Imagine this. You’re hooked up, watching the blood in one arm draw into a thin, clear tube, which feeds directly into an apheresis machine. As you study the device, you notice an output tube similar to the one in both your arms, filtering what turns out to be your blood stem cells. Another tube protrudes from the machine, and you trace its journey back into your other arm. A complete cycle of a blood stem cell donation is in progress. After more than four hours, the nurse, who has looked after you for the day, turns the machine off. By the end of the day, you’ve watched your stem cells filter into a bag, never to see them again. Your mind wanders to the person about to receive these blood stem cells. What are they doing right at this moment? How are they feeling? How are the blood stem cells given to them?
A blood stem cell transplant for the recipient is relatively straightforward. It’s very similar to a blood transfusion. The bag containing the blood stem cells is put into the recipient’s drip, either attached to their arm or, in most cases, by a central line in their chest or upper arm and is slowly infused into their bloodstream. This procedure is the same whether you donate by peripheral blood stem cells or bone marrow donation.
As soon as your stem cells enter the recipient’s bloodstream, they travel to the recipient’s bone marrow, located within the hollows of their bones. They then start the task of making new blood cells. In medical terms, this is called engraftment. While more blood cells are being created, the recipient will struggle to fight off infections due to the lack of white blood cells removed during chemotherapy, which takes place before transplant. Often the recipient’s red blood cells and platelets, necessary for oxygenation, reducing anaemia and uncontrollable bleeding, will fall, resulting in blood transfusions. The recipient is carefully monitored for the next 100 days, with some isolation precautions. If needed, they will also be treated with antibiotics.
Once engraftment occurs, the recipient will start to regain their resistance to infections. This marks the start of the recipient’s recovery process. It also signals that the donor’s blood stem cells haven’t been rejected by the recipient’s body and have taken over the production of new blood cells. At this point, the recipient is likely to have a new blood type, the donors! Once the recipient’s blood count starts to rise and they feel well enough, they can leave the transplant unit at the hospital. A recipient will be asked to stay close to the hospital for regular checkups, which often means living away from home. It can take up to six months for a recipient’s blood count to return to normal. It can take a year or longer for the immune system to fully recover, so recipients continue to take precautions to prevent infection.
As a donor, your day on the apheresis machine may feel like a distant memory after a few months. The first few months after transplant are critical for the recipient, and news of your recipient’s progress may not be available for several months. If there is an update about your recipient, the Donor Support Team can let you know. Often donors feel connected to their recipient, and it is normal to wonder how they are going post-transplant. However, it’s important to note that not all outcomes are positive. It’s up to you whether you want to know how your recipient is going.
What you go through to donate is an incredible and generous gift. It means so much to the recipient and their family as they embark on their post-transplant journey. Know this. If you do go on to donate or have donated, you are giving someone a second chance at life.
To learn more about the patient journey and how it works in tandem with your journey as the donor, visit the interactive donor/patient timeline.
Also, while you’re at it, check out Aleigha’s story after she underwent a blood stem cell transplant.