Information for the selected stem cell donor

You have been selected as a stem cell donor for a seriously ill patient. There are over 40 million members in stem cell registries worldwide, and among them, your stem cells are the best match for this patient. The purpose of this information is to explain the stem cell donation process. It is important that you understand what you’re committing to, so please read through the information package carefully.

Donation is always voluntary

Stem cell donation is always based on a voluntary desire to help an unknown patient. You and the patient will remain anonymous to each other throughout the process. Please consider your decision to donate carefully and make it independently. You can withdraw from the donation process at any time and do not need to provide a reason. However, it’s important to understand the consequences of withdrawal for the patient. About ten days before the scheduled donation, the patient begins intensive treatments to prepare for the transplant. These treatments destroy the patient’s own bone marrow and immune system. If a donation is canceled within two weeks of the planned date, there is a significant risk that the patient will die. Therefore, if you decide to withdraw, please do so as early as possible, before the patient’s conditioning treatment begins.

Medical examination

You will undergo a comprehensive medical examination, including infection tests (HIV, hepatitis, syphilis). A stem cell registry coordinator will contact you to schedule the appointment. You’ll visit a physician at Meilahti Hospital in Helsinki and have lab tests, including a blood sample and an ECG. You may eat and drink normally before the tests. The physician will ask you about your health and explain the donation process in detail, answering any questions you might have. Please reserve a full day for the health examination. Public transport is recommended.

About a week after the examination, the doctor will contact you with the results and the decision on your eligibility to donate. The stem cell registry will then reach out to coordinate the donation arrangements.

Two different methods of donation

There are two ways to donate stem cells: from the bloodstream or directly from the bone marrow. You have already been informed of which method is preferred for this patient. The donation process depends on the method. Currently, over 80% of donations are done from the bloodstream, and less than 20% from the bone marrow.

Donations take place either at Meilahti Hospital in Helsinki or at Turku University Hospital. There are experienced collection teams in both. Regardless of the method, the process takes about a week, and you’ll usually be on sick leave during that time.

Donation from blood stream

For donation from bloodstream, the process starts with daily injections of a white blood cell growth factor, typically administered at the collection hospital. The growth factor is normally present in small concentrations in the human body and is safe for the donor. You’ll likely stay in the collection city during this time. Injections are given for 4–5 consecutive days under the skin of the lower abdomen. The growth factor stimulates your bone marrow to release stem cells into the bloodstream. Each injection visit takes about 2 hours.

The actual donation occurs on the fifth (and possibly on the sixth) day of injections. You’ll spend the day at the hospital, where the blood is drawn through a cannula in one arm, passed through a machine that separates the stem cells, while the rest of the blood is returned through a cannula in the other arm. The procedure lasts about 5–6 hours. If not enough cells are collected the first day, a second session follows the next day.

You’ll lie in a quiet room throughout the procedure, with a trained nurse monitoring the process. Because of the cannulas, you won’t be able to bend your arms. The nurse will assist as needed.

If veins in the elbows aren’t suitable, a central venous catheter may be placed in a vein in the neck area. This is done by an anesthesiologist using local anesthesia, with your consent. If a central line is used and a second collection is needed, you’ll stay overnight in the hospital.

A small number of donors don’t produce enough stem cells with the initial growth factor injections. In that case, the doctor may recommend an additional medication or a switch to bone marrow donation. In such rare case, the doctor will agree on the procedure with the donor.

After the collection, the doctor checks your condition. If all is well, you can go home. Collection from bloodstream doesn’t significantly reduce your hemoglobin, as red cells are returned. Side effects of the injections may include bone pain, flu-like symptoms, headache, nausea, insomnia, sweating, chills, skin rash, or fever. These usually resolve quickly, and regular painkillers are effective.

Growth factor therapy has been used safely for years and causes no known long-term side effects. You’ll be on sick leave during the collection and for a few days after – about a week in total.

Donation from the bone marrow

If donation is from the bone marrow, it takes place at Meilahti Hospital in Helsinki. You’ll arrive the day before, undergo lab tests, meet a doctor, and stay overnight. The collection is done under general anesthesia. Doctors extract bone marrow from your pelvic bone using needles. The total volume collected is 300–1200 ml. The bone marrow regenerates quickly and the collection does not impair your body’s ability to produce blood.

