Bone marrow harvest: Information for people donating their bone marrow to a family member : University College London Hospitals NHS Foundation Trust

This page explains what bone marrow is and how it is collected and donated to your family member who needs a transplant. Here, ‘family member’ means a sibling, parent or child. If you have any questions about the procedure, please talk to your doctor or nurse.

Bone marrow is the soft, spongy tissue found inside large bones like the hip, breastbone and long bones. The most important part of the bone marrow are stem cells. These are early-stage blood cells that can grow into three main types of blood cells:

Red blood cells, which carry oxygen to all cells in the body
White blood cells, which help fight infections caused by bacteria and viruses
Platelets, which help blood to clot and prevent bleeding.

bone marrow and the blood cells it produces_Lymphoma Action copyright.png

Image produced by Lymphoma Action and reused with permission

Once the blood cells are fully mature, they are released into the bloodstream. You may hear your healthcare team refer to stem cells as haematopoietic progenitor cells (HPC).

The liquid part of the bone marrow is extracted under general anaesthetic using a special needle and syringe. This process is known as a bone marrow harvest. You will be asleep throughout the procedure and you will not feel any pain.

As a bone marrow donor, you will have various tests and a detailed medical check before the donation. This is to make sure that you are healthy enough for the procedure and general anaesthetic.

You will need to fast before the bone marrow harvest. This means no eating for six hours before the procedure. But you can drink plain water until two hours before. We will give you detailed instructions on how to fast.
We will examine you and review your health history. This may include any operations you have had, adverse reactions to medicines, and known allergies.
We will ask if you smoke or drink.
You will have a chest X-ray to check your lungs.
You will have an electrocardiogram (ECG) to check your heart’s rhythm.
We will take your urine sample to check for infections.
You will have several blood tests. These include tests for:
- full blood count
- blood type
- liver and kidney function
- viruses, including HIV, Hepatitis B, Hepatitis C and syphilis.

These tests help us find any underlying conditions or infections that could affect you or your family member who will receive your bone marrow. Please drink plenty of water before your blood tests. This helps to make your veins easier to find.

In the UK, the law requires us to check for viral infections before collecting and storing the bone marrow. The results of the viral blood test are valid for 30 days. If your bone marrow harvest is delayed, we may need to repeat this test.

We will review your family health history.
We will ask you some questions about your personal life. For example, what your marital status and occupation is.
We will review any medicines you may be taking and advise if any of them need to be stopped for the donation.
If you are a female of child-bearing age, you will need to take a pregnancy test before the donation. We will let you know when you need to take the test and we can also give you a pregnancy test kit.
We will ask you to avoid raw or undercooked meat (especially pork) and shellfish until after your donation. This will lower your risk of getting Hepatitis E. In recent years, more people in the UK have been getting Hepatitis E. Most people don’t have any symptoms, and the infection usually goes away on its own. But it can be harmful if passed to someone with a weak immune system.
You will stay in hospital for two nights during your bone marrow harvest so pack an overnight bag to bring with you.

If we have any concerns, even small ones, about your health and ability to donate, you will need extra tests to make sure you can be a donor. If these tests show that you cannot donate, this is to protect your health and safety.

If you need more tests to check your health, we will talk to you about it and make the arrangements. Some or all of these tests may be done through your own GP. We will send a letter to your GP with all the necessary details.

Travelling abroad

We will ask you not to travel abroad from the time of your medical check until two days after donating your bone marrow. This is because you may need extra travel-related blood tests which can interfere with your donation schedule.

If you have already made plans, please talk to your clinical nurse specialist (CNS).

As with any procedure, there are some risks of having a bone marrow harvest. They mostly relate to the use of general anaesthetic. But anaesthesia is generally very safe, especially for healthy people who have been cleared for the donation.

Here are some common side effects of having general anaesthetic. They affect between 1 and 10 in 100 people:

Soreness or bruising on the back of your hand or arm where a cannula (thin plastic tube) was inserted into a vein. A cannula is used to give you anaesthetic and fluids while you are asleep.
Sore throat from the tube used to help you breathe during the procedure.
Damage to teeth (especially caps, crowns or veneers), and slight bruising to your lips or tongue due to the breathing tube.
Muscle pains, headaches, feeling sick or being sick, which may be caused by the anaesthetic drugs. Painkillers and anti-sickness medicines can help to relieve these symptoms.
High temperature, low blood pressure or a slower heart rate. Your healthcare team will monitor you closely and manage these side effects if they happen.

Serious complications, such as problems with the heart, lungs, or allergic reactions during or right after anaesthesia, are very rare. They affect less than 0.01 in 100 people.

The anaesthetist, the doctor who puts you to sleep for the procedure, will stay with you the whole time. They will monitor your heart rate, blood pressure and oxygen levels. They will also adjust your anaesthetic drugs and give you fluids if needed.

There are also risks specific to the bone marrow harvest. They are rare and your healthcare team will tell you how likely these risks are for you:

Infection
Temporary bone, nerve or tissue damage where the needle is inserted. This may cause tingling or numbness around your hip or buttocks, or long-lasting back pain.
Short-term anaemia which may require a blood transfusion.

The doctor and clinical nurse specialist (CNS) will ask you to sign a consent form to undergo bone marrow harvest. This will confirm that you agree to have the procedure and understand what it involves.

They will review the donation process and go over the consent form with you before you sign. They will also answer any questions you may have so please ask if anything is unclear.

It is very important that you are sure about donating before your family member starts their pre-transplant conditioning treatment. This treatment will begin 10 to 14 days before you donate your bone marrow. After this treatment, they will need your bone marrow stem cells to survive. So, it is critical that you are fully committed to donating before they start their pre-transplant treatment.

You will be admitted to the hospital the day before your procedure. After the procedure, you will stay overnight for monitoring.
Your bone marrow harvest will take place in the operating theatre in the main hospital building (the Tower).
You will lie on your stomach during the procedure. The anaesthetist will place a cannula in a vein in your hand or arm to give you the anaesthetic.
Once you are asleep, the doctor will make a few punctures in your skin with a needle. They will then use a special syringe to reach the back of your hip bone and extract the bone marrow.
They will draw out about 1 to 1.5 litres (less than 2 to 2.5 pints) of blood and marrow, depending on your size. Your body will keep making new bone marrow, which will take about three weeks to replenish.
The bone marrow harvest takes 30 to 60 minutes to complete. You will not need any stitches. After the procedure, you will be taken to the recovery room, where the nurses will monitor your blood pressure, oxygen levels and heart rate. Once the anaesthetic wears off and your condition is stable, you will return to your hospital room.

Here are some side effects you may experience after the procedure:

Soreness and bruising around the sites where the needle was inserted in the hip area.
A dull ache and stiffness in the lower part of the back. We will give you pain relief for this.
Feeling very tired while your body makes new bone marrow.
Feeling sick – we can give you anti-sickness medicine to help with that.

These symptoms can continue for up to three weeks, but most people feel better within seven to 10 days. You should be able to return to your usual day-to-day activities within that time too.

You should be able to go home the day after your bone marrow harvest. If you need more time to recover, you may need to stay in hospital an extra night. A relative or friend should take you home.

Please take seven to 10 days off work and avoid energetic physical activity during that time. If your job is physically demanding, you may need to take more time off or start with lighter duties when you go back.

If you have any questions, or if you are worried about your symptoms, please contact us.

Please contact us if you notice any of the following:

signs of infection, such as raised temperature, body aches and feeling shivery or generally unwell
signs of anaemia, such as shortness of breath, palpitations, fatigue (extreme tiredness).