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National Marrow Donor Program

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NMDP , formerly known as the National Marrow Donor Program and Be The Match, is a nonprofit organization founded in 1987 and based in Minneapolis , Minnesota , that operates a registry of volunteer hematopoietic cell donors and umbilical cord blood units in the United States .

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56-416: The NMDP Registry is the world's largest hematopoietic cell registry, listing more than 22 million individuals and more than 300,000 cord blood units. Hematopoietic cells from NMDP donors or cord blood units are used to transplant patients with a variety of blood , bone marrow or immune system disorders. As of December 2020, NMDP had facilitated more than 100,000 transplants worldwide. The NMDP coordinates

112-724: A blood bank . There are many different blood types in humans, the ABO blood group system , and the Rhesus blood group system being the most important. Transfusion of blood of an incompatible blood group may cause severe, often fatal, complications, so crossmatching is done to ensure that a compatible blood product is transfused. Other blood products administered intravenously are platelets, blood plasma, cryoprecipitate, and specific coagulation factor concentrates. Many forms of medication (from antibiotics to chemotherapy ) are administered intravenously, as they are not readily or adequately absorbed by

168-574: A blood transfusion, because the metabolism of transfused red blood cells does not restart immediately after a transfusion. In modern evidence-based medicine , bloodletting is used in management of a few rare diseases, including hemochromatosis and polycythemia . However, bloodletting and leeching were common unvalidated interventions used until the 19th century, as many diseases were incorrectly thought to be due to an excess of blood, according to Hippocratic medicine. English blood ( Old English blod ) derives from Germanic and has cognates with

224-426: A pH below 7.35 is too acidic , whereas blood pH above 7.45 is too basic. A pH below 6.9 or above 7.8 is usually lethal. Blood pH, partial pressure of oxygen (pO 2 ) , partial pressure of carbon dioxide (pCO 2 ) , and bicarbonate (HCO 3 ) are carefully regulated by a number of homeostatic mechanisms , which exert their influence principally through the respiratory system and the urinary system to control

280-535: A registry's success depends on a large number of volunteer donors. The NMDP coordinates hematopoietic cell transplants by managing a worldwide network of affiliated organizations. These organizations (mostly hospitals and blood banks) have established relationships with the NMDP and work together to arrange the collection and transfer of donated bone marrow or PBSCs, or the transfer of previously collected cord blood. When an adult volunteer donor (marrow or PBSC) registers with

336-537: A similar range of meanings in all other Germanic languages (e.g. German Blut , Swedish blod , Gothic blōþ ). There is no accepted Indo-European etymology. Robin Fåhræus (a Swedish physician who devised the erythrocyte sedimentation rate ) suggested that the Ancient Greek system of humorism , wherein the body was thought to contain four distinct bodily fluids (associated with different temperaments), were based upon

392-423: Is blood plasma , a fluid that is the blood's liquid medium, which by itself is straw-yellow in color. The blood plasma volume totals of 2.7–3.0 liters (2.8–3.2 quarts) in an average human. It is essentially an aqueous solution containing 92% water, 8% blood plasma proteins , and trace amounts of other materials. Plasma circulates dissolved nutrients, such as glucose , amino acids , and fatty acids (dissolved in

448-933: Is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells , and transports metabolic waste products away from those same cells. Blood is composed of blood cells suspended in blood plasma . Plasma, which constitutes 55% of blood fluid, is mostly water (92% by volume), and contains proteins , glucose , mineral ions , and hormones . The blood cells are mainly red blood cells (erythrocytes), white blood cells (leukocytes), and (in mammals) platelets (thrombocytes). The most abundant cells are red blood cells. These contain hemoglobin , which facilitates oxygen transport by reversibly binding to it, increasing its solubility. Jawed vertebrates have an adaptive immune system , based largely on white blood cells. White blood cells help to resist infections and parasites. Platelets are important in

504-461: Is arterial or venous blood). Most of it (about 70%) is converted to bicarbonate ions HCO − 3 by the enzyme carbonic anhydrase in the red blood cells by the reaction CO 2 + H 2 O → H 2 CO 3 → H + HCO − 3 ; about 7% is dissolved in the plasma; and about 23% is bound to hemoglobin as carbamino compounds. Hemoglobin, the main oxygen-carrying molecule in red blood cells, carries both oxygen and carbon dioxide. However,

560-418: Is associated with a large number of beliefs. One of the most basic is the use of blood as a symbol for family relationships through birth/parentage; to be "related by blood" is to be related by ancestry or descendence, rather than marriage. This bears closely to bloodlines , and sayings such as " blood is thicker than water " and " bad blood ", as well as " Blood brother ". Blood is given particular emphasis in

