I’ve done it, twice, actually. Sort of. I’ll explain..
Once you join the registry, they (the National Marrow Donor Program- NMDP) do some basic typing to find preliminary matches. If you are a match, they will contact you for additional bloodwork. This has happened to me twice since 2007. The first time, nothing came of it, but the second time wound up being the whole shebang. If you are a potential match, they call you to get your permission to proceed, at which point they fedex you a box of bloodwork tubes. You have to go get a bunch of tubes drawn at a lab. It looks like a lot of blood but it’s actually less than if you were to donate blood. If you come back as the best match for the patient, they will call you for next steps.
When they contact you, they will let you know what kind of collection they want to do. The first type is a traditional marrow collection. The second type is a collection of peripheral blood stem cells (PBSCs). I have done both, for the same patient.
Once a marrow harvest is requested, you have to sign something in the neighborhood of 4,000 consent forms (you know.. approximately). You also have to get a full physical including x-rays and ekg. This is done by an independent doctor that typically the program contracts with, to make sure that you are in good enough health to donate. You’ll also have another round of bloodwork taken. Once everything is a go, you’d go to the hospital or donation center for some pre-op stuff and then the next day have the actual procedure done. Just an FYI, it’s considered a surgical procedure. Sometimes this requires travel if they cannot handle bone marrow harvests locally.
With the actual procedure, you’ll have to have someone there with you. I promise, the whole thing is way easier than what you’ve seen in movies or on TV. For starters, you are not awake. They put you under, and the harvest team flips you over and sticks two big needles into your backside. Your pelvic bones are the best place to collect marrow. Sometimes they need to reposition the needles, so for example, I have one little round scar on one side, and three little round scars on the other side. They’ll be on your lower back, right above your bum. Post-op, it’s really not so bad. You’ll be quite sore, but you’ll also be on painkillers so it’s really not a big deal. I was out of work for a week. I had pre-op stuff done on Monday, the procedure was early Tuesday morning (it takes about an hour and a half), and I went back to work the following Monday. I could have done with some additional time off, but it wasn’t an option for me. Rather than use all my personal accrued sick time, I took the time as unpaid and then the NMDP reimbursed me for lost wages. I received my first phone call about being a potential match for my patient in July, and underwent the procedure in October. Normally this process would probably be expedited but I was dealing with moving and a change in jobs so they had to accommodate me somewhat. Also, marrow recipients are located all over– my patient is actually in Denmark.
When I received an update on my patient after about two months, the recipient center (versus donor center) had requested a subsequent donation. Basically, my transplant took, and was doing well, but the patient was not producing enough red blood cells on her own. Rather than request a second bone marrow donation, they requested a peripheral blood stem cell donation, to boost her red blood cell production (since that is marrow’s job). My physical was still good from the first go-round, so I didn’t have to jump through all the hoops again. This time, I had to have some bloodwork done, and then in the week leading up to the actual procedure I had to go get daily injections of a drug called filgrastim. This drug increases the number of blood-forming cells in your bloodstream. Many people don’t have side effects from this drug, but I did. To say that it was unpleasant would be a huge understatement. I should have taken off work in advance, but I didn’t. I was miserable. Every bone in my body hurt, but the ones with large marrow reservoirs (pelvic bones, skull, sternum) were the worst. So then, I had to fly to Denver (from Kansas City) since they couldn’t do the actual procedure here. Being miserable + air travel = being extra miserable. Oh, and by the way, this was all on the NMDP’s dime: air travel, hotel, food, lost wages, etc. The next morning, I went to the hospital for the actual procedure, which is called pheresis. If you’ve ever donated plasma, it’s just like that. It’s basically the same machine. So, they hooked me up to the machine, needles in both arms. They suck blood out of one arm, filter it to get what they want (in this case, the stem cells) and put the rest back in the other arm. It takes like 3-4 hours. It was not fun, but at that point I was just happy to be getting the damn stuff out of me, you know? I was supposed to fly back to KC the next day but was delayed due to snowstorms.. luckily I had a couple of snow days off to recuperate. I felt better pretty much immediately after the procedure, but it took me a few days to feel totally normal again.
I haven’t yet received an update on my patient, so I’m not sure how she is doing. Would I do it again? Absolutely. Being a person’s only chance at survival is a pretty sobering, heavy experience, but it’s also a pretty amazing one. It’s definitely a unique opportunity for potential bone marrow donors, and I think the long-term definitely outweighs short-term discomfort.. though if I ever have to do a PBSC collection again, I’ll definitely be demanding some strong painkillers. Hopefully this gives you a pretty good idea of what’s involved in being a bone marrow and/or PBSC donor. PM me if you want more info!