Who becomes a bone marrow donor. Bone marrow donation: sampling procedure, types and possible consequences. Do donors get paid for donated bone marrow?

Donation, of course, is a noble and necessary thing. But everything that concerns human body is not nearly as easy as it seems. Each of the types of donation carries a certain amount of risk, both for the donor and for the recipient (recipient). There are still many misconceptions around donation.

Recipient risk Many people worry that when they donate blood, they can be infected with some kind of disease. In fact, the risk of being infected belongs to the recipient of the blood. After all, disposable instruments are used for taking blood. And the water recipient receives blood, he should be much more afraid of infection. In difficult births, donor blood can be used, few people know that only the blood of a non-smoker and a person who has not drunk alcohol for at least two days is suitable for newborns. Otherwise, a small citizen risks getting poisoned. The greatest risk is in those who have a weakened immune system, even the presence of donated blood antibodies can cause disease.

Donor risk It should be noted that when correct surrender blood Negative consequences for the donor are minimal. Many donors, on the contrary, believe that donating blood improves their immune system. Weakening can only be caused by frequent blood donations. But when taking blood, health workers pay attention to both the frequency of donation and the weight of the donor. 99% of contraindications for blood donation are associated with the risk to the recipient.

Organ donation

Heart and cornea transplanted only from dead man. Therefore, only the recipient is at risk. The problem that doctors are fighting is the rejection of foreign tissues. Even a seemingly perfectly matched organ can be rejected by the body as a foreign body. To reduce the risk of rejection, the patient is given immunosuppressive drugs, which increases the risk of catching any disease. In addition, the transplanted organ could be poorly examined. Despite all the risks of surgery and further engraftment, transplantation is the only way out for many patients.

Kidney donation

For the recipient, the risks are no different from those of other organ transplants. For the donor, the main risk is associated with the operation itself. Kidneys - paired organ Therefore, the functions of one kidney are easily taken over by another. A person with one healthy kidney has the same stomach as he would live with two, but, statistics recent years disappointing. Find a person with healthy kidneys becomes more and more difficult. For transplantation operations, a close relative is usually taken as a donor, then the chances of success of the operation are higher.

bone marrow donation

For donation bone marrow brothers and sisters are best suited, but sometimes a donor has to be found through donor services.

Donor risk Only 2-5% of stem cells are taken from a donor. This amount is enough to provide new system hematopoiesis in the recipient. This procedure is quite painful, and after it can be accompanied by pain in pelvic bones a few days. But for the donor, there is no danger to life, moreover, the donor can return home in the evening. The overwhelming majority of complications are caused by the donor's reaction to anesthesia, and not by the process of taking the bone marrow.

Risk to the recipient A bone marrow transplant is a complex procedure for the recipient. Before transplantation, the patient undergoes a course of chemotherapy and radiation to destroy his own bone marrow and cancer cells. The main task of the hospital staff is to prevent the donor bone marrow recipient from catching slightest disease. The patient is also prone to bleeding. During recovery, frequent blood transfusions are needed. The donor risks less than the recipient.

Who needs a bone marrow transplant and why? Who can become a donor? Bone marrow transplantation (BMT) is used primarily in the treatment of oncological diseases such as leukemia, lesions lymphatic system, neuroblastoma, as well as with aplastic anemia and a number of hereditary blood defects.

Statistics

What is bone marrow?

Bone marrow - the most important body hematopoietic system, carrying out hematopoiesis - the process of creating new blood cells to replace dying and dying. Bone marrow is located in the bones and does not differ from blood in appearance. Only it contains stem cells, which are responsible for immunity and the production of white blood cells, platelets and red blood cells.

How to become a donor?

Any person aged 18 to 45 weighing 50 kg or more can become a donor, if he did not have hepatitis B and C, tuberculosis, malaria, HIV, no oncological disease or diabetes.

1 way:

2 way:

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How to become a bone marrow donor

Today, more than 350,000 Russians suffer from leukemia, a cancer of the blood. About 60% of them need a bone marrow transplant, while no more than 20% of them have a compatible related donor. Therefore, most patients need to find an unrelated donor.

