the body system arises, which creates a demand for donors. The difficulty of the situation becomes finding the right person.
This procedure has not previously been performed, but bone marrow is now being transplanted to treat or improve survival for leukemia (blood cancer), lymphoma, aplastic anemia, multiple myeloma, breast cancer, and ovarian cancer. The main task of the donor is to donate hematopoietic stem cells, which become precursors in the formation of all other components of the blood. There are two main types of procedures for their transplantation - allogeneic and autologous transplantation.
Allogeneic transplantation
This type involves taking bone marrow from a person who best matches the patient’s genetics. As a rule, this becomes a relative. This donor transplant option can be of two types:
Autologous
This procedure involves freezing previously collected healthy stem cells and injecting them into the patient after high-intensity chemotherapy. If the procedure is successful, the person quickly restores the body’s immune system, and the process of hematopoiesis is normalized. This type of transplantation is indicated in case of remission of the disease or when the disease does not affect the bone marrow:
- with a brain tumor;
- ovarian and breast cancer;
- lymphogranulomatosis;
- non-Hodgkin's lymphoma.
How to become a donor
In order to be included in the bone marrow donor registry, a person must be 18-50 years old. Other requirements: no hepatitis C and B, malaria, tuberculosis, HIV, cancer, diabetes. To be included in the database, you must donate 9 ml of blood for typing, provide your data and sign an agreement to be included in the register. If your HLA type is compatible with any of the patients, additional testing will be required. You will initially have to give your consent, which will be required by law.
Some people are interested in how much donors are paid. In all countries, such activities are “anonymous, free and gratuitous”, so stem cells cannot be sold, they can only be donated. Sometimes you can find information calling for finding a donor to help a child with the promise of a reward. In this case, it is possible to sell the material on an individual basis; government agencies do not approve or support such transactions.
Who can be a donor
A potential donor is selected according to one of 4 options. They differ from each other, but pursue one goal - the maximum degree of compatibility. Suitable for transplantation:
How is bone marrow collected?
Bone marrow collection is performed in the operating room under general anesthesia to minimize the likelihood of injury and reduce discomfort. A special needle with limiters is inserted into the femur or iliac pelvic bone, where the maximum amount of material required. As a rule, repeated punctures are performed to obtain the required amount of fluid. There is no need to cut the fabric or sew it up. All manipulations are carried out using a needle and syringe.
The required amount of donor bone marrow depends on the size of the patient and the concentration of stem cells in the taken substance. Typically, 950-2000 ml of a mixture of blood and bone marrow is collected. This appears to be a large volume, but it represents only 2% of the total amount of the substance in the human body. Full recovery this loss will occur in 4 weeks.
Now they also offer donors to use the apheresis procedure. To begin with, a person is given special drugs that stimulate the release of bone marrow into the blood. Next, a procedure similar to donating plasma occurs. Blood is taken from one arm, and special equipment isolates the stem cells from the other components. The cleared fluid from the bone marrow is returned to the person's body through a vein in the other arm.
How does the transplant take place?
Before the transfer procedure, the patient undergoes an intensive course of chemotherapy, radical radiation necessary to destroy the diseased bone marrow. After this, pluripotent SCs are transplanted using an intravenous drip. The procedure usually takes one hour. Once in the bloodstream, donor cells begin to take root. To speed up the process, doctors use drugs that stimulate the functioning of the hematopoietic organ.
Consequences for the donor
Every person, before becoming a bone marrow donor, wants to know about the consequences of the operation. Doctors note that the risks during the procedure are minimal and are often associated with the individual characteristics of the body’s reaction to anesthesia or the insertion of a surgical needle. In rare cases, infection has been reported at the puncture site. After the procedure, the donor may experience side effects:
- painful sensation at the puncture site;
- bone pain;
- nausea;
- muscle pain;
- increased fatigue;
- headache.
Contraindications
Before becoming a voluntary bone marrow donor and undergoing examination, you should familiarize yourself with the list of contraindications. They largely overlap with the clauses prohibiting blood donation, for example:
- age more than 55 or less than 18 years;
- tuberculosis;
- mental disorders;
- hepatitis B, C;
- autoimmune diseases;
- malaria;
- presence of HIV;
- oncological diseases.
Video about bone marrow donation
Reviews
Elena, 33 years old
I really wanted to become a donor, but I am terribly afraid of bone punctures and pain. It turned out that you can donate the material along with blood. To do this, you need to take the medicine for a while, and the stem cells enter the bloodstream. Next, blood is taken along with it. The procedure takes longer, but there is no need to pierce the bones or general anesthesia.
Alena, 27 years old
Before becoming a bone marrow donor, I was very worried that it would be very painful. I often saw in TV shows how this procedure goes, how much it hurts people. Then it turned out that it was a bone marrow puncture, and its collection is less painful. When taking medications before the test, I felt tired, but after the procedure everything went away.
Kirill, 30 years old
When I was looking for how to become a voluntary bone marrow donor, I did not find information about whether it was possible to refuse once already in the database. As it turned out, it is possible. If for some reason you cannot undergo the procedure, you can refuse. I’ve been on the donor registry for 2 years now, and they haven’t called me yet.
The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.
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Today, the process of stem cell transplantation is the most effective method of treating oncological, hereditary, hematological, and autoimmune diseases in both adults and children. This article will be devoted to this issue.
Hematopoietic stem cells and their transplantation
Many people do not connect concepts such as stem cells and bone marrow transplantation, but they are closely interrelated. After all, this method of donation is a transplant. They reproduce quickly and produce healthy offspring. Hematopoietic cells are the precursors of blood cells, as well as human immunity. Stem cells transplanted into a patient restore the body's hematopoiesis and increase resistance to viruses. There is no other way to obtain these cells other than becoming a bone marrow donor. The source can be different tissues of the human body.
