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Bone marrow is where your body makes blood cells. Marrow is essential in creating:

  • red blood cells that transport oxygen
  • white blood cells that fight infections
  • platelets that help your blood clot

Some people live with conditions that stop their bone marrow from working as it should. These people often need a transplant to survive. To help, donors can give:

In 2020, there were more than 23,000 bone marrow or cord blood transplants in the United States. In most cases, the person received a transplant of their own blood. In more than 4,100 cases, the donor was a family member. In a little over 4,800 cases, the blood came from an unrelated donor.

People who register as donors agree to donate either bone marrow or PBSC, depending on the recipient’s needs. Bone marrow donations require surgery. PBSC donations do not need surgery. More than 85% of donations are PBSC.

This article will review both processes as well as the benefits and risks of donating.

Donating bone marrow is relatively low risk for the donor. It can save the life of a recipient.

About 18,000 people each year need a bone marrow or cord blood transplant to treat a life threatening illness. Most of those people — about 70% — do not have a suitable donor in their family and must find a match through a voluntary registry, like Be The Match.

The need is especially great for people of certain races or ethnicities. People who need a transplant are more likely to match with someone from the same race or ethnicity.

The Health Resources and Services Administration has expressed a special need for donors from the following backgrounds:

  • American Indian or Alaska Native
  • Asian
  • Black or African American
  • Hispanic or Latino
  • Native Hawaiian or other Pacific Islander
  • people with multiple racial backgrounds

Bone marrow donation can take place privately, where you directly contact a care center or transplant center caring for someone you know. It can also happen through voluntary registries that seek suitable donors for people in need of a transplant.

What makes an ideal match?

The ideal match is when a donor’s human leukocyte antigen (HLA) and those of the recipient are similar. HLA is a protein on your cells.

Every person on the Be The Match registry undergoes testing for six basic HLA markers. Several potential donors who match the recipient at this basic level undergo additional testing to find the best HLA match.

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To join a voluntary registry, you must meet several medical guidelines. These include not allowing people with certain conditions to donate bone marrow. The guidelines may change depending on the registry.

All registries have an age requirement. The National Marrow Donor Program requires you be between 18 and 40 years old to donate. They prefer donors be no older than 35.

Depending on the registry, some conditions that may affect your eligibility include:

  • autoimmune diseases
  • a history of cancer
  • HIV or AIDS
  • heart disease
  • liver disease, including cirrhosis and hepatitis B or C
  • chronic kidney disease
  • asthma
  • diabetes
  • osteoporosis
  • severe allergies to medication or latex
  • blood disorders, such as hemophilia
  • mental health conditions that require you take lithium

Consult with a specific registry to view their complete eligibility criteria. Even if you meet the medical guidelines and can join the registry, you may not be able to donate to a specific recipient due to your medical history.

If you’re on a voluntary registry, they will contact you if you’re a potential match. The registry will ask for current health information. You will usually have to participate in more testing to see whether you are the best person to donate marrow to this recipient.

If you are the best match, you will receive more information about the donation procedure. You will sign a consent form and have a physical exam.

Bone marrow

Bone marrow donation takes place in an operating room. You will receive general or local anesthetic to minimize any discomfort. A surgeon will use a needle to remove liquid bone marrow from either side of your pelvic bone.

You will stay in the hospital for a few hours after the donation, or perhaps overnight for observation.


PBSC donation involves a procedure called apheresis. During apheresis, blood comes out of your body through a needle in one arm. A machine removes the blood-forming cells from your blood and returns the rest of the material back to your body through a needle in the opposite arm.

A PBSC donation may happen in one session for up to 8 hours or two sessions of 4 to 6 hours.

For the 5 days before your PBSC donation, you will receive injections of filgrastim. This drug increases the number of blood stem cells in your body. Possible side effects of filgrastim include bone pain and headaches. They go away when you complete the injections.

How long does it take to recover after donating bone marrow?

Most donors recover from either bone marrow or PBSC donation within a few days, typically returning to everyday activities within 1 week.

