Being a stem cell or bone marrow donor: Your questions answered : University College London Hospitals NHS Foundation Trust

This page explains what you can expect if you are matched as a potential stem cell or bone marrow donor for your family member. Here, ‘family member’ means a sibling, parent or child. If you have any questions about being a donor, please talk to the team caring for you.

What is the difference between stem cells and bone marrow?

Stem cells are blood cells at a very early stage of development. They are a vital ingredient of the bone marrow, the spongy tissue inside the bones. Once mature, stem cells are released from the bone marrow into the bloodstream.

There are two ways to collect stem cells:

by a procedure called stem cell collection
by a procedure called bone marrow harvest.

The method of collection will depend on your individual circumstances. The team caring for you will talk to you about this in detail.

You can visit our pages listed below to find out more about stem cell collection or bone marrow harvest. If you'd like this information printed, ask your nurse or doctor.

Stem cell collection and donation: Information for people donating their stem cells to a family member: University College London Hospitals NHS Foundation Trust (uclh.nhs.uk)

Bone marrow harvest: Information for people donating their bone marrow to a family member: University College London Hospitals NHS Foundation Trust (uclh.nhs.uk)

What is tissue typing?

Tissue typing is a test that helps determine how similar two people’s tissues are, based on their genetic makeup. It looks at 10 key markers – five of which are inherited from each parent.

When siblings share the same parents, there are three possible outcomes:

There is a 25% chance (1 in 4) that the markers will match, and you might be asked to donate.
There is a 25% chance (1 in 4) that the markers will not match, meaning you would not be able to donate to your sibling.
There is a 50% chance (1 in 2) that the markers will half-match, and you could still be asked to donate.

If you are donating to your child or parent, there is a 50% chance (1 in 2) that the markers will match.

If you are not a match, we can look for a donor through the Anthony Nolan Bone Marrow Registry. This is the largest donor registry in the UK and is also used worldwide to find unrelated donors.

How do I find out if I’m a match?

All that is needed is a blood test. Your GP can take a sample of blood and send it to our testing centre. It takes about three to four weeks for the results to come back and we will contact you when we have them. If you are a match, you will need to decide if you are willing to donate cells to your family member. If you decide not to donate, this will remain confidential.

What happens if I’m not a match but I would still like to donate?

If you are under 30 years of age and would like to join the donor register to help someone else, you can contact Anthony Nolan on 0303 303 0303.

If you are under 49, you can contact the NHS Stem Cell Donor Registry, previously called the British Bone Marrow Registry (BBMR), on 0300 123 23 23. Please mention that you have had your blood tested at the Anthony Nolan.

If you are under 55, you can contact the charity DKMS on 020 8747 5620. Please mention that you have had your blood tested at the Anthony Nolan.

What happens if I am asked to be a donor?

You will need to have some further tests and a detailed medical check to make sure you are healthy enough for a stem cell collection or a bone marrow harvest. Your health is our priority, and we want to make sure that donating your cells will not affect it in any way.

We will give you written information explaining the procedure and talk to you about the process in detail.

The following tests and checks will take place three to four weeks before the procedure:

A doctor will examine you and review your medical history.
You will have a chest X-ray to check your lungs and an ECG to check your heart’s rhythm.
You will have several blood tests. These include tests for:
- full blood count
- blood type
- liver and kidney function
- viruses, including HIV and Hepatitis B.

Please drink plenty of water before your blood tests. This helps to make your veins easier to find.

We will also ask for your consent (permission) to go ahead with the procedure. You will have all the time you need to ask questions or discuss any issues before signing the consent form.

Where will my stem cell donation take place?

The stem cell donation will take in the Apheresis Unit at the University College London Hospital Macmillan Cancer Centre.

For most people this is an outpatient procedure without an overnight stay in hospital. But if you need a central line placed at the top of your leg for the donation, you will have the procedure as an inpatient. This means you will need to stay in hospital overnight. We will talk to you about this at the medical check.

When will it happen?

We will schedule your stem cell donation to align with the end of your family member’s chemotherapy (and possibly radiotherapy) treatment.

Is there anything I need to do to prepare?

