Bone marrow is most often donated voluntarily for transplantation into a friend, loved one or stranger in need. Bone marrow transplants can treat blood diseases, including some cancers. Before donating, a donor must register with the National Marrow Donor Program (NMDP) or similar donor program, follow the procedures and satisfy specific requirements, for the health and safety of the donor and the recipient.
Initial Medical Screening
The NMDP requires potential donors to be between the ages of 18 and 60, be generally healthy and have a maximum body mass index (BMI) of 40. Donors also cannot be underweight, but there are no objective criteria to determine a minimum appropriate BMI. The potential donor must complete an extensive health history questionnaire, which will determine if the person is automatically excluded from registering as a donor due to medical history. Donating bone marrow would pose too high a risk to some people, or it would be too risky for a recipient to receive their bone marrow.
The NMDP has established some criteria which are absolute exclusions to joining the registry. These include: HIV/AIDS; most autoimmune diseases; many back and spine conditions; bleeding disorders; pulmonary diseases such as emphysema, sleep apnea and cystic fibrosis; most cancers or history of cancers, even after being cured or healed; most heart disease, except controlled arrhythmia; serious kidney disease or kidney removal; hepatitis B and C; diabetes mellitus treated with insulin; tuberculosis in the previous year; and chronic lyme disease. The NMDP’s website provides an exhaustive list of exclusion criteria, as well as other conditions that do not generally exclude a person from registering as a potential donor.
If not automatically excluded for medical reasons, the person can register with the NMDP and will undergo a cheek swab for tissue typing. He may he asked to pay for part of the cost of tissue typing.
If the person is a tissue match and is selected as a potential donor, she will receive a complete physical examination, including chest X-ray, electrocardiogram, urine tests and blood tests. She will be screened for pregnancy and infectious diseases (HIV, Hepatitis B, Hepatitis C, cytomegalovirus, syphilis and human T-lymphotrophic virus). Emotional concerns are also addressed.
A person is eligible to register regardless of past residency or travels. However, if selected as a tissue match and potential donor, he will receive extensive questioning in this area, to screen for people at high risk for Creutzfeld-Jacob Disease (CJD), a fatal brain disease that is a variant of mad cow disease. CJD may be transmitted through blood or bone marrow, and there is no test to screen for the disease. People living in certain areas of Europe during certain time frames since 1980 may be at high risk for CJD, and cannot register as potential bone marrow donors.
Donating bone marrow is always voluntary, and any potential donor has the right to change his mind at any time, including the day of the procedure.