Bone Marrow Donation..Insight Please!

BeenThereDoneThat74, MSN, RN · Mar 22, 2006

Hi

Hope I can help you. I worked in peds, but the concepts are the same (diseases are usually different).

Would you be able to tell me who is eligible to donate

The donor needs to be HLA matched. There are at least 6 factors that are matched in someones blood to identify a donor. You can be an imperfect match (meaning 4/6 or 5/6 factors match), but the best, of course is a perfect match. Siblings are the best suitable donors. There is a 1 in 4 chance of a sibling matching. I'm not sure about the recipients kids (I work with kids, so they don't have offspring) as far as their chances of matching. A spouse is just as good (or bad) as your average joe off the street. BTW, you don't have to be ABO compatible, the recipient will convert blood types if it's an ABO mismatch.

what health factors would keep you from donating

Usually any cancers, HIV, blood disorders.

what is the success rate for the recepiant once they get the marrow,

Depends on the degree of match, the disease, how advanced the disease is.

what are the risks for both the donor and
recepiant?

For the donor, not really a big deal. They harvest the bone marrow either peripherally or via an IO needle in the pelvis (more preferred). And yes, they do anesthetize the donor. The donor will feel pain post-procedure, and somewhat anemic (they lost a bunch of blood), but recover in 1-2 days normally. Often for kids who donate, they'll admit them overnight prophylactically. For the recipient, it is major, to say the least. Either chemo and/or radiation beforehand (to wipe out the immune system), the transplant itself is an infusion (like a blood trans). Afterwards, the biggest complications are infection, bleeding, anemia, nutritional issues, graft vs. host disease (sort of like rejection, but not exactly)

This is a scary time right now so I am trying to have a clear view as to what is going to happen.

I can't imagine what you and your family are going through. Any other questions I can try to answer, let me know.

caroladybelle, BSN, RN · Mar 22, 2006

Agree with above.

In addition, sometimes the donor may have to receive some meds/injections to mobilize certain factors.

Also, the best likely matches will be from close blood relatives. Matched unrelated donors (MUD transplants) are harder to come by.

In addition, depending on the disorder that they are treating, and its specific aspects ( for AML, is it M1 - M7, etc - what specific chromesomal makeup), sometimes the MD will actually prefer a slightly more distant match, to use that difference and the Graft Vs. Host disease to actually destroy the recipients' cancer.

I will hold your MIL in my prayers and thoughts.

Newbie Nurse SMP · Mar 23, 2006

Hi All,

Thank you, thank you, thank you for your insight on this matter. We are having such an issue getting set up for the blood test! It is very aggrevating! I thought it was a matter for having your doctor write a script for the blood test but I was sadly mistaken.

But really I appreciate your help with this you cleared up many of my questions!

Hugs to everyone...:icon_hug: :icon_hug:

MIA-RN1, RN · Mar 23, 2006

when my husband was first diagnosed w/ leukemia, the doctor tested his siblings and it was covered under our insurance. They tested only until they found a match, which was his brother.

My BIL's medical history, lifestyle etc were all taken into account, so all kinds of other testing was included. The collection etc was also all covered, and we persuaded our insurance to give us approval to aphorese him early and 'bank' it. (It was a struggle to get insurance do this) He had to take meds....I think some type of growth hormone?..to amp up his bone marrow production. His worst side effect was bone pain. That can be treated w/ pain meds but because of his past history, he opted to avoid narcotics. Anyway, it took a few hours on an aphoresis machine and then he was fine.

Husband hasn't had the transplant and with our fingers crossed may never need it, so I can't give you any info on that.

We did learn that parents aren't matches, since the child gets 1/2 of everything from one parent and 1/2 from the other, there is no way for a parent to be a compatible match. Many matches come from siblings who share the same parents as the patient. Many others are from the nat'l bone marrow donor registry. (which is only a quick fingerstick to join into)