You’ll have a four-day course of injections to ‘mobilise’ (move) the stem cells out of the bone marrow and into your bloodstream. You can have these done close to home, for example at your GP practice or by local district nurses. Or a family member can give you the injections.

You can continue working and doing your usual day-to-day activities. But you should avoid strenuous activity or exercise during the four days of injections.

We will ask you to use contraception during the course of injections and for one month after.

Most donors experience some side effects with the injections. You may feel pain or aching in your bones or joints, and you can take your usual painkillers to help with it. The pain usually stops as soon as we have collected your stem cells. There are no known long-term side effects.

How do you collect the stem cells?

We collect the stem cells using a machine called a cell separator.

A needle is placed into a vein in each arm.
The blood is taken from one arm into the cell separator.
The cell separator spins the blood and separates the stem cells. They are then collected into a collection bag.
The rest of the blood is returned through the needle in the other arm.

How long does it take to collect the stem cells?

You will be connected to the cell separator for about four to five hours on each day of collection. Many donors collect enough stem cells in one day. But some need to return the following day for a second collection. Your nurse will let you know if you have enough stem cells at the end of the day.

Are there any side effects of having my stem cells collected?

During the stem cell collection, you might feel some tingling in your lips, nose or fingers, or experience cramping in your hands. This happens because of a solution added to your blood to prevent clotting while it passes through the cell separator. If you notice any of these symptoms, let your nurse know. They can help to relieve them.

The collection process itself should not be painful.

How long will it take me to recover following the stem cell donation?

You should feel well enough to go back to work and your daily activities the following day.

Where will my bone marrow donation take place?

The bone marrow donation, also called bone marrow harvest, will take place at University College Hospital (the Tower). You will have the procedure as an inpatient, and you will need to stay in hospital for two nights.

When will it happen?

The donation will take place about one week after your family member’s chemotherapy has started.

Is there anything I need to do to prepare?

You will need to fast before the bone marrow harvest. This means no eating for six hours before the procedure. But you can drink plain water until two hours before. We will give you detailed instructions on how to fast.

What happens during the bone marrow harvest?

The bone marrow harvest will take place in the operating theatre. You will have a general anaesthetic so you will be asleep for the procedure. The bone marrow will be taken from the back of your hip bones (pelvis) using a special syringe. We will remove up to 1.5 litres of bone marrow.

How long does it take?

You will be asleep for about one hour.

How will I feel afterwards?

You are likely to have some lower back pain and you may feel tired and weak for about one to two weeks. You may need a short course of iron tablets, but this is more common in women.

You may also experience some side effects of having a general anaesthetic. These include feeling or being sick, having a sore throat and feeling thirsty. We can help to relieve these side effects so it’s important that you let us know if you are feeling unwell in any way.

How long will it take me to recover following the bone marrow harvest?

We recommend that you take a week off work. You may feel tired for longer than this but any back pain should have resolved by then.

Is there anything I should do before the donation?

There is no special preparation needed but we will ask you to follow the guidance below:

If you are a female of child-bearing age, you will need to take a pregnancy test before your donation.
Avoid raw or undercooked meat (especially pork) and shellfish until after your donation. This will lower your risk of getting Hepatitis E.
Avoid alcohol the night before donation. It’s important that you are well-hydrated for the procedure.

Will I have to give more cells in the future?

Yes, we may ask you to donate more cells in the future. This usually happens within the first two years following your initial donation. It will depend on your family member’s health needs which we will monitor.

Can I choose how my cells are collected?

We may recommend a specific collection method, based on your family member’s treatment needs. But we will always consider your preference and be guided by what works best for you. For reference, about one in 10 donations are done through a bone marrow harvest. The rest use stem cell collection.

Will you cover any of my expenses?

Unfortunately, we do not cover any expenses for donors, including travel and accommodation costs.

Important things to remember as a donor

A stem cell or bone marrow transplant is a complex procedure that carries some risks for your family member. Their healthcare team will have talked to them about these risks to make sure they are comfortable to go ahead with the procedure.
Unfortunately, not every transplant procedure is successful. Remember that you are giving your family member the best chance of a cure by donating your bone marrow or stem cells to them.