Have you ever thought that one donation from you could completely save another person's life? Yes, it's true. The most valuable gift you can give to someone suffering from a serious blood cancer like leukemia, or another serious blood disease, is bone marrow donation. Hearing this name may sound a little scary, but it's not as complicated or painful as you think. Today, we'll talk about this very simply, in a way that you can understand.
What exactly is bone marrow donation?
Simply put, bone marrow donation is the process of taking a portion of a healthy person's bone marrow and giving it to a patient whose bone marrow is failing. Inside the large bones in our body (like the hip bone), there is a soft, spongy tissue. We call it bone marrow . This is the blood-making factory in our body. Red blood cells, white blood cells, and platelets are all made from a special type of cell inside this bone marrow. We call them stem cells .
So, donating bone marrow means taking a small amount of the bone marrow fluid containing these precious stem cells from a donor's hip bone using a special needle. This procedure is performed under general anesthesia, so the donor does not feel any pain.
Why do some people need a bone marrow transplant?
Some people, due to congenital or acquired diseases, cannot produce blood properly in their bone marrow. Or, they start producing abnormal cells, such as cancer cells.
A bone marrow transplant may be necessary mainly in the following medical conditions:
- Blood cancers: Cancers such as leukemia and lymphoma.
- Bone marrow failure diseases: For example, in a disease called aplastic anemia, the bone marrow stops producing any blood cells.
- Some hereditary diseases such as thalassemia: In such diseases, bone marrow transplantation is sometimes the only solution.
When a patient's diseased bone marrow is completely destroyed (through chemotherapy or radiation) and replaced with bone marrow from a healthy person, that new bone marrow settles in the patient's body and begins to produce healthy blood.
In other words, this is like rebuilding the factory in a patient's body. This has the potential to lead to a complete recovery.
How do you find the perfect match?
This is the most challenging part of the process. Not just anyone can donate bone marrow to another person. The tissue types of the donor and recipient must match exactly . This is called HLA (Human Leukocyte Antigens) matching.
Simply put, HLA is a set of protein markers on the surface of every cell in our body that help us recognize that "this is part of my body." If these markers don't match exactly, the patient's body can recognize the newly donated bone marrow as "foreign" and reject it.
- Best match: This HLA match is usually most likely to occur with one's own brother or sister (about 25%).
- Outside the family: About 70% of people cannot find a matching donor within their family. In such cases, it is necessary to find a match through International Donor Registries.
Does ethnicity matter when donating bone marrow?
Yes. These HLA markers are strongly linked to race and genes. This means that the chances of finding a matching donor for an Asian person are much higher among Asians than among Europeans. That is why it is very important to have donors of all races registered.
Can I also become a contributor? What do I need to do to do that?
Becoming a bone marrow donor is a great thing to do to save a life. In Sri Lanka, the first thing to do is usually to find a suitable donor from the patient's family. If there is no family member, doctors try to find someone through international donor registers.
If you are interested in becoming a contributor, there are registration programs that operate internationally. The process generally goes like this:
1. Registration: Once you register through the relevant institution, they will take a cell sample from the inside of your mouth (cheek) using a swab.
2. HLA type identification: They test the sample, identify your HLA type, and enter that information into their database.
3. Finding a match: If your HLA type matches a patient anywhere in the world, they will contact you.
4. Confirmation: Then, more blood tests are done to confirm the match is 100%.
5. Donation: If everything is OK, you will be directed to the donation process with your consent.
What are the possible reasons for not being able to donate bone marrow?
Not everyone can donate bone marrow. Certain health conditions make you ineligible to become a donor. Some of these reasons are listed in the table below.
| Status | Description |
|---|---|
| Age | Generally, people over the age of 60 cannot donate. |
| Cancer | If you have previously had cancer and received treatment (chemotherapy/radiation). |
| Heart disease | Severe heart conditions. |
| Autoimmune diseases | For example: Diseases that affect the entire body, such as rheumatoid arthritis. |
| Infections | Infections such as HIV/AIDS, hepatitis B or C. |
| Diabetes | If you are using insulin injections. |
This list is not exhaustive. If you are interested in becoming a donor, it is best to discuss your health situation with your doctor for advice.
How does the donation process happen?
Once you are accepted as a donor, your complete health status will be checked before you donate. Several tests will be done, such as blood tests, ECG, and chest X-ray.
This is what happens on the day of giving:
1. Anesthesia: You are taken to an operating room and put under general anesthesia, so you don't feel anything.
2. Bone marrow aspiration: While you are lying on your stomach, doctors insert a special hollow needle through the skin behind your hipbone and withdraw the bone marrow fluid into a syringe. You may need to insert the needle several times to get the amount you need.
3. Quantity: Usually about 500 - 1000 ml of fluid is removed. While this may sound like a large amount, it is less than 10% of the total bone marrow in your body.
4. Time: The entire process takes about an hour.
What happens after a tooth extraction? How long does it take to heal?
After the surgery, you will be taken to a recovery room. Once you regain consciousness, you can go home in a few hours. However, you will not be able to drive that day.
After the donation, you can expect the following:
- Back and hip pain: There may be some pain and bruising at the injection site for a few days. This can be treated with over-the-counter painkillers (such as Paracetamol).
- Fatigue: You may feel a little tired for a few days.
- Recovery: Most people can resume their normal activities within two to three days. Your body will rebuild the amount of bone marrow that was removed within a few weeks. Sometimes doctors may recommend that you take iron supplements for a while.
The biggest benefit of this is that your donation gives another person a second chance at life. That's a priceless feeling.
Take-Home Message
- Bone marrow donation is a noble sacrifice that can save the life of someone with serious illnesses such as leukemia.
- The donor does not feel any pain because this process is performed completely unconsciously.
- Not just anyone can donate; a good HLA tissue type match between the donor and recipient is essential.
- The donor can usually return to normal life within a few days. The body regenerates the received bone marrow within a few weeks.
- If you are interested in becoming a donor, talk to your doctor about it and get more information and guidance.
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