616-440: Is bright red, because carbon monoxide causes the formation of carboxyhemoglobin . In cyanide poisoning, the body cannot use oxygen, so the venous blood remains oxygenated, increasing the redness. There are some conditions affecting the heme groups present in hemoglobin that can make the skin appear blue – a symptom called cyanosis . If the heme is oxidized, methemoglobin , which is more brownish and cannot transport oxygen,

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672-407: Is circulated around the body through blood vessels by the pumping action of the heart . In humans, blood is pumped from the strong left ventricle of the heart through arteries to peripheral tissues and returns to the right atrium of the heart through veins . It then enters the right ventricle and is pumped through the pulmonary artery to the lungs and returns to the left atrium through

728-480: Is dangerous to health, and severe hypoxia (saturations less than 30%) may be rapidly fatal. A fetus , receiving oxygen via the placenta , is exposed to much lower oxygen pressures (about 21% of the level found in an adult's lungs), so fetuses produce another form of hemoglobin with a much higher affinity for oxygen ( hemoglobin F ) to function under these conditions. CO 2 is carried in blood in three different ways. (The exact percentages vary depending whether it

784-426: Is formed. In the rare condition sulfhemoglobinemia , arterial hemoglobin is partially oxygenated, and appears dark red with a bluish hue. Veins close to the surface of the skin appear blue for a variety of reasons. However, the factors that contribute to this alteration of color perception are related to the light-scattering properties of the skin and the processing of visual input by the visual cortex , rather than

840-436: Is free to bind oxygen, and fewer oxygen molecules can be transported throughout the blood. This can cause suffocation insidiously. A fire burning in an enclosed room with poor ventilation presents a very dangerous hazard, since it can create a build-up of carbon monoxide in the air. Some carbon monoxide binds to hemoglobin when smoking tobacco. Blood for transfusion is obtained from human donors by blood donation and stored in

896-461: Is in equilibrium with lymph , which is continuously formed in tissues from blood by capillary ultrafiltration. Lymph is collected by a system of small lymphatic vessels and directed to the thoracic duct , which drains into the left subclavian vein , where lymph rejoins the systemic blood circulation. Blood circulation transports heat throughout the body, and adjustments to this flow are an important part of thermoregulation . Increasing blood flow to

952-561: Is known as the Haldane effect , and is important in the transport of carbon dioxide from the tissues to the lungs. A rise in the partial pressure of CO 2 or a lower pH will cause offloading of oxygen from hemoglobin, which is known as the Bohr effect . Some oxyhemoglobin loses oxygen and becomes deoxyhemoglobin. Deoxyhemoglobin binds most of the hydrogen ions as it has a much greater affinity for more hydrogen than does oxyhemoglobin. In mammals, blood

1008-511: Is oxygenated and dark red when it is deoxygenated . Medical terms related to blood often begin with hemo- , hemato- , haemo- or haemato- from the Greek word αἷμα ( haima ) for "blood". In terms of anatomy and histology , blood is considered a specialized form of connective tissue , given its origin in the bones and the presence of potential molecular fibers in the form of fibrinogen . Blood performs many important functions within

1064-488: Is produced predominantly by the liver , while hormones are produced by the endocrine glands and the watery fraction is regulated by the hypothalamus and maintained by the kidney . Healthy erythrocytes have a plasma life of about 120 days before they are degraded by the spleen , and the Kupffer cells in the liver. The liver also clears some proteins, lipids, and amino acids. The kidney actively secretes waste products into

1120-571: The Islamic , Jewish , and Christian religions, because Leviticus 17:11 says "the life of a creature is in the blood." This phrase is part of the Levitical law forbidding the drinking of blood or eating meat with the blood still intact instead of being poured off. World Marrow Donor Association World Marrow Donor Association (WMDA) is an organization based in Leiden , Netherlands , that coordinates

1176-529: The acid–base balance and respiration, which is called compensation. An arterial blood gas test measures these. Plasma also circulates hormones transmitting their messages to various tissues. The list of normal reference ranges for various blood electrolytes is extensive. Human blood is typical of that of mammals, although the precise details concerning cell numbers, size, protein structure , and so on, vary somewhat between species. In non-mammalian vertebrates, however, there are some key differences: Blood

