What is a bone marrow transplant?
Bone marrow transplantation consists of the transfusion of progenitor cells taken from the donor's bone marrow in the patient to replace the recipient's diseased cells. In this way, new healthy cells develop in the patient.
These transplants are indicated in congenital diseases or those developed after birth, such as acute or chronic leukemias, spinal cord disorders and immunodeficiencies. Although bone marrow transplantation is generally discussed, in fact what is done is an infusion of progenitor cells from the donor's marrow into the patient.
What is bone marrow?
Bone marrow is a soft-consistency tissue that fills the inside of long bones and the spongy cavities of bones. It is in this tissue that there are progenitor cells, that is, with the ability to differentiate and give rise to any peripheral blood cell, the so-called progenitor/stem cells. These cells constantly renew themselves by maintaining a relatively constant number throughout life.
Can you only donate bone marrow once?
No. The bone marrow is a tissue that regenerates quickly, so it is possible to make more than one donation.
Who pays for the bone marrow donation process?
All medical procedures involving donation are borne by the patient's health subsystem, as well as travel and other non-medical costs. The only costs that may be charged to the donor are those relating to the time required for the donation process.
Can a donor withdraw from the process after learning that he or she is a match for a patient?
yes. As a volunteer, the donor has no legal obligation and can withdraw at any time for various reasons. However, you should bear in mind that a change in attitude at the end of the process can be fatal for a person who is preparing for transplantation.
How likely is it to find a compatible donor?
Considering all these approaches, approximately 80% of all patients have at least one potential compatible donor.
However, not all patients for whom an identical donor has been identified make it to the transplant stage.
What is umbilical cord blood?
Umbilical cord blood is blood in the vessels of the placenta and umbilical cord, usually rejected but can be collected after birth.
Umbilical cord blood is rich in cells that, because they are in a very immature state, have a high capacity for division, self-renewal (hematopoietic progenitor cells) and have the potential to give rise to all the constituent cells of the blood.
What are hematopoietic progenitor cells?
Haematopoietic progenitor cells are the stem cells with the potential to give rise to all types of blood cells. This type of cells is present in bone marrow, peripheral blood, and umbilical cord blood.
What is umbilical cord blood used for?
The main objective of umbilical cord blood donation is to perform a transplant of any patient in the world who needs it and who is compatible.
This type of cells is currently used in the treatment of patients with different types of cancer, such as leukemias, lymphomas and other diseases associated with the blood or immune system.
If the harvest is not used for transplantation, it may be used for other therapeutic alternatives or for research, and it may be rendered unusable if it does not meet the minimum technical requirements.
Can cord blood be used if the disease manifests itself in adulthood?
The amount of cells that can be harvested in a unit of cord blood is relatively small. In the case of older and heavier children, the stored units do not have a sufficient number of cells, making it necessary to use other compatible donors.
The search for a compatible donor is possible by searching databases shared by international banks (which store units for allogenic use), similar to what happens with the databases of potential bone marrow donors (CEDACE).
Who can donate cord blood to the Public Cord Cell Bank?
Any pregnant woman with no history of behaviors or risk factors or congenital diseases can be a candidate for cord blood donor. The donation and collection process for the Public Umbilical Cord Cell Bank (BPCCU) is carried out between the 28th and 35th week of pregnancy.
Where can I donate cord blood?
The collection of umbilical cord blood for the Public Umbilical Cord Cell Bank is carried out in authorized hospitals or maternity hospitals and with which the Public Umbilical Cord Cell Bank has entered into collaboration protocols. Harvesting is carried out as long as it is technically possible and does not pose any risk to the newborn or the mother.
Currently, the donation of umbilical cord blood to the Public Umbilical Cord Cell Bank occurs in the following maternity hospitals (collection units):
- Centro Hospitalar de São João – Porto
- Júlio Dinis Maternity Hospital – Centro Hospitalar do Porto
- Pedro Hispano Hospital – Matosinhos Local Health Unit
- Hospital Prof. Doutor Fernando Fonseca
Does cord blood donation affect normal birth procedures?
No. Cord blood donation is completely safe for both mother and newborn and does not alter any procedures associated with childbirth.
Donation takes place only after birth and does not require blood samples to be taken from the baby (a maternal blood sample will be requested after delivery).
Do I have to pay to donate cord blood?
No. The donation to the Public Bank of Umbilical Cord Cells does not translate into any charges for the donor, and is therefore completely free.
The Public Umbilical Cord Cell Bank is responsible for the costs associated with the collection, processing, analysis, cryopreservation, and storage of the donated units.
When donating umbilical cord blood to the Public Umbilical Cord Cell Bank, is the unit always stored, making it available for transplantation?
Yes, if the harvested unit meets all national and international quality and safety requirements.
The umbilical cord blood unit intended for transplantation must contain a sufficient number of cells for the transplant to work, as well as preserve its grafting capacity.
If the unit does not meet the characteristics required by these standards, it may be used in research or rejected.
If the pregnancy is with twins, can cord blood be donated to the Public Umbilical Cord Cell Bank?
No, since the volume of blood obtained from each placenta is lower than that usually collected in individual births and insufficient to perform transplants on patients who require this therapy.
Is it possible to collect blood for both the public and private banks at the same time?
It is not possible to donate simultaneously to the public and to the private. In addition to the limited volume of blood collected at each birth and not allowing to obtain a unit with enough cells to be used in transplantation of hematopoietic parents, the Public Umbilical Cord Cell Bank does not accept donations shared with other banks.
The criteria for donating to private banks are different from the criteria for donating to the Public Umbilical Cord Cell Bank.
Can healthcare providers donate cord blood?
Not all healthcare workers are excluded as donors. However, some functions performed by these professionals are considered risky because they have contact with patients or biological products potentially infected with agents not detectable by currently available laboratory tests.
How is the privacy of the mother and the baby affected after cord blood donation?
The Public Umbilical Cord Cell Bank keeps all associated data records confidential.
Is the pregnant woman informed whether the unit has been preserved or not?
The donor is not told to whom the blood components were transfused, or the organ donation, where the donor's family does not know who the organ recipients were.
However, the donor will be contacted if changes are detected in the tests carried out on the unit and in the donated samples, or if additional tests are required.
Source: Portuguese Institute of Blood and Transplantation (IPST)