Hematopoietic stem cell donation

Allogeneic hematopoietic stem cell transplantation is now an important treatment for numerous diseases. Donation of hematopoietic stem cells, either through bone marrow (BM) harvesting or peripheral blood stem cell (PBSC) collection, is a well-established and generally accepted procedure. The BM is aspirated from the posterior iliac crest under spinal or general anesthesia, and common side effects include fatigue and local pain. PBSC collection requires 4-6 days of G-CSF injections and leukapheresis 1-2 times. Common side effects of these procedures include bone pain, fatigue, and headache. The side effects of BM and PBSC collections are mostly transient and well tolerated. Severe adverse events are uncommon in healthy donors. At present, there is no definitive evidence to show that the stem cell donation increases the risk of marrow failure or cancer development. Nevertheless, all donors must be carefully evaluated and fully informed before donation. Donors must be able to provide informed consent without being coerced or pressured. Donors and graft products must be examined for potential agents to avoid transmitting infections and other diseases that may jeopardize donor's health during stem cell collection or recipient's well being after transplantation. Understanding the potential physical and psychological complications of stem cell donation and factors that may increase risks is very important to ensure that transplantation physicians maintain positive attitude in conducting this benevolent practice.