The transplant procedure itself is paid for by the state, but the search and activation of a donor costs a lot of money. If a donor is found in Russia, then the patient will have to pay more than 350 thousand rubles for the examination of the donor and the preparation of the transplant, and the search and procurement abroad costs more than 1.4 million rubles. That is why it is so important to replenish the Russian register of bone marrow donors. We will talk about what bone marrow is, how it is obtained and how to enter the donor registry.

Despite the fact that becoming a donor is simple and safe, as of September 2018, the domestic database has only a little over 84 thousand applicants. There are more than 32 million of them in the international registry, but for many patients, the bill for 1.5 million for search and activation is an unbearable amount. Meanwhile, after BM transplantation, most patients recover and are able to return to normal life!

Who needs a bone marrow transplant

The bone marrow (BM) is an organ of the hematopoietic system that is located in the bones and visually resembles blood. It contains stem cells responsible for immunity, renewal and restoration of the hematopoietic system. Therefore, donor CM is used in the treatment of oncological diseases, such as leukemia, lymphoma, neuroblastoma, etc. The patient is injected with healthy donor stem cells, and they restore the body's ability to normal hematopoiesis, destroying the tumor clone. Sometimes this is the only way to save a person's life.

Who can become a bone marrow donor

Anyone between the ages of 18 and 45 weighing over 50 kg can take a CM if they themselves do not have oncological diseases, diabetes, infections that can be transmitted through blood transfusion (HIV, hepatitis B and C), tuberculosis, malaria, as well as severe chronic diseases.

To check how suitable the bone marrow of another person is for transplantation, a blood test is performed to determine the HLA genotype - a set of genes responsible for tissue compatibility. An HLA-identical related donor can only be a sibling. In some cases, for health reasons, transplantation can be performed from the parents.

A suitable donor may be stranger sometimes even from another country. You can find this in special registers.

Donor registers

Today, registries of potential CM donors exist all over the world. The largest - the IBMTR International Registry - contains data on 32.7 million donors from all world databases. Speaking about individual countries, the national register of Germany stores information about 8 million, the USA - about 9 million, Russia - a little more than 84 thousand donors.

How to donate bone marrow

There are two ways to pass the CM:

1. Under anesthesia, the donor is made several punctures in ilium(exfusion), and with the help of a hollow needle and syringe, BM is taken from the pelvic bones. A couple of days after the procedure, the donor may feel unwell and weak. Discharge from the hospital occurs 1-2 days after exfusion. The donor's CM is restored in two weeks.
2. 3 days before harvesting, the donor is injected with a special drug that stimulates the active release of stem cells into the blood. In the hospital, blood is taken from his vein, passed through a special device that separates stem cells, and returned through a vein in his other arm. The procedure lasts about 5-6 hours.

How to become a donor

To become a donor, you need to come to the National Research Center for Hematology or Invitro and donate blood for typing, the results of which will later be entered into the unified donor database of the Russian Federation. If your set of genes matches that of the recipient, you will be invited to the hospital for a talk with doctors, additional examination before preparing the CM.

You can donate blood for typing from 8.00 to 14.00 at the address:
New Zykovsky passage. d.4,

What conditions require bone marrow donation?

The bone marrow, or rather its component - hematopoietic stem cells - is necessary for violations of the patient's hematopoiesis and immunity. First of all, these cells are needed for malignant formations blood - various kinds of leukemias and lymphomas. Bone marrow transplantation also helps in the treatment of immunodeficiency (congenital and acquired), bone marrow diseases, metabolic disorders and autoimmune diseases.

Bone marrow transplantation does not guarantee that the patient will fully recover, but will significantly increase his chances of prolonging his life.

How to become a bone marrow donor?

First of all, close relatives of the patient are asked to become a bone marrow donor: the probability that their cells will suit the patient is the highest. However, sometimes incompatibility arises, then they look for a person whose material will not cause immune reactions and will not lead to rejection.

Potential donors are entered into a special register, but first they go through a typing procedure, during which it is determined who their cells can suit (a set of genes responsible for compatibility is established - the HLA phenotype). To do this, a person just needs to donate blood. Note that anyone aged 18-50 who does not have a history of serious diseases (hepatitis, cancer, HIV, and others) can become a bone marrow donor.

