What Is It Like to Donate Stem Cells or Bone Marrow?

People usually volunteer to donate stem cells for an allogeneic (allo) transplant either because they have a loved one or friend who needs a match or because they want to help others. Some people give their stem cells so they can get them back later for an autologous (auto) transplant.

Learn more about donating stem cells for another person or for your own transplant, how to volunteer as a donor, and how to donate your baby’s cord blood.

If you want to donate stem cells to someone else

If you want to see if you can donate stem cells to a specific person, speak with that person’s care team. If you want to join a volunteer donor registry to possibly donate to someone you don’t know in the future, contact NMDP.

First steps

Medical guidelines are in place to protect the health of possible donors, as well as the health of the person getting the stem cell or bone marrow transplant (the recipient).

As a potential donor, you will:

• Answer questions about your health. Potential donors are asked questions to make sure they are healthy enough to donate.
• Have a full physical assessment and blood testing. Blood tests will check for any infections that could cause a problem for the person getting the cells.
• Test for your HLA type. This is done with a simple cheek swab or blood test. HLA is a group of genes that are important for your immune system. They help the immune system tell the difference between your body’s own cells, viruses and tissues, and the cells of someone else.

Who covers the costs?

HLA testing costs are usually covered by the donor registry or by the stem cell recipient’s medical insurance.

Allo stem cell donors don’t have to pay for harvesting or stem cell donation because the recipient’s insurance company usually covers the cost. Still, be sure to ask about insurance coverage before you decide to harvest your bone marrow or donate stem cells.

What happens when you join a volunteer donor registry?

If you join a volunteer donor registry, the registry will most likely keep your tissue type on file until you reach age 61, unless you ask to be removed sooner. The registry will contact you if you are a potential match for a recipient, but you are under no obligation to donate.

For more information about donor eligibility guidelines, contact NMDP or the donor center in your area.

Donating your baby’s cord blood

If you are pregnant and want to donate your baby’s cord blood, it’s important to plan ahead. Make arrangements early in your pregnancy, at least before the third trimester.

Donation is safe and doesn’t affect the birth process. This is explained in more detail below, under How Stem Cells are Collected.

Informed consent and further testing before donation

If you are a good match for someone who needs a transplant, the next steps are:

• Learn about the transplant process. Donor nurse coordinators and doctors at the donor center will teach you about the transplant process so you can make an informed decision.
• Make a decision and give consent. If you decide to donate after you fully understand the risks, you must sign a consent form.

It’s important that you don’t feel pressured to donate. Donating your stem cells is always a choice.

How stem cells are collected

Stem cells may be collected from these 3 different sources:

• Bone marrow
• Peripheral stem cells
• Umbilical cord blood

Each method of collection is explained below.

Collecting stem cells from bone marrow

This process is often called bone marrow harvest. It’s a surgical procedure done in an operating room while you are under general anesthesia (medicines to put you into a deep sleep so you don’t feel pain).

The cells are taken from bone marrow found in the back of your pelvic (hip) bone.

During the bone marrow harvest

• While you lie face down, a large needle is put through your skin and into the back of your hip bone.
• The needle is pushed through to the center of the bone and the thick, liquid marrow is pulled out through the needle.
• This is repeated several times until enough marrow has been taken out (harvested).
• The amount of marrow taken depends on your weight. Often, about 10% of a donor’s marrow is collected (about 2 pints). This takes around 1 to 2 hours.
• Your body will replace these cells within 4 to 6 weeks.

If blood is taken from you before the marrow donation, it is often given back to you at this time.

After the bone marrow harvest

After the bone marrow is harvested, you are taken to the recovery room while the anesthesia wears off. You might have a sore throat or nausea caused by the breathing tube and the anesthesia medications.

You might be taken to a hospital room and watched until you are fully alert and able to eat and drink. In most cases, bone marrow donors can leave the hospital within a few hours or by the next morning.

• You might have soreness, bruising, or aching at the back of your hips and lower back for a few days.
• Some people feel tired or weak and have trouble walking for a few days. Over-the-counter pain medications or nonsteroidal anti-inflammatory medications are helpful.
• You might be told to take iron supplements until the number of red blood cells returns to normal.

Most bone marrow donors get back to their usual activities in 2 to 3 days. But it could take 2 or 3 weeks before you feel completely back to normal.

Rare complications

Some rare complications of bone marrow harvest can include:

• Anesthesia reactions
• Infection
• Nerve or muscle damage
• Transfusion reactions (if a blood transfusion of someone else’s blood is needed — this doesn’t happen if you get your own blood)
• Injury at the needle insertion sites

Collecting peripheral blood stem cells

For this procedure, stem cells are taken from your blood.

Before collection: growth factor injections

Normally, you have very few stem cells in your blood, so for several days before starting the donation process you will be given a daily injection (shot) of hormone-like substances called growth factors (such as filgrastim or others).

These injections cause your bone marrow to make and release a lot of stem cells into your blood.

Growth factor medications can cause some side effects:

• Bone pain and headaches (these are the most common)
• Nausea
• Sleeping problems
• Low-grade (mild) fevers
• Tiredness
• Pain

These side effects go away once the injections are finished and collection is completed. Over-the-counter pain medications or nonsteroidal anti-inflammatory drugs may help with pain.

