How stem cell donation worksRegister as a stem cell donor
You can donate stem cells in two ways: via blood or via bone marrow. Which procedure is chosen, is decided by the patients physician. As a donor you can state a preference if you are called upon. Donating stem cells only takes place at the LUMC in Leiden or the Radboud UMC in Nijmegen. The donation is always entirely voluntary and anonymous. You will not receive payment for donating the stem cells. However, all expenses incurred are reimbursed by the patient's insurance. Absence of work in due to stem cell donation is regulated in the “Wet Uitbreiding Loondoorbetalingsverplichting bij Ziekte” (WULBZ).
Once you are a stem cell donor, the odds are, you may never be called upon. If you are a match with a patient, we will contact you. Only then - after extensive information and (medical) testing - the actual donation of the stem cells will follow. This will take some time, so we plan the stem cell donation in consultation with you.
Around 70% of donations are carried out using the collection via blood method (PBSC). This is when blood stem cells are collected from the donor’s blood stream by removing blood from one arm, running it through a machine that separates out the stem cells, then returning the blood to the donor through their other arm.
To ensure that you are able to donate enough blood-forming cells for the transplant, you will receive daily G-CSF injections for four consecutive days before your donation. G-CSF is a naturally occurring growth hormone that stimulates the production of stem cells in the blood of the donor before collection.
This is a non-surgical procedure and takes around 4-6 hours.
Administering the G-CSF can cause a flulike feeling as a side effect. Some donors experience a nagging painful sensation in the lower back and upper legs, due to the production of extra stem cells. These side effects are harmless and usually gone the day after the donation. After the donation you can be tired for a few days.
In some cases, it’s better for the patient if the stem cells are collected directly form the bone marrow. Around 30% of donations are carried out using the collection via bone marrow.
This is when the blood stem cells are collected from the bone marrow at the back of the hip bone (not the spine). This is the bone that one can feel just above of the buttocks. It is a large and sturdy bone, from which bone marrow can be removed without any problems. In this procedure, about 4 % of the total bone marrow is taken.
The procedure is carried out under general anesthetic so that no pain is experienced. The collection itself takes 1-2 hours and you can go back home in the afternoon. Most donors return to their regular activities within a week.
The patient physician decides which method is best for his or her patient.
As a donor you can still agree with the chosen method; stem cell donation is always voluntary. If your choice does not match the physicians preference it means that you will not become the donor for this patient. The method of donation which is determined on the patients disease and ‘type’ of patient.
There is a difference in the final “product” between the two ways of donation. Due to these differences the effect of the stem cell product in the patient's body differs per donation method.
With donation via blood, the product contains many stem cells, which means it can start up the new stem cells quicker, also meaning they produce new blood cells faster. The product also contains many white blood cells that can have an anti-leukemia effect. A disadvantage of these white blood cells is that they can also provoke graft versus host disease. This means that the stem cells of the donor can attack the body of the patient with serious health risks as a result.
When stem cells are donated via bone marrow, the product contains fewer stem cells and fewer white blood cells, but other additives that ensure that the product gives better results with certain diseases. With bone marrow donation there is usually less graft versus host disease. Bone marrow donation is currently being used in the Netherlands for specific diseases (for example Aplastic Anemia). There is also a strong preference for a bone marrow product if the patient is a child.
In addition to the preference of the patients physician and the donor himself, the donor doctor also has a say in the method of donation. If a donor is not suitable for a certain form of donation, the other method of donation may be chosen in consultation, even if this was not the preference of the patient's physician.
Step 1: potential match
When you are matched to a patient we will contact you. We will do this by phone. If we cannot reach you, we will leave a voicemail message and send an e-mail.
In this call, we will inform you about the two ways of donation and go through a medical questionnaire with you. We will also ask if you are still prepared to donate stem cells, and if there are any holidays we should take into account.
Step 2: blood sample
We will need to do a blood test. For this, we will send you the blood collection tubes by post. You can go to your local GP or hospital for the collection, after which you can send the blood tubes back to Matchis by post.
Step 3: wait
After you have sent your blood back, we will test it on a couple of things. For example, a second and more extensive HLA typing is done to check whether you really are the best match. In addition, blood is checked for certain viruses such as hepatitis and HIV.
If possible, several of potential donors are contacted for a single patient. The patient's transplant center may then need more time to decide which of the potential donors is the best match. The waiting time is approximately 3 months.
Step 4: the best match
If it appears that you are the best match for the patient, we will contact
you to set a date and the method of collection. In addition, we will make an appointment at that time for an extensive medical examination and a meeting with our donor doctor at Matchis.
Step 5: medical examination & information
For the medical examination we ask you to come to the office of Matchis. This is possible in Leiden or in Nijmegen. During the medical examination, your blood pressure and urine are tested and we will make a heart film and a lung photo.
You will immediately know if you are completely healthy! In addition, we have an extensive conversation with you in which we discuss the advantages and disadvantages of stem cell donation and possible side effects in the long term. We also ask on which collection method you as a donor would and would not want.
Step 6: prepare for stem cell donation
If you are donating stem cells via blood, you must administer a growth factor twice a day five days before the stem cell donation. This is called G-CSF and ensures that more stem cells end up in the bloodstream. You will get instructions in the hospital or at home. After these instructions you will be able to inject the G-CSF yourself . G-CSF is a naturally occurring growth hormone that is normally produced by the body when you have the flu. If you are donating stem cells via bone marrow, there will be a ?? at Matchis the day before collection. A short questionnaire is filled in here and there will be another blood test done.
Step 7: the donation
It's time! The day has come for you to really donate stem cells. This will take place in one of these ways: via blood or via bone marrow. Under the tabs above you can read how both ways work. After the donation, we do a follow-up at various times to check how you are doing. Four weeks after the donation you will be asked to see your local gp to check whether you have recovered completely.