What is the procedure for selecting bone marrow from a donor?

If a person entered in the national donor registry turned out to be suitable for bone marrow transplantation (compatibility with a particular patient is checked), he is invited to come to the stem cell collection procedure. This is done in two ways: the material is taken from the pelvic bones or from the blood.

Collection of bone marrow from the pelvic bone

The donor is hospitalized the day before the procedure, it is performed under general or epidural anesthesia. At the time of the operation, several punctures are made to the donor, from which the bone marrow is taken. The donor donates approximately 1000 ml of fluid: this is only about 5% of the entire share of the bone marrow. The procedure takes about half an hour.

Bone marrow sampling through blood

A week before the procedure, the donor begins to take a special drug that causes the release of stem cells into the blood. The essence of the operation is the separation of the donor’s blood: a person’s blood is taken from a vein, it is driven through a special device, with the help of which hematopoietic stem cells are separated. The rest of the blood is returned to the body through a vein in the other arm. This method takes much longer - up to 5-6 hours.

Consequences after the bone marrow sampling procedure

Physicians assure that healthy person donation does not threaten anything: the body will fully recover after a while. However, small backfire for well-being are still available. If bone marrow sampling was carried out through the pelvic bones, a person may experience ailments associated with anesthesia (nausea, dizziness), in addition, he may feel bone pain for some time. It takes about a month for the body to fully recover.

The selection of bone marrow through the blood can cause the same unpleasant sensations as with ARVI: headaches and joint pain, sometimes the temperature rises. The body recovers within two weeks.

IN rare cases possible complications: anemia, infectious diseases. Note that donors are provided with special insurance, so in case of problems free treatment guaranteed.

Do donors get paid for donated bone marrow?

Official medicine assumes that donation is a voluntary assistance of a person to those who suffer, therefore no cash payments is not provided, although the funds engaged in the search for donors may encourage him with some nice bonuses. Unofficially, the price, according to some reports, can reach several thousand euros.

Patients spend significantly more on treatment. Thus, in Germany, the price of a bone marrow transplant operation and follow-up in the clinic reaches 210 thousand euros, in Israel - up to 240 thousand dollars. Over $20,000 has to be paid to find a suitable donor. In Russia, the search is paid for by charitable foundations, and according to the Podari Zhizn Foundation, 800-1000 sick children need bone marrow donors every year.

Not everyone can become a donor, since it is necessary to prepare for this procedure in advance - bad habits, undergo a medical examination to detect diseases unacceptable for donation, refuse potent drugs, have a weight of more than 50 kg and be over 18 years old.

In the Russian Federation there are hundreds of blood sampling points for donation to those in need, for example, only in Moscow it can be donated in 32 specialized institutions. Donors can donate blood for free, or they can earn on this one, but not much:

1. When donating blood of a rare type, subject to the fulfillment of all requirements before its collection, the donor will earn 800 rubles for a volume of 450 ml, the frequency can be 1 time in 60 days.
2. For the delivery of the liquid in the blood composition - plasma, the payment will already be 1,500 rubles for an amount of 600 ml, the procedure, if desired, is repeated every month.
3. When taking erythrocytes from a donor, a monetary reward is paid in the amount of 2,500 rubles.

Before the procedure, to determine the suitability of a donor, you will need to submit a few drops of biomaterial for analysis, which are not subject to payment.

After the first delivery, the biomaterial is sent to the quarantine zone for 6 months. The donor during this time must come to repeated procedure already paid. If this does not happen, then the material will be destroyed, and in order to be able to earn money on donation, you will have to start all over again. Employees of the medical institution are required to notify the person about the return visit.

There are other methods of compensation for a voluntary donation action - a free balanced lunch at the expense of the state to restore lost energy after a voluntary act of blood donation, as well as the right to 2 paid days off in case of working at a budgetary enterprise. And most importantly, this is the first step to the title " Honorary Donor Russia”, which became the most relevant in 2018.

It is important that after the first donation of blood or its components, the donor can only count on a free lunch or compensation for it, payment will begin after the second arrival at the reception point.

