Bone Marrow Donation Process for Healthy Adults
Bone marrow donation involves either a surgical bone marrow harvest under anesthesia or peripheral blood stem cell (PBSC) collection via apheresis after growth factor injections, with PBSC now being the preferred method in approximately 72% of cases due to faster donor recovery and lower complication rates. 1
Two Methods of Donation
Bone Marrow Harvest (Traditional Method)
- Surgical procedure performed under general or spinal anesthesia requiring hospital admission for 1-3 days 2
- Multiple needle aspirations from the posterior iliac crest (hip/pelvic bones) to collect marrow 3
- Target collection: 2×10⁸ total nucleated cells per kg of recipient weight (achieved in 93.6% of harvests) 3
- Recovery time: median 3 weeks to return to normal activities 1
- Time off work: typically 7-10 days 2
Peripheral Blood Stem Cell (PBSC) Collection (Now Preferred)
- No surgery or anesthesia required - cells collected via apheresis (similar to blood donation) 4
- Requires 5 days of granulocyte colony-stimulating factor (G-CSF) injections to mobilize stem cells from bone marrow into bloodstream 4
- Outpatient procedure lasting 4-6 hours 1
- Recovery time: median 1 week (significantly faster than bone marrow harvest) 1
Pre-Donation Requirements
Screening Process
- Behavioral and medical history screening to exclude high-risk donors 5
- Infectious disease testing: HIV-1, HIV-2, hepatitis B, hepatitis C 5
- Physical examination for signs of infection or contraindications 5
- HLA typing to ensure compatibility with recipient 5
- Blood tests including complete blood count and comprehensive metabolic panel 3
Donor Selection Criteria
- Generally healthy adults aged 18-60 years (though donors up to 70 may be considered in specific circumstances) 5
- No active infections or malignancies 5
- Adequate baseline blood counts 3
- Ability to tolerate anesthesia (for bone marrow harvest) or apheresis procedure 2
Common Side Effects and Symptoms
Bone Marrow Harvest
- Pain at collection site (back/hip): reported by 82% of donors 1
- Anesthesia-related symptoms: throat pain (33%), post-anesthesia headache (17%) 1
- Fatigue: reported by 59% of donors 1
- Transient decreases in hemoglobin, requiring occasional transfusion support 2
- All symptoms typically resolve within 3 weeks 1
PBSC Collection
- Bone pain (various sites): reported by 97% of donors during G-CSF administration 1
- Fatigue: reported by 70% of donors 1
- Headache, myalgias, and flu-like symptoms from G-CSF 4
- Symptoms resolve rapidly after collection, typically within 1 week 1
Safety Profile
Serious Adverse Events
Bone marrow harvest: 1.34% serious adverse event rate 2
PBSC collection: 0.6% serious adverse event rate (significantly lower than bone marrow harvest, P < 0.05) 2
Blood Count Changes
- Transient alterations in white blood cells, platelets, and hemoglobin occur during donation 1
- Most counts return to baseline by 1 month post-donation 1
- Long-term hematologic effects are rare 1
Post-Donation Monitoring
- Follow-up blood counts at 1 month and beyond to ensure recovery 1
- Ongoing registry participation for long-term safety monitoring 5
- Donors can be contacted for additional donations if needed 5
Important Caveats
The National Marrow Donor Program and international registries maintain strict protocols for donor safety, including adverse event reporting systems 5, 2. While donation is generally safe, donors receive no personal therapeutic benefit and are exposed to medical procedures purely for the recipient's benefit, creating an ethical obligation for meticulous donor care 4. The choice between bone marrow harvest and PBSC collection is typically made based on recipient needs and transplant center protocols, though PBSC has become the dominant method due to superior donor safety profile and faster recovery 1, 2.