How much marrow will be taken ? It depends on the patient's weight. In the case of a child, it could be only 300ml, whereas if the recipient is an adult, the amount could be over 1,000ml. Standards are set for the total amount extracted from the donor based on the donor's weight. It also must be less than 5% of the donor's total bone marrow stem cells. Bone marrow stem cells usually replenish themselves in about a month. The donor can lead a normal life even during that time. What are the risks to the donor ? We cannot rule out the possibility of the donor's health being affected by the bone marrow extraction. However, generally donors recover quickly. Between 1959 and 1996, more than 60,000 extractions were carried out in the world (according to the International Bone Marrow Transplant Registry records) of which two resulted in death, one in Italy and one in Japan. Because extraction is done under anesthesia, there is always the possibility of a fatal accident, as is the case in any such surgery. However, the recent introduction of monitoring equipment for anesthesia has greatly improved safety. Is it acceptable to refuse to be a donor after registration ? Volunteer donors are acting entirely of their own free will. After the donor registration, donors are asked for their consent at every step of the process until they are selected as donor candidates. During that time they can say no at any time. However, once the donor gives the final consent and signs his or her name in agreement, the patient begins preparation for the transplantation. The patient's marrow is killed by chemotherapy and/or radiation, and he or she becomes totally defenseless. Should the donor withdraw at this stage, it would be fatal for the patients. Therefore, withdrawal is not permitted after the so-called "final consent". Can the donor select the recipient ? The Bone Marrow Program has to be impartial. The donor, therefore, cannot select the recipient. Can the donor meet the recipient ? Direct communication between the donor and the patient is forbidden in order to operate the marrow program in an entirely fair manner, as well as to protect the privacy of both the donor and the recipient. However, it is possible to send anonymous letters through the Japan Marrow Donor Foundation. Who is responsible for the medical expenses incurred during marrow donation ? All medical expenses for marrow donation such as physical examinations and hospitalization are free. However, the transportation fees for the registration are borne by the donor. Will there be any compensation for lost work-days ? Because marrow donation is a favor based on the donor's goodwill, there is no compensation for unpaid wages due to health checkups and hospitalization. In the case of government workers, and in some companies, "Marrow Donor's Leave" is being introduced. Will there be any compensation for the donor if there should be any complication arising from bone marrow extraction ? If this were to occur, the Marrow Program would pay up to 100,000,000 yen. The payment is uniformly 100,000,000 yen for death and between 3,000,000 and 100,000,000 yen for resulting injury. Have there been any cases where donors cannot donate after registration ? Volunteer donors who are healthy at the time of registration can develop problems later on. At each stage the prospective donor's health is checked and if any problems are discovered, the donor is told that he or she cannot be a donor. What is DNA typing ? It is a method of examining the gene alignment of HLA in order to affirm the exact HLA compatibility. This is already being done in Europe & USA, and also in our JMDP to improve the accuracy of the examination and to expedite the process. Why are we not told our HLA types ? To preserve the fair and impartial management of the marrow program the volunteers cannot be told their HLA types. Is it possible that the information registered could be use for any other purposes ? None, whatsoever. Why do you require the family's consent ? Since registered donors are adults, consent from their family members is not required legally. However, there have been quite a few cases where the donors were obliged to withdraw at the final stage because of family objections. That is why we ask for the consent of family members as well as the donor. How many patients want transplantation ? Each year about 6,000 people develop illnesses like leukemia, of which 2,000 want transplantation. Of those, 1,000〜1,500 are expected to ask for the help of the marrow program. If you have any other questions, please contact the Japan Marrow Donor Foundation. Free Dial 0120-377-465