For desperate people, another way to make a living by donating is to sell your own kidney on the black market. Officially, this procedure is prohibited both in our country and around the world. IN private clinic the cost varies from $600 in the outback to $5,000 in the capital. Undoubtedly, the operation for the patient will cost many times more, but the volunteer himself will receive the indicated money.

It should also be taken into account that the fee for bone marrow donation in our country is not provided, it is voluntary and anonymous. Therefore, the main volunteers for this procedure are close or relatives of a sick person.

Donation fee abroad

Abroad, in Europe and the USA, a certain “Code of Ethics” for donors was issued several years ago, which states that the procedure is purely voluntary, and is not aimed at a measure of enrichment, but at helping other people. Therefore, in developed countries, neither for blood, nor for plasma, nor for bone marrow, donors from the state receive a penny, only a free buffet for recuperation and a trinket for memory.

True, in some private clinics, if an urgent transfusion is needed or there is a lack of antibodies, payments for a volunteer can range from $15 to $25.

In the black markets for the sale of human organs abroad, there are completely different earnings. So, a person who decides to voluntarily part with one of the kidneys can receive $ 20,000 - $ 30,000, provided that he is suitable for health reasons. And in the poor countries of Asia and Africa, residents are ready to part with their organs for an amount not exceeding $ 1,000.

What is an "Honorary Donor"?

With multiple blood donations, a person can receive an Honorary Donor of Russia certificate. Not everyone can be awarded this title - you need to donate blood at least 40 times or at least 60 times - plasma or red blood cells. The state provides various benefits to such people. In 2018 they are as follows:

1. Annual monetary compensations, which are tied to the subsistence minimum in Russia and amount to 5% of it.
2. Possibility of obtaining free tickets for a spa vacation in the Russian Federation, moreover, out of turn.
3. Discounts in pharmacies on medicines prescribed by a doctor.
4. Possibility of obtaining budget food in specialized institutions on a free basis, or replacing it with cash payments.
5. Paid time off at the place of work on the day of delivery of the biomaterial.

Interesting from BBQcash:

The Ministry of Health of the Russian Federation plans to introduce more significant benefits for honorary donors, such as discounts on the provision of a mortgage loan, an increase in monetary allowance upon retirement, as well as a decrease in the retirement age, as well as early granting of the title "Veteran of Labor" with all the consequences social benefits from this.

What documents are required to receive the title of "Honorary Donor of Russia"?

The Ministry of Health of the Russian Federation has the right to confer the title of "Honorary Donor". To start the procedure, you must:

1. Provide a passport of a citizen of the Russian Federation.
2. Prepare in advance and bring all the information from medical institutions proving the required number of donation procedures performed.
3. Prepare an application for granting the title and submit it for consideration.

After passing all the formalities, the documents are considered, and the person receives his certificate, which confirms the right to use the above benefits.

In the human body, red bone marrow performs the function of blood renewal. Violations of his work entail serious illness, the number of which is constantly growing. So there is a need for a transplant of this element of the body's system, which creates a demand for donors. The difficulty of the situation becomes finding the right person.

Previously, this procedure was not performed, but bone marrow is now being transplanted to treat or improve survival in leukemia (blood cancer), lymphoma, aplastic anemia, multiple myeloma, breast cancer, ovarian cancer. The main task of the donor is to donate hematopoietic stem cells, which become precursors in the formation of all other components of the blood. For their transplantation, there are two main types of procedures - allogeneic and autologous transplantation.

Allogeneic transplant

This type involves the sampling of bone marrow from a person that is as close as possible genetically to the patient. As a rule, they become a relative. This donor transplant option can be of two types:

autologous

This procedure consists in the fact that pre-harvested healthy stem cells are frozen and planted in the patient after high-intensity chemotherapy. With a successful procedure, a person quickly restores the body's immune system, the process of hematopoiesis normalizes. This type of transplantation is indicated in case of remission of the disease or when the disease does not affect the bone marrow:

• with a brain tumor;
• ovarian cancer, breast cancer;
• lymphogranulomatosis;
• non-Hodgkin's lymphoma.