According to 2016 research, the median recovery time for bone marrow donation was 16 days. The median recovery time for a PBSC donation was 7 days.

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You’ll be under local or general anesthesia during the donation process. The potential risks of donating include the risks that come with anesthesia.

Complications are rare but may include:

  • anesthesia reactions
  • transfusion reactions
  • infection
  • nerve damage
  • muscle damage

Side effects of general anesthesia may include:

  • sore throat from the breathing tube
  • nausea
  • vomiting

Side effects of local anesthesia may include:

  • decrease in blood pressure
  • headache

Common side effects of donation include:

  • back pain
  • hip pain
  • muscle pain
  • fatigue or tiredness
  • trouble walking
  • headache
  • bruising

Risks specific to donating bone marrow include damage to the bones, nerves, or muscles in your hip area.

Side effects more specific to PBSC donation include chills and lightheadedness.

Side effects in related donors

A 2019 study found that donors who were related to the recipient had an increased risk of pain and other side effects.

The cause was unclear, but study authors suggested that different approval processes for related donors may be a factor. They also suggested that related donors may be more likely to accept greater risk.

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Is donating bone marrow painful?

You’ll be under general or local anesthesia during bone marrow donation. You should not feel any pain during the procedure.

Afterward, you may experience muscle, back, or hip pain, or headache. Muscle pain may last for a few days or weeks.

Do you get paid to donate bone marrow?

Donating bone marrow is voluntary. Unlike plasma donation, you do not get paid to donate bone marrow.

The process is not necessarily expensive for donors. Be The Match covers expenses for donors, including travel, accommodation, and meals.

Can I donate bone marrow more than once?

Your body takes about 4 to 6 weeks to completely replace the stem cells you donated. You should be able to donate again after this time.

According to 2018 research, people who donate a second time have a similar experience to the first time they donated. But the yield of stem cells wasn’t as high the second time around.

Still, it’s rare to find a second match. According to the Asian American Donor Program, the chances of an unrelated match are between 1 in 100 and 1 in 1 million.

Do you need to register to donate bone marrow?

If you want to volunteer for anyone who may be a match for your bone marrow, you can join a registry like Be The Match. You can also speak with a healthcare professional, especially if you know someone who may need your marrow.

You can arrange private bone marrow donations through the recipient’s transplant doctor or transplant center.

Can men who have sex with men donate bone marrow?

Donors must meet medical guidelines. There are no medical guidelines at Be The Match that stop men who have sex with men or LGBTQIA+ people from joining the registry.

If they are a match with someone who needs a marrow transplant, there will be further discussions about medical history.

Can I decide not to donate after I’ve joined a registry?

You always have the option not to donate. But let the registry know of your decision as soon as possible so they can keep looking for another suitable donor.

Can I meet or talk with the recipient of my bone marrow?

Be The Match allows anonymous contact between bone marrow donors and recipients during the first year after the transplant. They may meet or otherwise communicate without anonymity after at least a 1-year waiting period.

For this to happen, both the donor and recipient must agree to share personal contact information.

Where can I register?

Here are some common registries where you can sign up to be a bone marrow donor:

  • Be The Match, the National Marrow Donor Program
  • Gift of Life, an international registry
  • DKMS, initially a German program that now includes the United States and five other countries
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A donor program or private center may ask you to donate either bone marrow or PBSC. The two are very distinct procedures. Below is a summary of how the two compare:

Donating bone marrowDonating PBSC
Proceduresurgery under anesthesiaapheresis
Preparationno special preparation5 days of filgrastim
Duration1–2 hours of surgery; full day in hospital8–12 hours over one or two sessions
Hospital staypossible overnight stay for observationoutpatient procedure
Median recovery time16–20 days7 days

Bone marrow and PBSC donation are important in saving the lives of people who need transplants. The two forms of donations have very different procedures. The recipient’s doctor will determine which type of donation is needed.

You can donate privately to a loved one or join a volunteer registry. Donor safety is important, and both types of donation are relatively low risk.