Afterward...
What are the long-term consequences of bone marrow and
peripheral blood stem cell (PBSC) donation? Specifically,
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Is there any intermediate or longer-term impact on the
health of a bone marrow donor, especially one who donates more than
once?
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Are there intermediate or long-term effects on a PBSC
donor from taking filgrastim?
Marrow donation is a common procedure now, yet there have not
been the research studies on long-term effects we would like to see.
One German study of 40 donors noted "no
long-term effects" observed in followup. We have not found other
longitudinal studies.
Interestingly, the one area that has received the most
analysis is the psychological impact of marrow donation:
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A University of
Pennsylvania study measured the psychological impact of bereavement on
sibling bone marrow donors. Prior to donation, all donors reported high
levels of self-esteem, mastery, happiness, and satisfaction. Following
donation, donors whose sibling-recipient died felt less positively
about the value of their donation over time. However, they experienced
improvements in self-esteem, happiness, and satisfaction compared to
donors whose sibling-recipients were still living.
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A French study
evaluated the psychological impact of the donation experience of 22
donors. The results showed a wide range of outcomes in terms of
personal reaction, attitudes toward donation, relationships with family
members, and awareness of the risks involved.
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A University of Massachusetts
nursing study of the donation experience is based on interviews with 12
donors. The study revealed that the donors had little or no reluctance
to donate and would do so again. The donors felt "deep personal
satisfaction and gratitude." Stressful aspects on the donation
experience included unanticipated pain after donation, negative outcome
of the transplantation, and relationships with the bone marrow
recipients' families. The study recommends improvements in education
prior to donation as well as the monitoring of the donor's
psychological well-being throughout and after the procedure.
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A study of 37
Chinese bone marrow donors illustrates the significance of culture in
the donation experience. In this case, the study authors found the
following perceptions of the donation experience: association with bad
and good fortune; religious concerns associated with complete bodies;
barriers posed by the extended family; fulfilling personal identities
linked to perceptions of altruism, reciprocity and generosity; and the
differences between the expectations and realities of the donation
experience. They note "the act of body fluid donation cannot be
isolated from the expectation of life-long immersion in the dominant
social and cultural processes of the time." Donation in China is viewed
as more of a self-fulling act than a social act. The study suggests
providing more educational and emotional support to donors.
An issue for anonymous donors is whether you will
be able to
contact your recipient and get updates on their health after your
donation. How contact happens depends on the policy of the transplant
center. Often there is a one year waiting period before any
communication is permitted between the donor and recipient. Keep
in mind that not all recipients who receive a marrow transplant
survive. Also, the recipient must agree to the contact.If you are open
to contact with the recipient, check with the transplant team about
their policy.
 
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