How to become a donor

In order to be included in the bone marrow donor registry, a person must be 18-50 years old. Other requirements: no hepatitis C and B, malaria, tuberculosis, HIV, cancer, diabetes. To be entered into the database, you must donate 9 ml of blood for typing, provide your data and sign an agreement on entering into the register. If your HLA type is compatible with any of the patients, you will need to undergo additional research. Initially, you will need to give your consent, which will be required by law.

Some people are interested in how much donors are paid. In all countries, such activity is “anonymous, free and gratuitous”, so it is impossible to sell stem cells, they can only be donated. Sometimes you can find information with a call to find a donor to help a child with a promise of a reward. In this case, it is possible to sell the material in individually, state structures do not approve and do not support such transactions.

Who can be a donor

A potential donor is selected according to one of 4 options. They differ from each other, but they pursue one goal - the maximum degree of compatibility. Suitable for transplant:

How is bone marrow taken?

Bone marrow sampling is performed in the operating room general anesthesia to minimize the chance of injury and reduce discomfort. A special needle with limiters is inserted into the femur or iliac pelvic bone, where the maximum amount of material needed is. As a rule, repeated punctures are performed to obtain the desired amount of fluid. There is no need to cut the fabric or sew it up. All manipulations are carried out with a needle and syringe.

The required amount of donor bone marrow depends on the size of the patient and the concentration of stem cells in the taken substance. As a rule, 950-2000 ml of a mixture of blood and bone marrow are collected. It seems that this is a large volume, but it is only 2% of total substances in the human body. Full recovery this loss will occur in 4 weeks.

Donors are now also being offered the apheresis procedure. To begin with, a person is injected special preparations that stimulate the release of bone marrow into the blood. The next step is similar to plasma donation. Blood is taken from one arm, and special equipment isolates the stem cells from other components. The fluid cleared from the bone marrow returns to the human body through a vein in the other arm.

How is the transplant

Before the transfer procedure, the patient undergoes an intensive course of chemotherapy, the radical radiation necessary to destroy the diseased bone marrow. After that, pluripotent SCs are transplanted using intravenous drip. The procedure usually takes one hour. Once in the bloodstream, donor cells begin to take root. To speed up the process, doctors use drugs that stimulate the work of the hematopoietic organ.

Consequences for the donor

Every person, before becoming a bone marrow donor, wants to know about the consequences of the operation. Doctors note that the risks during the procedure are minimal, more often associated with the individual characteristics of the body's reaction to anesthesia or the introduction of a surgical needle. In rare cases, an infection has been recorded at the puncture site. After the procedure, the donor may experience side effects:

• pain at the puncture site;
• bone pain
• nausea;
• muscle pain;
• increased fatigue;
• headache.

Contraindications

Before you become a voluntary bone marrow donor and undergo an examination, you should familiarize yourself with the list of contraindications. They largely intersect with the points on the prohibition of blood donation, for example:

• age over 55 or under 18;
• tuberculosis;
• mental disorders;
• hepatitis B, C;
• autoimmune diseases;
• malaria;
• the presence of HIV;
• oncological diseases.

Video about bone marrow donation

Reviews

Elena, 33 years old

I really wanted to become a donor, but I am terrified of bone punctures and pain. It turned out that you can donate material along with blood. To do this, you need to take the medicine for a while, and the stem cells enter the bloodstream. Next, blood is taken along with him. The procedure lasts longer, but there is no need to pierce the bones and general anesthesia.

Alena, 27 years old

Before becoming a bone marrow donor, I was very worried that it would be very painful. I often saw in TV shows how this procedure goes, how much it hurts people. Then it turned out that it was a bone marrow puncture, and its sampling is less painful. When taking medications before the delivery, there was a feeling of fatigue, after the procedure everything went away.

Kirill, 30 years old

When I was looking for how to become a voluntary bone marrow donor, I did not find information on whether it is possible to refuse already being in the database. As it turns out, you can. If for some reason you are unable to complete the procedure, you can refuse. I have been on the donor register for 2 years now, until I received a call.

The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on individual characteristics specific patient.

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