The Donor Process
DONOR REGISTRATION
1. You learn about marrow donation. The C.W. Bill Young / DoD Marrow Donor Center will have representatives standing by to inform you about becoming a volunteer donor and the donation process. Brochures and a video explaining marrow donation for volunteers will be available.
2. You sign a consent form (DoD Form DD 2576) to be listed on the Department of Defense and National Marrow Donor Program (NMDP) Registry and provide additional information about yourself including a brief medical questionnaire.
3. Buccal swabs (4) or a small blood sample (about 2 tablespoons) is taken.
4. You are registered as a potential volunteer marrow donor. Your tissue (HLA) type is determined and entered into the DoD and NMDP Registry. Your blood is tested at the Navy HLA (human leukocyte antigen) testing laboratory to determine your tissue (HLA) matching type. The results of the HLA typing, along with some of the information from the questionnaire you completed, are added to NMDP’s main computer. The information is coded so you can only be identified by C.W. Bill Young/DoD Marrow Donor Center personnel.
MATCHING WITH A PATIENT
5. Once registered in the NMDP computer, marrow transplant medical teams throughout the U.S. and the world can search the NMDP file to determine if your HLA type matches the HLA type of a patient who needs a transplant. If the transplant center decides that your tissue (HLA) type is a potential match with a patient, you are then requested as a “preliminary match” through the C.W.Bill Yong/DoD Marrow Donor Center.
6. A donor coordinator from the C. W. Bill Young/DoD Marrow Donor Center will inform you of your status. If you wish to continue, you sign an additional consent form. If you are a member of the military, your Commanding Officer also signs the consent to continue, so he or she is aware that there is a relatively high chance (about 1 in 10) that you will donate marrow.
7. Several tests have to be done to find out if you are the best match for the patient. A second sample of your blood is obtained and sent to the transplant center for extensive confirmatory HLA typing and another sample is sent to a lab to test your blood for infectious disease markers. If your precise HLA-type is compatible with the patient and your infectious disease testing is acceptable, the transplant center will then request you as a match for the patient. The C.W.Bill Young/DoD Marrow Donor Center will be informed and a coordinator from the Donor Center will call you and determine if you are willing to proceed. If you are willing to proceed, the coordinator will spend time with you on all the aspects of the donation and will also send you materials to read and a video to watch so that you are fully informed of the donation process. There are two sources of blood stem cells that a transplant center will request; marrow or peripheral blood stem cells (PBSC). Your assigned coordinator will inform you of the transplant center choice of procedure.
DONATING MARROW OR PBSC
8. You decide whether to donate. After being fully informed about the donor experience, you make the decision - with the support of family and friends – to become a marrow donor. If you wish to proceed, you will be brought to a hospital, usually Georgetown University Hospital in Washington, D.C. or the University of Maryland Greenbaum Medical Center in Baltimore, Maryland for a physical exam and additional health testing. Upon completion of your physical examination, a donation date is scheduled. If you are active duty military, command approval is also obtained.
9. A small amount of your marrow is collected. Marrow is extracted from the back of your pelvic bone using a special needle and syringe in an NMDP approved collection center, usually Georgetown University Hospital in Washington, D.C. or the University of Maryland Greenbaum Medical Center in Baltimore, Maryland. You are under anesthesia during this simple surgical procedure.
10. You recover quickly from the procedure. Typically, the donor stays overnight in the hospital. After being discharged, you can resume normal work activities after a few days. You will likely experience some soreness for about a week - each individual experiences a different level of discomfort. Your marrow naturally replenishes itself. A Georgetown University Hospital marrow collection team member or University of Maryland Greenbaum Medical Center collection team member and the C. W. Bill Young/DoD Marrow Donor Center staff will stay in contact with you until you have completely recovered. You will be periodically informed of the patient’s progress.
11. The Transplant Center may request that blood stem cells be collected from your circulating blood (PBSC donation) instead of your bone marrow. Your assigned coordinator from the C.W. Bill Young/DoD Marrow Donor Center will discuss this procedure with you. PBSC collection takes place at one of the apheresis centers in the Washington D.C. area. They are located at either the Georgetown University Hospital in Washington, D.C., the University of Maryland Greenbaum Medical Center in Baltimore, Maryland, or at Fairfax Pathology Associates in Fairfax, Virginia.
12. PBSC Donation: To increase the number of blood stem cells in the bloodstream, you will receive daily injections of a synthetic hormone called filgrastim (a synthetic version of a naturally occurring hormone in your body) for four days before the collection and a fifth injection on the day of your collection. Your blood is then removed through a sterile needle in one arm and passed through a machine that separates out the blood stem cells. The remaining blood is returned to you through the other arm.
13. After you donate marrow
or PBSC, your assigned coordinator will call you to see how you are
doing. They will keep in touch with you until you are feeling back
to normal. Most donors are back to work in a few days and back to their
normal physical routine within a few weeks.
Click to see the National Marrow Donor Program's
"ABC's
of Marrow or Blood Cell Donation"