Bone marrow donation

This is an information about the process of being a bone marrow donor.

Bone marrow donation

This booklet is about the implications of donating bone marrow, and about what it means to be a donor. The booklet is a supplement to the interview you will have later with the physician. We hope that it will answer some of your questions.

Why perform a bone marrow transplant?

Bone marrow transplant is a treatment for very different diseases, such as blood cancer (leukaemia), bone marrow failure (aplastic anaemia) as well as various congenital diseases. Common for these diseases is that they affect the function of bone marrow. Transplanting bone marrow from a healthy donor replaces the sick bone marrow of the patient and restores the function of
the bone marrow.

Bone marrow is a thick fluid mixed with blood and is found in the cavities of the large bones. The fluid bone marrow is sucked out of the iliac crest in the hip of the donor and is given to the patient through a blood vessel, just like a regular blood transfusion. You will be under general anaesthesia when the physician draws your bone marrow. We call this a bone marrow harvest.

Examination of donor before bone marrow donation

We want to make sure that you are healthy before you donate bone marrow.

Therefore, we will invite you to a preliminary examination at Rigshospitalet. The preliminary examination takes one day and includes an interview and a general medical examination, in which your heart, lungs etc. are checked. If you are over the age of 18 you will also undergo an X-ray examination of your lungs, and at all events you will talk to an anaesthesiologist because you will be under general anaesthesia when your bone marrow is harvested.

Moreover, we will take blood samples. This is to ensure that your blood count is normal and to get information about the types of infections you have had. For example, Danish legislation requires us to test for HIV. It may also be necessary to carry out additional examinations in connection with the preliminary examination. The staff will inform you about this if this is relevant for you.

Bone marrow donation

When donating bone marrow, you will be admitted to the hospital on the day before the actual bone marrow harvest. Information about time and place will be stated in the first letter you receive from the hospital. We usually reckon
that you can be discharged from the hospital on the day after the donation. The total admission time will be two days. You do not have to take any special precautions when donating bone marrow, however you should avoid exposure to unnecessary risks, for example to infections.

You should not eat, drink or smoke from midnight before the day of admission. On the morning of the actual day of transplant, you will be taken to the operating theatre. Here you will undergo general anaesthesia, so you will not feel
anything during the procedure. The bone marrow is sucked out of the iliac crest in your hip using special needles. The iliac crest is located just beneath the skin and is a thin shell around the cavity where the bone marrow is located.

The harvesting of bone marrow
The harvesting of bone marrow

The needle will be inserted several times in both iliac crests, and a total of about 1500ml of fluid (bone marrow and blood) will be extracted. However, the amount depends on the size of you and the patient. The procedure itself only takes about one hour.

The bone marrow extracted only constitutes a small part of the total bloodforming bone marrow in your body. Since all healthy people have a considerable excess of bone marrow, you will not be short of bone marrow after the donation. The bone marrow harvested is restored within a few weeks. You will be given fluid intravenously to replace the bone marrow. In rare cases, a blood transfusion may be necessary. As quite a lot of blood is sucked out with the bone marrow, there will be an decrease in the amount of red blood
cells (a fall in the haemoglobin count) after the donation. You will be offered iron pills in order to increase production of red blood cells.

Discomfort and risks

You may feel nauseous in the first hours after the anaesthesia. In the first couple of days after the procedure, you will be sore where the bone marrow was removed. The soreness will go away quickly, and most donors feel fine 2-3 days after the bone marrow harvest. It may take a little longer for some donors.

We recommend that you take four days of sick leave after the bone marrow harvest. In some cases, there may be a superficial skin infection in the area where you were injected. This could be swelling, soreness, redness
and perhaps fever.

In such cases, antibiotics in tablet form may be considered, and you should contact the department to which you were admitted or your own GP.

Every anaesthetic procedure is associated with risks. However, these risks are extremely small for healthy people. The risk of serious complications in connection with anaesthesia is estimated to be 1 in 50,000. As a donor, you will be covered by the hospital’s patient insurance policy.

Follow-up examination

About one month after the bone marrow harvest, we will check that your blood values are normal by taking a blood sample. We can take the blood sample at the department, or your own GP can take the sample, if this is more convenient. We will also ask you to complete the questionnaire you have received and return it to us. This will give us feedback on how you have experienced the process.

Accommodation

If you live close to Rigshospitalet, you can spend the night at home. If not, we can arrange for you to stay at the Patient Hotel.

Loss of earnings

You will be compensated for loss of earnings and expenses in connection with transport and similar for the preliminary interview, preliminary examination and stem cell harvest.

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