“I got sick when I was 13 years old. The doctors said that the only solution was a bone marrow transplant: it was necessary to find a compatible donor,” says, on the occasion of the Xmas Lunch of Admo - Bone Marrow Donors Association, Filippo , 21 years, struck in 2011 from acute lymphoblastic leukemia. But the compatibility is extremely rare: between brothers and sisters occurs only once in four (25%), and never between parents and children or between aunts, uncles and cousins. Between individuals non-relatives, only one person in 100 thousand might be the right one. “My sister was not genetically compatible - says - and so my data were included in the international database. In 2012, thanks to a donor German fully compatible, I could do the transplant. Unfortunately, however, it is not gone well but my donor was so helpful that he decided to help me for the second time. Now, after almost 7 years I can say that the second transplant saved my life.” It is a real team game: it must not be forgotten that, if on the one hand there is the donor, on the other hand there is the patient for whom the arrival of the bag is, in a sense, the arrival of life. Donate with a withdrawal from bone marrow, The bone marrow, not to be confused with the spinal cord, is a tissue comprising hematopoietic stem cells, i.e. cells that are capable of reproducing blood cells: red blood cells, white blood cells and platelets. But how is the donation done? There are two ways: the bone marrow can be taken directly from the basin, precisely from the iliac crest to the rear, or from the peripheral blood. In the first case the donor is under general anesthesia or epidural. The intervention lasts about 45 minutes and after collection the donor is kept under control for another 24-48 hours before being discharged. In any case, the bone marrow regenerates naturally in a little over a week. Donate with a blood test In the second case, instead, you made a withdrawal of blood but, since the hematopoietic cells are found in bones, we need to make from the bones to arrive in the blood. So in the 5 days prior to donation, the donor is given a drug that is a ‘growth factor’. The objective is to promote the growth of stem cells in the bone marrow and to facilitate their transition from the bones to the peripheral blood. “This type of sampling, termed apheresis, uses a machine that is a separator cell,” explains Nicoletta Bags , head of the laboratory of Histocompatibility/IBMDR Hospitals Galliera. “The blood drawn from one arm through a sterile circuit, arrives in a centrifuge where the stem cells are isolated and collected in a bag, while the rest of the blood is reinfused in the opposite arm. This type of withdrawal lasts about 3-4 hours and it is the method of donation is more frequently used in about 8 cases out of 10”. How to Register Donors, “This year we exceeded 49 thousand donors registered in the Registry of bone Marrow Donors - says the Bags - and there have been about 280 donations in Italy. Of these, for the first time a significant number, almost 80, were made abroad. In addition, the number of transplants from donors are not family members continues to climb”. To join the Registry, just a simple saliva tests: painless, fast and secure. With a small spatula that has small teeth, the donor rubs the inside of the cheek from both sides to pick up a lot of mucous. At this point, making a flush with a special mouthwash that is a stabilizer that is phone able to collect all the cells of the oral mucosa. The material is then shipped as soon as possible in the laboratory which is done typing, that is, the genetic analysis. Almost all of them can give: you just have to have between 18 and 35 years of age, weigh at least 50 kg and enjoy good health. If compatible, it is invoked once entered in the Register of Donors, if you have the case in which the genetic profile is compatible with that of a patient waiting for a transplant, you will be contacted within 14 days. The donor identified is subjected to various tests to assess his state of health to decide whether or not to proceed with donation. “As soon as I turned 18 I enrolled to the Registry - tells Emma , a student at bologna, 22 years of age - and after a few months I was called in because I was found to be compatible with a patient while waiting for a transplant. I donated with a simple blood test and after a few hours I returned home. This is truly a minimal amount of effort that can totally change someone's life. Many people ask me if I know the person to whom I donated the marrow, but I do not think that it makes sense to know name and surname of the patient: it is just a form of personal gratification and is very far removed from the concept of donation”. The Italian law enforces anonymity, but there is the possibility of a contact between the donor and the patient, which can take place through the centre of the donor or the transplant center. The absence of geographical limits, “The transplantation from a non-family donor, " explains Massimo Cardillo , Director of the National Transplant Centre - has as a limit their compatibility. For this, the more donors, the greater is the probability of finding the ‘suitable’. The bank is the world, that is, all of the international registries are linked: the biggest one is German. Our has a population of about 500 thousand subscribers”. If the donor is Italian is better. “The reason is solely genetic,” explains Fabio Ciceri , President of the Italian Group Trapiantologi Bone Marrow. “The chromosomes you inherit, and those italians have their own identity: for this, find a compatible donor can offer better clinical results. The donor – states Ciceri – is a true brother to the genetic, like a family member, it makes possible the transplantation, the only chance of cure for serious diseases of the blood. Each donor can then make the difference”.
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