After the collection of bone marrow or peripheral blood stem cells is complete, the bag of cells is packed in a cooled box for transport and given to the courier. The box never leaves the courier, who will personally carry and hand deliver it to the transplant center. By the time the courier arrives, the recipient is usually fully prepped and ready for transplantation. The transplant process is simple: the donated cells are infused through an IV into the patient’s blood. The bone marrow or PBSC naturally find their own way into the cavities of the recipient’s bones, and settle in to begin creating new bone marrow, blood cells, and an immune system. This process is called engraftment.

Engraftment process

During the engraftment process the patient typically remains in a clean room, as, without a functioning immune system, the risk of infection is high. The length of recovery time for each patient varies, depending on many factors, including the type of treatment they are receiving. The transplant center will test the recipient’s blood frequently for indicators that the marrow is functioning and producing new cells. The first sign that engraftment is successful is usually an increase in neutrophils, a type of white blood cells, which can start to appear after 10 to 20 days. Platelet counts usually begin to rise in the weeks after neutrophil engraftment occurs.

Transfusions and growth factors

Occasionally, the recipient may need additional transfusions of red blood cells or platelets. A donor leukocyte infusion or DLI is where a matching donor is asked for a white blood cell only donation to help the patient's recovery process. Growth factors may be administered to help speed the engraftment process.  

Graft vs. host disease

Should the recipient experience graft vs. host disease, where the transplanted cells see the recipient’s cells as possible enemies, treatment is given to control the condition.

Recovery

Once the patient’s immune system has recovered sufficiently, he or she can return home and gradually resume normal activities and go on with life. Every patient is different, and so is their recovery.

Communicating with and meeting your recipient

Gift of Life receives periodic updates on the recipient’s recovery, usually after 1 month, 6 months, and then annually, and can share this information with the donor. Under current regulations in the United States, the donor and recipient may exchange anonymous letters for the first year. These are transmitted by the donor registry through the transplant center; no direct contact is permitted and any identifying information in the letters is removed. Both the donor and recipient may participate in correspondence, but neither is obligated to do so. International recipients may be subject to different rules. If your transplant recipient is outside the United States, international agreements and regulations apply, which may be the same as or different from those inside the U.S. Some countries only allow the exchange of anonymous letters, and several do not permit any contact.

If the required waiting period has passed and both donor and recipient are agreeable to learning each other’s identities, this information can be shared by the donor registry and the transplant center, and you are then free to contact each other.

Thank you for being a donor and a hero

Whether you ever meet your recipient or not, you are a hero for having stepped forward and saved the life of another human being. This is an incredible gift, and means so much not only to that person, but to their family, friends, co-workers and community. Thank you for donating. Every donor is a hero to us!