If chosen as a bone marrow match for a patient, you will follow the footsteps
of many other donors through an important and exciting process. Once you
commit to this process, the patient whom you match also begins a process
that prepares him/her for your donation.
A patient requiring a bone marrow transplant obtains "replacement"
stem cells.
The use of marrow from another person requires careful testing to ensure
the match between the patient and donor is very close. On most cells of
the body, there are protein molecules, (antigens) that mark the cells as
being "of self." These unique markers are what the immune system
will recognize as "belonging."
The National Marrow Donor Program (NMDP) maintains a Registry of more
than 3 million volunteers willing to become stem cell donors if matched
with someone like Travis who needs a marrow transplant. The search for a
matched donor through the NMDP Registry involves several steps. The NMDP's
process ensures that both the recipient and the donor are well-prepared
for transplant.
HLA Typing and Search Reports Transplant recipients and donors are matched
by comparing Human Leukocyte Antigen (HLA) typing. There are six HLA antigens
that are considered important for marrow matching, two A antigens, two B
antigens and two DR antigens. For a number of reasons, when donors are added
to the NMDP Registry, they are usually HLA typed for the A and B antigens
only. A "perfect" match is a donor who has the same six antigens
as the patient.
Marrow collection and transplant.
The marrow is collected from the donor using a surgical procedure at
a collection hospital as close as possible to the donor.
The timing of the collection is coordinated with your preparation for
marrow transplantation. The marrow is collected and taken by courier to
your transplant center where you receive the donor's marrow in a process
similar to a blood transfusion.
Follow-Up
After the marrow collection and marrow transplant, the NMDP follows the
recovery of both the donor and recipient. Donors are followed until they
feel "completely recovered," usually three to four weeks. Data
on recipient recovery is collected at three, six and twelve months and annually
thereafter.
Time Frame
Searching for a potential unrelated marrow donor can be a lengthy process.
Time is needed to contact and schedule appointments for potential donors
for further compatibility testing, to perform the tests, and to receive
and evaluate the laboratory results. It is important for the Transplant
Center to evaluate the search results as early as possible and plan a search
strategy accordingly, and keep you informed.
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�Questions &
Answers
What is Marrow?
Marrow is a substance found in the cavities of the body's bones. It resembles
blood and contains stem cells, which produce red cells, white cells and
other blood components.
Who needs a marrow transplant?
Marrow transplantation has become the only real "cure" for
many diseases. Approximately 75 percent of all transplants facilitated through
the NMDP are for patients who have been diagnosed with some form of leukemia.
In addition, marrow transplants are a treatment for patients with anemias,
lymphomas and a number of other life-threatening blood diseases. Patients
who do not have a matched donor within their family turn to the NMDP's Registry
for an unrelated marrow donor.
What is required to become a donor?
Anyone between the ages of 18-60 and in general good health can become
a volunteer marrow donor. New volunteers can join the Registry by taking
a simple blood test. If a volunteer matches a patient, that person will
be contacted and further testing arranged. Once that is completed, if the
volunteer is a precise match for the patient, special counselors will provide
the volunteer with detailed information about the marrow donation process
and their options as a volunteer marrow donor.
How does a donor match a patient?
On most cells of the body, there are protein molecules called antigens
that mark the cells. Human Leukocyte Antigen (HLA) is the name given to
the system used to identify the antigens that the immune system recognizes.
There are a total of six markers - three antigens inherited from the mother
and three antigens inherited from the father. To determine a person's HLA
type, a blood test is performed to identify which HLA markers are present.
A potential donor's blood is tested this way when they join the Registry,
and the results are entered onto a database called the STAR� (Search
Tracking and Registry) System. When a search is initiated, the patient's
antigens are compared with the antigens of each of the more than 3 million
volunteer donors. These preliminary searches can, and often are, repeated
to compare the patient's antigens to each day's new donors. If any potential
matches are identified, patients consult with their physicians to determine
the next step in the transplant process.
If I become a donor, will I meet the patient?
Volunteer unrelated marrow donation is done anonymously through the NMDP.
For at least the first year after the transplant, the donor and recipient
communicate only in anonymous writing through the NMDP. If both the patient
and donor wish to meet after one year, NMDP coordinators can assist in that
process.
How Do I Become A Marrow Donor?
You learn about marrow donation and give a small blood sample.
The National Marrow Donor Program (NMDP) Donor Center representatives
inform you about becoming a volunteer donor and the donation process. After
you consent to being listed in the Registry, you give 2-3 tablespoons of
your blood. Your human leukocyte antigen (HLA) type is determined and entered
onto the NMDP Registry.
Your blood is tested to determine its HLA type. The results are added
to the NMDP's main computer, which is searched internationally on behalf
of patients who need a marrow transplant. You are contacted if a preliminary
match is found. If the computerized Registry indicates that your marrow
may match any of the patients in need, your donor center coordinator informs
you of your status and arranges additional testing.
A compatible match is identified. Further testing may indicate that your
precise HLA-type is compatible with the patient. Counselors provide you
with detailed information about the marrow donation process and your options
as a volunteer donor. You also receive a thorough physical examination.
You decide whether to donate. After being fully informed about the donor
experience, you make the decision -- with the support of your friends and
loved ones -- to become a marrow donor.
A small amount of your marrow is collected. In the hospital, marrow is
extracted from the back of your pelvic bone using a special needle and syringe.
You are under general anesthesia during this simple surgical procedure.
You recover quickly from the procedure. Typically, you stay overnight in
the hospital. After being discharged, you can resume normal activity, although
you may experience some soreness for several days, a week or slightly longer.
Your marrow naturally replenishes itself within a few weeks.
If you would like to talk with a donor information representative, please
contact the NMDP's Coordinating Center at 1-800-MARROW-2. |