Donation of Cells from Marrow or Blood
After all levels of Confirmatory Typing (CT) have been completed, and the donor has received medical clearance based on results of physical exams, the donation takes place. Usually it is timed to occur at the precise when the recipient has completed the BMT chemotherapy and/or radiation protocol (called the conditioning regime), so that the transplant will take place as soon as the donor stem cells arrive.
In most cases, the donor goes to a donor center or hospital credentialed to conduct the stem cell or marrow harvest, in or near to his/her home community. Once the stem cells are collected and stored in a blood bag, they are hand-carried by courier directly to the recipient’s TC. Occasionally due to special logistical circumstances, a donor may be brought to a center or hospital in the community where the recipient is located. However, the donor and recipient do not meet, due to confidentiality regulations governing unrelated BMT donations. For more detailed information about the donation process, see: Steps of Marrow and PBSC Donation
Transplanting Cord Blood
If the transplant will be of umbilical cord blood, the CB unit (CBU) will usually be shipped frozen its crypreserved state, using a specialized medical courier service. The CBU will be shipped in advance of the completion of the receipient’s conditioning phase, so that the thawing process may be precisely timed at the transplant center. The cord blood needs to to be transfused at the exact time that the patient is ready for it. More detailed information on the collection, testing, freezing, and transplantation of cord blood may be found on the website of one of the public cord blood banks, which is located in New York.
BMT Takes Place
The donated stem cells, no matter what their source, are infused into the recipient, whose diseased immune system as been eradicated through chemotherapy and/or radiation. The transplant is often called a “rescue” therapy, as it restores life to a patient who has literally been bought to the brink of death. The transplant itself is similar in appearance to a blood transfusion, except that the cells usually infused through a central venous catheter, or central line, that has been surgically implanted in the patient. The day of transplant is called Day Zero, and starts off a countdown measured in days to track the patient’s recovery. The transplant process is very complex, is different for each patient, and carries with it many risks and many hopes. Despite the challenges, it has become a treatment that offers increased chances of survival to more patients.