The stem cells can be obtained in two different ways. The choice depends on the indications given by the specialist and it reflects the patient’s and the donor’s characteristics.
The first and older way of obtaining HSC consists in bone marrow grafting from the posterior iliac crest and it requires hospitalization of the donor. The donor will be treated in the nearest qualifies centre where HSC are obtained after general or epidural anesthesia in about 45 minutes. The procedure has minimal risks which are connected with anesthesia and modality of grafting.
The quantity of bone marrow blood obtained from the pelvic bones varies according to the size of the donor and the necessity of the patient but it is usually around 0,7 and 1 L. After the donation the donor is kept under scrutiny as a precaution for a few hours and then discharged with an indication to rest and take it easy for 4-5 days. The bone marrow subtracted from the donor regenerates itself in 7-10 days. The donor could manifest a slight pain in the area where the grafting has taken place, but it is self limited and vanishes in a few days. The donor will then be followed for a year post donation to keep his health condition under control.
The second way to donate HCS is to harvest them from peripheral blood after a specific stimulation with hematopoietic growth factors.
During the last few years, there has been a rise in usage of the new transplant protocols which use HSC harvested from the peripheral blood stream after adequate stimulation with growth factors.
In this case, a specific drug is administered 3-4 days before blood is grafted. The drug is a growth factor that allows stem cells to divide at a faster rate and facilitate their mobilization from bone marrow to the peripheral blood stream; the drug is given with a subcutaneous injection. Hematopoietic stem cells are obtained after blood cell separation procedures: the blood, taken from the veins in an arm, is passed through a sterile circuit and placed in a centrifuge where the cellular fraction needed for the transplant is separated from the blood and transferred in a container while the rest of the blood is returned to the patient via infusion.
There are no additional counter indications for this method but donors with difficult venous access are excluded.
The symptoms caused by the pharmacological stimulation of the donor include: slight fever, headache, bone pains and fatigue and they promptly end after the procedure. Throughout the whole world thousands of donors have donated HSC using this method and no serious side effects have been reported.
The donor is monitored for 30 days after donations to avoid any possible side effect. The donor may also be contacted up to 10 years post donation as a follow-up.
It is clear that neither of the two donation methods produce organic damage.