Let the collection team know if you have any other side effects.

During collection

After the shots, your blood is removed through an IV catheter (a thin, flexible plastic tube) put in a large vein in your arm, neck, or chest. The blood is then put through a machine that separates the stem cells from the other blood cells.

The stem cells are kept while the rest of the blood is returned to you, often through the same catheter. (In some cases, a catheter is put in each arm — one takes blood out and the other puts it back.)

This process is called apheresis. It takes about 2 to 4 hours and is done as an outpatient procedure. Sometimes, the process needs to be repeated for an additional day to collect enough stem cells.

Side effects can happen because of the catheter or the apheresis procedure, including:

• Problems with the catheter (blockage of the catheter, trouble placing it in the vein, or infection of the catheter at the area where it enters the vein)
• Bruising at the needle site
• Blood clots
• Low platelet counts

Low calcium levels can happen because of the anticoagulant drug used to keep the blood from clotting in the machine. This can cause:

• Lightheadedness
• Tingling around your mouth, fingers, and toes 
• Chills
• Muscle cramps

These side effects go away after the donation is complete, but you may be given calcium supplements to treat them.

Collecting umbilical cord blood

Cord blood is the blood left in the placenta and umbilical cord after a baby is born. Collecting cord blood doesn’t pose any health risk to the baby or the mother. Cord blood transplants use blood that would otherwise be thrown away.

How cord blood is collected

• After the baby is born, the umbilical cord is clamped in two places and cut between the clamps.
• The placenta and umbilical cord are cleaned.
• The cord blood is put into a sterile container, mixed with a preservative, and frozen until needed.

Donating to a public blood bank

Some parents choose to donate their baby’s cord blood to a public blood bank at no cost, so that it can be used by anyone who needs it. Many hospitals collect cord blood for donation, which makes it easier for parents to donate.

Storing cord blood for your own family use

Other parents choose to save and store cord blood in case the child or a close relative needs it someday. This is often done if there is a family history of diseases that may benefit from stem cell transplant.

If you save cord blood for your own family use, you will be charged a collection fee and annual storage fees.

Planning ahead

If you choose to donate your baby’s cord blood, you will need to arrange it before the baby is born.

• Some banks require you to make these plans before the 28th week of pregnancy.
• Other banks accept later setups.
• You will need to sign a consent form and answer health questions for this process.

For more about donating your newborn’s cord blood, call 1-800-MARROW-2 or visit the NMDP website.

Using a private company to store cord blood

There are several private companies that will save and store your newborn’s cord blood for your own family use. But there are a few things to keep in mind:

• A single cord blood unit might not have enough stem cells for most adults, so personal cord blood use could be limited.
• Some diseases that can be treated with transplant require stem cells that come from another donor (allo transplant).
• Infusing auto cord blood stem cells that contain the same disease or condition will not cure the disease.
• The shelf life of cord blood is not known. More studies are being done to find out how long cord blood remains usable.
• The private collection fee can be a few thousand dollars, along with a few hundred dollars per year to store the cord blood. Costs will probably increase over time, and they may vary from one part of the country to another.

More information on private family cord blood banking can be found at the Parent’s Guide to Cord Blood Foundation.

Donating stem cells for your own transplant

If you donate cells for your own transplant (auto stem cell donation), this will be done by bone marrow harvest or by collecting peripheral stem cells from your blood.

For the most part, the collection process is the same, except that you are both the donor and the recipient. Your stem cells will be collected for your own use.

In some situations, the process is a little different:

• Depending on your disease and treatments, you might get chemotherapy before you get injections of the growth factor drug (the drug that tells your body to make stem cells).
• If you had certain kinds of chemo in the past, or if you have an illness that affects your bone marrow, it might be hard to collect enough stem cells. Even after several days of apheresis, there may not be enough for the transplant.

Who can’t donate bone marrow or stem cells?

A bone marrow donation is a life-saving procedure that can help people with cancer or other types of blood disorders. But there are some situations in which a person can’t be a donor.

A person usually can’t be a donor if they are:

• Under 18 years old
• Over a certain age (usually 60, depends on the registry)
• Pregnant

Or if they have:

• High-risk infectious diseases like Hepatitis B or C, HIV/AIDS, or active TB
• Certain autoimmune or chronic health conditions, such as systemic lupus, blood cancers, or blood disorders.
• Too low of a weight or excess body weight
• A substance use disorder

Some of these factors (like being pregnant or having certain health conditions) may make you ineligible as a donor. But for other factors, you might still be able to donate after the donor center reviews your health conditions.  

Donor centers carefully review each possible donor’s health before approving them for donation.

Can cancer survivors donate stem cells or bone marrow?

Yes. People who have survived certain types of cancer can donate stem cells or bone marrow.

• Survivors of “in situ” cancers (diagnosed in the very early stages) can donate.
• So can people with a history of precancerous cells.
• Survivors of solid tumor cancers can donate if it’s been more than 5 years since treatments completed (with no chemo or radiation).

Learn more

• Finding a Stem Cell Donor
• Getting a Stem Cell or Bone Marrow Transplant