Where are these cells located?
Our stem cells are found in the hematopoietic substance found in the bones. Most of all it is observed in the pelvic, breast bones, and spine. For a long time, hematopoietic stem cells were formed only in the bone marrow. For this reason, most foreign registers have the same name. They are called bone marrow donors.
In the 90s, it was scientifically proven that thanks to the introduction of special drugs into the human body, it is possible to briefly remove stem cells from the place of their formation into the bloodstream, and extract them from it using special equipment.
What else should you pay attention to before becoming a bone marrow donor? In Samara, more than ten years ago, a bank was created on the basis of the Clinical Center for Cell Technologies. There they learned to receive in a different way.
Where to find a donor?
Unfortunately, in Russia such programs are in their infancy. There is no full-fledged register and state support. Measures to create this transplant base are gradually being introduced. Every year there are more and more donors. To increase the number of volunteers, it is important to inform the population, conduct training seminars and lectures.
When a family is in trouble and relatives want to help the patient, they are soon faced with the question of how to become a bone marrow donor. After all, it is precisely this that needs to be transplanted to a loved one. But they are not always able to help in this matter, since only about 30% of loved ones have full stem cell compatibility. The ideal option is a bone marrow transplant from a twin, but these are isolated cases.
If there is no compatibility among close people, then it is necessary to resort to the help of our country’s bone marrow donor database. But their number is negligible. Therefore, the next step to finding donors is to contact foreign registries. But it is important to understand that this is a very expensive procedure, the cost of which is several tens of thousands of euros.
Many countries are actively working to expand unrelated donor lists of hematopoietic stem cells. This is due to the spread of diseases that can only be cured in this way. Currently, there are about sixty bases that are united into a common worldwide one. The total number of possible donors is approximately 20,000,000 people. Thanks to such international registries, it is possible to find a suitable option for 60-80% of sick patients. We’ll find out how to become a bone marrow donor and a member of the global database below.
Creation of a register of donors of hematopoietic bone marrow cells in Russia
In the Russian Federation, work has already begun on creating stem cell registers. However, the total number of potential donors tested is small; there are about two thousand of them. It is clear that such a quantity does not allow for an effective selection of cells for all patients in need of help. Therefore, we definitely need to ask ourselves how to become a bone marrow donor. There is no such method of donation in Yekaterinburg. But such services exist in other cities. A small register of donors in Chelyabinsk was created on the basis of a station in the region. Potential patients are voluntarily and anonymously included in this data list, subject to their free participation in the absence of any health contraindications.
Requirements for a bone marrow donor
Any healthy person can become a potential donor. Suitable age is 18-55 years. He should not be sick with tuberculosis, AIDS, hepatitis B and C, malaria, cancer, or mental disorders. This is the first step to becoming a bone marrow donor. In Voronezh, a bone marrow donation campaign was recently held among city residents. The research results were anonymously entered into a list, the so-called registry.
A volunteer donates twenty milliliters of blood to any of the transfusion stations. The blood fluid from the vein will undergo tissue typing. This is done in St. Petersburg, after these procedures all donor data will be entered into the Russian registry.
Donation in Nizhny Novgorod
Every year in Russia more than one and a half thousand people need stem cell transplants, most of whom are children. This can help patients restore blood formation and the immune system. Due to the minimal number of hematopoietic cell donors in our country, the opportunity to help these children is minimal, especially since the genotype of each person is individual, and the probability of finding a suitable donor is 1:30,000. Therefore, Russian doctors use a foreign donor registry, but perhaps this problem will be resolved soon.
Various events are held throughout the country, during which people are explained how to become a bone marrow donor. IN Nizhny Novgorod This action was very successful among students of the Linguistic University and the Academy of Water Transport. After the meeting, the donor register Russian Federation increased by dozens of people who agreed to undergo this procedure.
How is bone marrow harvested?
For a bone marrow transplant, the donor is hospitalized for a day. This procedure must be performed under general anesthesia. Before becoming a bone marrow donor, you must undergo a medical examination to determine if you can tolerate anesthesia.
Bone marrow is taken from special wide needles. The operation may take several hours. During the intervention, only a few percent of the bone marrow is collected. The donor is allowed to leave the clinic the same day. Within a few days, some pain will be felt in the bones, which can be easily relieved. Complete recovery of the bone marrow will occur within a two-week period.
Taking stem cells from blood
The procedure in question is practically painless. This is important for those interested in becoming a bone marrow donor. In Moscow, there are many people who want to join the ranks of volunteers for money. But this procedure is free of charge.
Within five days before collection, the patient is injected subcutaneously with a medication that releases the cells into the bloodstream. Then it is connected to a special machine, with the help of which blood is taken. The material is subsequently broken down into its components. The latter are delivered to the laboratory, where they are processed in a special way. The beneficial cells are collected in a bag, and the rest of the blood is returned to the donor. This procedure lasts several hours.
Refusal of the procedure
Entering data into the register does not oblige you to anything, since becoming a bone marrow donor in Russia or in another country is just a desire and consent to donate hematopoietic cells and save a life. The likelihood of a particular donor being compatible with a patient is catastrophically low. But the more Russian donors are represented in the bone marrow registry, the higher the likelihood of a cure for our patients. After all, residents of the Russian Federation are genetically significantly different, for example, from Europeans and Americans.
Whether or not you choose to donate your bone marrow is a personal matter, but it is important to understand that no one is immune from disease, and an indifferent attitude towards the problem of donation can become a tragedy for all humanity in the future.
