Your lymphocyte donation via Apheresis

What is a lymphocyte donation?

Lymphocytes are the white blood cells found naturally in your blood stream. They are usually donated when a patient needs a top-up of these cells after their stem cell transplant – it’s known as a ‘DLI’ or ‘DLC’ and happens in about 15% of patients. This could be part of the original treatment plan, or it could happen if your recipient’s disease returns and their body needs an extra boost.

If you have been asked to donate your Lymphocytes for research please have a read through here to find out your cells may be used.

How does the donation work?

Donating lymphocytes is very similar to peripheral blood stem cell (PBSC) donation. However there are some key differences. Here are the steps you can expect:

What to expect before your donation: 

If you are donating to a patient you will need another medical before your donation to ensure you're still able to donate. You may not need to have all the tests repeated as some of them may still be valid from your first donation. At your medical they will assess if you require a central line, you can read more about central lines here.

For a lymphocyte donation unlike PBSC you do not receive a course of injections prior to the donation.

If you are donating for research, it is likely you will need some repeat tests before your donation to ensure you are still eligible to donate. Your Coordinator will explain this to you.

What to expect during your donation: 

Donating lymphocytes is a common procedure and takes around 4-5 hours, the procedure is always one day only unlike PBSC which can occur over two days. It happens on an outpatient ward, and a nurse will be available to support you during your donation. There may be other donors or patients receiving treatment on the ward with you.

• During the procedure, you will lie on a bed or reclining chair as a specialised needle is inserted into each arm, using cannulation. Cannulation is when a catheter is inserted into your veins in order to be able to have continuous blood flow. If you have donated blood before, this method is very similar. This enables blood to be drawn from your arm and passed into the apheresis machine. At your medical your veins will be assessed to ensure the needles used are the appropriate size for good blood flow. 
• Inside the machine your lymphocytes are filtered out along with some plasma, which the cells are suspended in, and collected in a special bag. The red blood cells and remaining plasma are then put back into your bloodstream through the second needle.
• You’ll be asked to stay fairly still throughout the donation so when you need to use the toilet you'll need to flag a nurse to assist you. You cannot be disconnected from the machine once your donation has started so this will have to happen bedside with the necessary steps taken to assure your privacy.
• The apheresis machine uses an anticoagulant to process your cells, this can sometimes cause a tingling sensation in the mouth. If you experience this please flag it to a nurse and they will provide you with treatment to offset this side effect.

What to expect after your donation: 

Recovery can look different for everyone, however we find donors are usually recovered after 1 - 2 days. After you have donated our donor follow-up team will contact you to provide our post donation care and ensure you have a full recovery, to find out more about this, please view our post donation care advice page. 

Will you be asked to donate again? 

Often the amount collected from this donation is more than enough for the patient, and so their hospital may cryopreserve a portion to use if the patient needs them again in the future. 

However there is a chance you’ll be asked to donate again, though for your safety we would limit the amount of times you would donate. We want to remind you that you are under no obligation to do so, and we are very grateful for everything you’ve already done. 

Organising your medical and donation

Your Donor Provision Coordinator will arrange everything for medical and donation, including transport and accommodation. 

When will you donate? 

Your coordinator will let you know the date the researchers have requested, or the dates which the patient’s hospital have requested in line with the patient’s treatment. These requested dates are what is ideal for the hospital, but they’re not set in stone and can be moved to suit your availability too.

If donating for a patient, you’ll be booked in at the Collection Centre in the weeks leading up to your donation for your medical, and one day for your lymphocyte donation. You can find out more about what to expect at your medical here.

Your medical and donation will happen at the same collection centre, with the medical usually being 2-4 weeks before the donation. The medical should take a maximum of 2 hours, during which time you will have an ECG, a blood draw and be asked to provide a urine sample. You will also be counselled for the procedure, be asked about your general health, any family health history and be asked to sign the consent forms.

If you are donating for research, you will not need an additional medical, but it is likely you will need some repeat tests before your donation to ensure you are still eligible to donate.

If you have any questions, please contact your coordinator.

Where do you donate? 

We try and find the most convenient Collection Centre for where you live, and your coordinator will chat through the locations that are available for the proposed dates. 

We currently have Collection Centres in London, at the London Clinic in Marylebone, UCH in Euston and King’s in south London, as well as in Sheffield, Manchester and Oxford.  

Please note: We cannot guarantee a booking at your preferred hospital.

Travelling to your donation 

We cover all travel costs for you and a companion. We can also provide a hotel close to the Collection Centre if you have to travel a long distance. Any travel or food costs you have can be reimbursed in line with our policy. Find out more about our donor expenses.

Precautions to take ahead of your donation

If you are feeling unwell

If you are feeling unwell, have a temperature or there is a change in your health – please your Donor Provision Coordinator know as soon as possible, if it is an emergency and out of hours please call 07710 599161.

Sexually Transmitted Infections (STIs)

If you’re sexually active, particularly with a new partner or more than one partners, please take extra precautions to prevent any risk of contracting an STI.

If you become sexually active with a new partner in between your medical and donation, please inform us.

If an undiagnosed infection is transmitted to the patient or research cells it could have serious consequences. The NHS has lots of advice on safer sex:  https://www.nhs.uk/live-well/sexual-health/sex-activities-and-risk/

Pregnancy

If you’re sexually active, please use a reliable form of contraception until after your donation. Pregnant donors are not able to go ahead with their donation as this could be a risk to the baby.

A note on Hep E

Over the last few years there has been a rise in the number of people acquiring Hepatitis E in the UK. Most healthy people are symptomless, and the infection clears by itself, but it can be very risky if transmitted to a patient or research cells.

The most common way for people to catch Hepatitis E is through eating raw or undercooked meat (especially pork products) and shellfish, so from now until after your donation, please be very careful with what you eat.