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1232-405: The clotting of blood. Blood is circulated around the body through blood vessels by the pumping action of the heart . In animals with lungs , arterial blood carries oxygen from inhaled air to the tissues of the body, and venous blood carries carbon dioxide, a waste product of metabolism produced by cells, from the tissues to the lungs to be exhaled. Blood is bright red when its hemoglobin

1288-428: The erectile tissue in the penis and clitoris . Another example of a hydraulic function is the jumping spider , in which blood forced into the legs under pressure causes them to straighten for a powerful jump, without the need for bulky muscular legs. Hemoglobin is the principal determinant of the color of blood ( hemochrome ). Each molecule has four heme groups, and their interaction with various molecules alters

1344-482: The pulmonary veins . Blood then enters the left ventricle to be circulated again. Arterial blood carries oxygen from inhaled air to all of the cells of the body, and venous blood carries carbon dioxide, a waste product of metabolism by cells , to the lungs to be exhaled. However, one exception includes pulmonary arteries, which contain the most deoxygenated blood in the body, while the pulmonary veins contain oxygenated blood. Additional return flow may be generated by

1400-479: The urine . About 98.5% of the oxygen in a sample of arterial blood in a healthy human breathing air at sea-level pressure is chemically combined with the hemoglobin . About 1.5% is physically dissolved in the other blood liquids and not connected to hemoglobin. The hemoglobin molecule is the primary transporter of oxygen in mammals and many other species. Hemoglobin has an oxygen binding capacity between 1.36 and 1.40 ml O 2 per gram hemoglobin, which increases

1456-507: The CO 2 bound to hemoglobin does not bind to the same site as oxygen. Instead, it combines with the N-terminal groups on the four globin chains. However, because of allosteric effects on the hemoglobin molecule, the binding of CO 2 decreases the amount of oxygen that is bound for a given partial pressure of oxygen. The decreased binding to carbon dioxide in the blood due to increased oxygen levels

1512-976: The Gift of Life Marrow Registry and the NMDP formed an associate donor registry partnership. In July 2007, the Caitlin Raymond International Registry became an affiliated registry with the NMDP. Caitlin Raymond closed its doors a few years later. The NMDP receives annually about US$ 23 million from the US government through the Health Resources and Services Administration . The US Navy also provides some funding. The program also receives income from donations, from monetary donations from tissue donors for tissue typing (about $ 50 as of 2008), from fees charged for in-depth database searches (initial searches are free, full searches can cost several thousand dollars), and from

1568-527: The NMDP's Be The Match registry, have access to these worldwide volunteer donors, either through the BMDW or through individually arranged agreements. Although based in the United States, the NMDP has worldwide connections. More than 50 percent of the transplants arranged by the NMDP involve either a foreign patient or a foreign donor. The NMDP contracts with seven donor centers (where donors are recruited) outside of

1624-401: The NMDP, their HLA and contact information is sent to the NMDP, which stores it in their computers. The NMDP also has nearly 238,000 cord blood units, listed by HLA type, in its Be The Match registry. These cord blood units are stored at 19 NMDP-affiliated cord blood banks around the world. Physicians look for donor material on behalf of a patient by submitting the patient's HLA tissue type to

1680-410: The NMDP, which then searches its computerized database for matching donor (marrow or PBSC) or cord blood units. If the NMDP finds a match with an adult donor, they notify the donor. After educating the potential donor about the donation process, the NMDP asks them to donate. If the potential donor wishes to proceed, they receive a medical exam, which includes testing the blood for infectious diseases. If

1736-519: The United States. These are located in The Netherlands , Israel , Sweden , Norway , and Germany (three centers). In addition, the NMDP is affiliated with many transplant centers (where patients can receive transplants using cells from NMDP donors) outside of the United States. Although the NMDP operates the sole federally funded and Congressionally authorized stem cell registry in the United States, another domestic registry exists. In May 2004,

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1792-483: The actual color of the venous blood. Skinks in the genus Prasinohaema have green blood due to a buildup of the waste product biliverdin . Substances other than oxygen can bind to hemoglobin; in some cases, this can cause irreversible damage to the body. Carbon monoxide, for example, is extremely dangerous when carried to the blood via the lungs by inhalation, because carbon monoxide irreversibly binds to hemoglobin to form carboxyhemoglobin, so that less hemoglobin

1848-473: The blood or bound to plasma proteins), and removes waste products, such as carbon dioxide , urea , and lactic acid . Other important components include: The term serum refers to plasma from which the clotting proteins have been removed. Most of the proteins remaining are albumin and immunoglobulins . Blood pH is regulated to stay within the narrow range of 7.35 to 7.45, making it slightly basic (compensation). Extra-cellular fluid in blood that has