You may feel fatigued from anesthesia and lower hemoglobin, but you’ll receive iron supplements. Other temporary symptoms may include sore throat, dizziness, nausea, or pain at the injection sites. Needle marks may leave small, temporary scars. Total recovery usually occurs within two weeks.

Risks are minimized by the medical examination. Bone marrow donation does not weaken your immune system or reduce the effectiveness of vaccinations. You’ll be on sick leave for about a week and return home the day after the procedure.

Donation from the blood or bone marrow?

The choice of donation method depends on the patient’s condition. The doctor will explain the risks and discuss the selected method. The type of transplant can significantly impact the patient’s outcome. For example, bone marrow is usually used for children to reduce risk of graft versus host disease. Adults with aggressive leukemia often receive transplants from bloodstream, as they offer stronger therapeutic effects despite the increased risk of graft versus host disease.

Stem cell transfer to the patient

Your donated stem cells will be transplanted in a hospital, in Finland or abroad. They must be transplanted quickly after collection. Once in the patient’s body, the cells migrate into the bone marrow and start producing healthy blood cells, giving the patient a chance to recover. Stem cell transplantation is the patient’s last treatment option. Without it, they are unlikely to survive. Among adult patients, 50–70% recover thanks to a transplant. For children, the success rate is over 90%.

How to prepare for donation

Before your donation, do not donate blood, maintain excellent hand hygiene, and avoid contact with people with a cold. Refrain from getting new tattoos, piercings, acupuncture, or traveling to high-risk areas. If in doubt, contact the stem cell registry. If you fall ill, inform the stem cell registry immediately. If less than two weeks remain until donation and you get sick, outside office hours contact the blood service emergency number.

For female donors, pregnancy is a contraindication for donation. Use effective contraception and take the pregnancy test the stem cell registry sends you.

Avoid aspirin and other medications containing acetylsalicylic acid for two weeks before the donation to reduce bleeding risk. Bring comfortable clothing and hygiene supplies to the hospital. Though everything is planned, delays can occur, so bring something to read, watch, or listen to. A meal is provided on the donation day. For safety reasons, you are not allowed to drive yourself home – use public transport instead.

After the donation

After the donation, if you have fever, signs of infection, or significant bleeding at the injection site, contact the stem cell registry.  A doctor will call you about a week later to check on you. Follow-up blood tests are used to monitor your recovery. You’ll also receive follow-up survey one and five years after the donation. If you have any concerns or questions about your recovery, you can contact the stem cell registry at any time. You can ask the stem cell registry about the patient’s condition approximately one and a half years after your donation.

Second donation

You may be asked to donate again, though this happens to fewer than 10% of donors, sometimes years later. A person can usually donate no more than twice. The patient may need a second transplant if the original one fails or the disease relapses.

The most common repeat donation is white blood cells, without any need of growth factor injections. This process is more straightforward than stem cell donation and takes place in Helsinki or Turku.

Compensation of expenses

The stem cell registry reimburses direct costs of the medical examination and donation – travel, meals, accommodation, loss of income – based on receipts. The coordinator will help you with travel arrangements and provides the necessary forms, including the one for your employer and insurance.

Accommodation is arranged for donors coming from out of town. You can request reimbursement immediately after the medical examination or together with expenses from the donation itself. The costs will be reimbursed even if the stem cell donation is canceled. The reason for cancellation may be, for example, a change in the patient’s condition, which requires the physicians to choose a different course of treatment or schedule.

The donation of stem cells is voluntary, and no remuneration is paid for it. Finnish law also prohibits payment for donations. You will receive a sick leave certificate for both the health examination day and the donation. Regular loss of income due to full-time employment will be compensated based on a statement from your employer. The daily allowance for entrepreneurs is calculated based on their annual pension insurance income.

Insurance issues

The stem cell registry takes care of the donor’s insurance coverage. You do not need to worry about any insurance matters related to the donation procedure. The insurance coverage includes life, medical expenses, and disability insurance.

Consent signature and data protection

All test results and other information concerning you will be treated confidentially, and those processing the data are bound by confidentiality obligations. The recipient of the stem cells will not be given any information about your identity or any other information concerning you. The personal data of stem cell donors is stored in the stem cell registry and is only used internally within the stem cell registry and to ensure traceability as required by law. Before the donation, you must sign a written consent form for the donation of stem cells.

You can contact the stem cell registry at any stage.

Thank you for your willingness to help an unknown patient.