There are four steps to the donation process: Initial Recruitment, Confirmatory Typing, Markup, and Donation. The second step, confirmatory typing, is repeat tissue typing to confirm the compatibility of the donor and patient before a bone marrow or peripheral blood stem cell (PBSC) transplant and is an important process for potential donors to go through; only 30% of donors are called to go through this step.
When a registered donor is asked to go through Confirmatory Typing (CT), they have been selected as a possible match for a patient in need of a bone marrow or PBSC transplant. Essentially, a doctor searching the bone marrow registry has determined that a certain individual could be a match for their patient and is requesting further testing of the volunteer donor. When this occurs, a Gift of Life Donor Services Coordinator contacts the donor to inform them that they have been chosen and asks them to consider giving a blood sample which will be analyzed to ensure that the person is a suitable match for the patient in need and will be screened for markers of infectious diseases.
Before consenting to a blood draw, the volunteer will have a brief information session with the donor services center to learn about what is required of them at this step and to answer any questions they may have. A consent form authorizing testing must be signed, and a health history questionnaire must be completed.
Once these documents are received, a blood draw will be scheduled by a member of the Donor Services team at a lab that is convenient to the donor’s work or home. There are restrictions concerning the shipping and receiving of blood products, so the sample must be drawn in the morning on specific days. Every effort will be made to accommodate schedules so that the appointment will be as convenient as possible. On average, it takes four to six weeks for the blood test results to come back. Based on those results, the transplant center will select one of three options: the donor will be requested to donate, the donor will be released, or they will be placed “on hold.”
A potential donor can be released for a variety of reasons. It is possible that a more suitable donor has been found or the patient is not yet ready to receive a transplant. Though a donor may not be selected to move forward for the patient they were tested for, they may still be called for another patient in the future. Sometimes, though, a donor is placed “on hold.” This means that the transplant center is not ready to release them, nor do they want to request them as a donor yet. A donor can be placed on hold between three and six months, and a Gift of Life Coordinator will keep in contact to give updates on their progress.
If the individual is requested to donate, it means they are a match! What does it mean to be a match? A person has two types of tissue markers that are compared in the matching process; when the transplant center looks at the match level, they are looking at how similar the tissue types of both patient and donor are. If enough of the markers match, then the donor is asked to donate. They will go on to the next step, Markup, and will participate in an information session to further educate them on the donation process. If they consent to donating bone marrow or PBSC, they will be asked to sign a form indicating their intent to proceed with the donation and will then undergo a physical exam.
Though only approximately 8% of donors called for confirmatory typing are asked to proceed to the next step, confirmatory typing is still vitally important. “CT is the first step in a very important process. We would never find matches without this vital step,” remarks Kristin, a Gift of Life Donor Services Coordinator. When a donor goes through confirmatory typing, they are not alone. Donor Services staff makes sure to answer any questions a person might have and are great to work with. If you are ever called to go through this step, they will be there to guide you through.
Jay Feinberg | Gift of Life Blog