1904-475: The body, including: Blood accounts for 7% of the human body weight, with an average density around 1060 kg/m , very close to pure water's density of 1000 kg/m . The average adult has a blood volume of roughly 5 litres (11 US pt) or 1.3 gallons, which is composed of plasma and formed elements . The formed elements are the two types of blood cell or corpuscle – the red blood cells , (erythrocytes) and white blood cells (leukocytes), and

1960-422: The cell fragments called platelets that are involved in clotting. By volume, the red blood cells constitute about 45% of whole blood, the plasma about 54.3%, and white cells about 0.7%. Whole blood (plasma and cells) exhibits non-Newtonian fluid dynamics . One microliter of blood contains: 45 ± 7 (38–52%) for males 42 ± 5 (37–47%) for females Oxygenated: 98–99% Deoxygenated: 75% About 55% of blood

2016-411: The circulating blood (peripheral blood stem cells (PBSCs)). Hematopoietic cells are a type of adult (i.e., non-embryonic) stem cell that can multiply and differentiate into the three types of blood cells: red blood cells , white blood cells , and platelets . Bone marrow and PBSCs come from living adult donors; they can be extracted from the bone marrow or from the blood. Bone marrow is extracted from

2072-720: The collection of hematopoietic ("blood-forming") cells that are used to perform what used to be called bone marrow transplants , but are now more properly called hematopoietic cell transplants . Patients needing a hematopoietic cell transplant but who lack a suitably matched donor in their family can search the Be The Match Registry for a matched unrelated donor or cord blood unit. Hematopoietic cells are used to transplant patients with life-threatening disorders such as leukemia , lymphoma , aplastic anemia , as well as certain immune system and metabolic disorders . Hematopoietic cells can come from bone marrow, umbilical cord blood, or

2128-548: The collection of the HLA phenotypes and other relevant data of volunteer hematopoietic cell donors (used to perform what used to be called bone marrow transplants , but now referred to as hematopoietic cell transplants ) and cord blood units across the globe. The global database with volunteer donors was founded in the Netherlands in 1988. Today, the Search & Match Service of WMDA is

2184-413: The digestive tract. After severe acute blood loss, liquid preparations, generically known as plasma expanders, can be given intravenously, either solutions of salts (NaCl, KCl, CaCl 2 etc.) at physiological concentrations, or colloidal solutions, such as dextrans, human serum albumin , or fresh frozen plasma. In these emergency situations, a plasma expander is a more effective life-saving procedure than

2240-416: The donor's pelvic bones while the donor is under general or local anesthesia. PBSCs are collected from the donor's blood after five or six days of taking a drug that causes hematopoietic cells in the bone marrow to move into the circulating blood. In both cases, recovery is usually swift and donors typically have fully restored marrow and blood cell counts in under two weeks. Cord blood cells are obtained from

2296-431: The exact color. Arterial blood and capillary blood are bright red, as oxygen imparts a strong red color to the heme group. Deoxygenated blood is a darker shade of red; this is present in veins, and can be seen during blood donation and when venous blood samples are taken. This is because the spectrum of light absorbed by hemoglobin differs between the oxygenated and deoxygenated states. Blood in carbon monoxide poisoning

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2352-492: The fees charged to the transplanting hospital once a match is found and the stem cells have been transferred. The latter charge amounts to about $ 21,000, which is somewhat more than other registries in the US and abroad charge. (The final cost to the patient or the patient's insurance company for the completed transplant can range from $ 100,000 to $ 250,000.) The NMDP pays affiliated donor centers and recruitment groups for every new donor they sign up. Blood Blood

2408-530: The lungs is still roughly 75% (70 to 78%) saturated. Increased oxygen consumption during sustained exercise reduces the oxygen saturation of venous blood, which can reach less than 15% in a trained athlete; although breathing rate and blood flow increase to compensate, oxygen saturation in arterial blood can drop to 95% or less under these conditions. Oxygen saturation this low is considered dangerous in an individual at rest (for instance, during surgery under anesthesia). Sustained hypoxia (oxygenation less than 90%),

2464-407: The movement of skeletal muscles , which can compress veins and push blood through the valves in veins toward the right atrium . The blood circulation was famously described by William Harvey in 1628. In vertebrates, the various cells of blood are made in the bone marrow in a process called hematopoiesis , which includes erythropoiesis , the production of red blood cells; and myelopoiesis ,

