Adam (above, left) donated blood stem cells to save James's life. Adam learned he was a match in April, but his collection took place in June after all the necessary steps were completed. The transplant was a success, and the two men met in person for the first time (above right) during a Gift of Life event with the Boston Red Sox at Fenway Park.  

When volunteer donors in Gift of Life’s registry learn they are a match for a patient, many of them want to drop everything, travel immediately to our collection center, and donate ASAP – because they know how urgent this transplant is for the patient. Fighting blood cancer is a process where timing is incredibly important, but then, the donor is told that the donation day may not be scheduled for another six weeks, or even longer! What is going on? Why does it take so long?

Our Medical Directors, Dr. Bruce Lenes and Dr. Michael Hsu, shed light on the complicated and sometimes lengthy steps that are required between identifying you as a match, and when the patient actually receives your donated stem cells or marrow.

The time between when the patient’s physician identifies the need for a transplant and the date when the infusion of peripheral bloods stem cells (PBSC) or marrow (BMT) are delivered to the transplant center varies for each patient. There are many medical and logistical reasons for this delay.  The following steps  must all be completed before a lifesaving transplant takes place.

1. Identify and select the correct donor – This function is performed by the transplant center’s physicians. If there are no family members (siblings) who match, they review and evaluate the age, sex, health, eligibility, and compatibility of the potential unrelated donors who have joined the Gift of Life registry and have their genetic information stored in the registry’s computer files. If there are several matches, one must be selected as the best possible match for the patient’s particular condition and for their clinical medical status.


2. Donor preparation – Once the best match has been identified, Gift of Life contacts the potential donor to share the news that they have been selected as a potential match, and discuss with them what needs to happen next. These preparations are carefully designed to ensure the donation will be safe for the donor to proceed with, and the cells obtained from the donor are safe for transplant recipients to receive.


3. Patient preparation – The patient must be ready for the transplant to give them the best chance for success. Recipients are often very ill and need to be stabilized before they can tolerate a transplant. It may take several weeks to accomplish this important step.


4. Inducing remission – Many times, the patients are treated with chemotherapy or radiation to induce a temporary remission from their disease before the transplant process can proceed. This remission prepares the recipient’s bone marrow to accept the transplanted cells and allows them to grow and mature in the bone marrow space.   


5. Logistics for the patient – The transplant center must sort out all the logistics and paperwork for the patient such as the availability of insurance coverage, and all the various forms that need to be completed before undergoing a major medical procedure.


6. Arranging the collection date – While the patient is being prepared, Gift of Life is arranging all the logistics for the donor, including when they are available to take time off from work, if and where they need to travel to donate, as well as the schedule at the collection center to ensure when beds and staff will be available for the donation to take place.


7. Collection day for the donor – Finally, the donor arrives at the collection center and the procedure goes forward. There is additional paperwork for Gift of Life to complete, and it must all be double-checked to ensure everything was done correctly and accurately.


8. Transport of the stem cells to the transplant center – Once the stem cells or marrow are collected, the bag of cells will either be cryopreserved (frozen) until the recipient is ready for transplant, or Gift of Life hands the cells off to a specially-trained courier who will hand carry the product to the patient’s transplant center anywhere in the world.


9. Transplant takes place – Once the cells arrive at the transplant center, the transplant is typically completed quickly as an infusion of the cells into the veins of the recipient, similar to a blood transfusion.


10. Patient engraftment – Over the days, weeks, and months following the transplant, the stem cells or marrow will integrate into the patient’s body, finding their way into the bone marrow space in the center of the large bones of the body. The donor cells begin to produce new marrow, blood cells and immune system cells. This process is called engraftment. Once engraftment is far enough along, the patient can return home to continue their recovery.

All these steps need to be completed without error and in complete compliance with all national, state, and local standards and regulations to ensure both donor and recipient safety.

Can anything be done to speed up the process?

Gift of Life is working on a novel program to identify a set of “super donors,” those who have common genetic profiles and therefore can match a large number of recipients. We plan to collect and cryopreserve their cells in a biobank before there is ever an identified need for them. That would allow us to provide lifesaving stem cells to transplant recipients in a matter of days, not weeks.

What should I expect if I’m ever a match for a patient?

If you get that miraculous call that you’ve matched a patient – Congratulations! You may have the chance to save their life! 

You’ll work with a Donor Services coordinator to give you all the information needed, and to help arrange any necessary blood tests to confirm you’re the best match for this patient, and to answer all your questions. You’ll have a medical exam, and then, if you’re chosen by the transplant center as “The Donor,” your coordinator will schedule your donation date.

As described above, this process usually takes some weeks, so you’ll have the chance to arrange time away from classes or work. There is no cost to you for being a donor; Gift of Life will make all the travel, transportation, and hotel arrangements for you and one companion, and you’ll receive a meal stipend.

A year after you donate, you may have the opportunity to meet the person you saved! Both parties must agree to exchange information for this to proceed. If your patient lives outside the United States, a different timeframe may be followed.

Our website is full of information about matching with a patient, the donation process, and hundreds of stories from our donors about their donation experience and their meetings with the people whose lives they have saved.

As always, if you have questions, please reach out to us at 800-962-7769 or info@giftoflife.org.