2520-464: The observation of blood clotting in a transparent container. When blood is drawn in a glass container and left undisturbed for about an hour, four different layers can be seen. A dark clot forms at the bottom (the "black bile"). Above the clot is a layer of red blood cells (the "blood"). Above this is a whitish layer of white blood cells (the "phlegm"). The top layer is clear yellow serum (the "yellow bile"). In general, Greek thinkers believed that blood

2576-419: The oxygen is consumed; afterwards, venules and veins carry deoxygenated blood back to the heart. Under normal conditions in adult humans at rest, hemoglobin in blood leaving the lungs is about 98–99% saturated with oxygen , achieving an oxygen delivery between 950 and 1150 ml/min to the body. In a healthy adult at rest, oxygen consumption is approximately 200–250 ml/min, and deoxygenated blood returning to

2632-467: The patient considers a number of clinical factors to decide whether to use an adult donor's marrow or PBSC, or cord blood for a particular patient. The NMDP cooperates with World Marrow Donor Association (WMDA), an organization that coordinates communications among the world's registries. BMDW is based in Leiden , The Netherlands. Throughout the world, there are an estimated 30 million volunteer hematopoietic cell donors. Most national registries, including

2688-455: The potential donor meets all requirements, the NMDP collects their bone marrow or peripheral blood stem cells and sends them by courier to the patient. If the NMDP finds a match to a cord blood unit, they notify the cord blood bank that stores that unit and arrange to send it to the patient. Cord blood units are shipped frozen, in specially designed coolers, and are thawed after arrival at the patient's hospital. The transplant physician evaluating

2744-505: The production of white blood cells and platelets. During childhood, almost every human bone produces red blood cells; as adults, red blood cell production is limited to the larger bones: the bodies of the vertebrae, the breastbone (sternum), the ribcage, the pelvic bones, and the bones of the upper arms and legs. In addition, during childhood, the thymus gland, found in the mediastinum , is an important source of T lymphocytes . The proteinaceous component of blood (including clotting proteins)

2800-422: The second and the third most supplied organs, with 1100 ml/min and ~700 ml/min, respectively. Relative rates of blood flow per 100 g of tissue are different, with kidney, adrenal gland and thyroid being the first, second and third most supplied tissues, respectively. The restriction of blood flow can also be used in specialized tissues to cause engorgement, resulting in an erection of that tissue; examples are

2856-489: The surface (e.g., during warm weather or strenuous exercise) causes warmer skin, resulting in faster heat loss. In contrast, when the external temperature is low, blood flow to the extremities and surface of the skin is reduced and to prevent heat loss and is circulated to the important organs of the body, preferentially. Rate of blood flow varies greatly between different organs. Liver has the most abundant blood supply with an approximate flow of 1350 ml/min. Kidney and brain are

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2912-443: The total blood oxygen capacity seventyfold, compared to if oxygen solely were carried by its solubility of 0.03 ml O 2 per liter blood per mm Hg partial pressure of oxygen (about 100 mm Hg in arteries). With the exception of pulmonary and umbilical arteries and their corresponding veins, arteries carry oxygenated blood away from the heart and deliver it to the body via arterioles and capillaries , where

2968-438: The umbilical cord and placenta of a newborn baby after the cord is clamped and cut as in a normal delivery. The cord blood is then stored frozen in a bank until needed for a transplant. The baby is not harmed in any way by this collection, as the cord blood is collected from tissues that in the past had been discarded as medical waste . The Be The Match Registry is one of many registries of unrelated donors and cord blood units in

3024-448: The world. Most large, developed nations have such registries. Large registries of unrelated donors are needed because only about 30% of patients with diseases treatable with hematopoietic cell transplantation can find a fully HLA matched donor among their family members. The remaining 70% require an unrelated hematopoietic cell donor as a transplant source. Because the odds that two random individuals are HLA matched exceeds one in 20,000,

3080-489: Was discovered in the year 1900 by Karl Landsteiner . Jan Janský is credited with the first classification of blood into the four types (A, B, AB, and O) in 1907, which remains in use today. In 1907 the first blood transfusion was performed that used the ABO system to predict compatibility. The first non-direct transfusion was performed on 27 March 1914. The Rhesus factor was discovered in 1937. Due to its importance to life, blood

3136-464: Was made from food. Plato and Aristotle are two important sources of evidence for this view, but it dates back to Homer's Iliad . Plato thinks that fire in our bellies transform food into blood. Plato believes that the movements of air in the body as we exhale and inhale carry the fire as it transforms our food into blood. Aristotle believed that food is concocted into blood in the heart and transformed into our body's matter. The ABO blood group system

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