Initial Screening

Overview

Once you're matched, your center starts screening right away: blood work, physical exams, and genetic tests to confirm the match is real. It feels routine like a normal doctor visit, but it's the first key safety step for everyone involved.

This takes one or two weeks total from start to finish. Your team checks that you're truly a genetic match, that you're healthy enough to donate safely, and that nothing blocks you from proceeding. Most donors pass screening with no issues. If something comes up, your team explains it clearly and tells you what happens next.

The first steps after matching

Initial screening involves several key components. Your coordination center performs blood work, physical exams, and genetic matching tests. These assessments identify any conditions that would prevent safe donation.

Key screening steps:

• Complete blood count, chemistry panel, and infectious disease testing
• HLA confirmation and crossmatch to verify genetic match
• Physical examination by your donation center physician
• Heart rhythm assessment (EKG) if bone marrow collection is planned
• Identification of any medical conditions that would prevent safe donation

The first steps after being matched

Once you're identified as a potential match, you'll be contacted by your donation coordination center. They'll confirm your willingness to proceed and schedule your initial screening appointment. This conversation is straightforward: "We found a patient who might match you. Are you ready to move forward with evaluation?"

If you say yes, screening begins within days. If you need time to think, that's okay—the center will give you a few days, though not weeks. The patient is waiting, and the timeline matters. But they also understand hesitation, and you can always ask questions before committing.

Initial screening involves meeting with your coordination center's medical team, providing a detailed health history, and undergoing basic blood work and physical examination. The goal is to identify any medical conditions that would make donation unsafe and to confirm you're healthy enough to proceed.

• Coordination center contacts you directly
• You have a few days to decide
• Initial screening happens within 1-2 weeks
• Multiple appointments clustered in early weeks
• You can ask to slow down if needed

Health history review

Your coordination center will ask you detailed questions about your medical history. Have you ever had cancer? Are you taking any medications? Do you have diabetes, heart disease, or high blood pressure? Have you ever had a serious infection like hepatitis or tuberculosis? Do you use drugs or tobacco?

These questions aren't judgmental. They're essential for understanding your health. Being honest is critical—if you hide something and it emerges later, it delays the entire process and potentially puts you and the patient at risk. If you're not sure about something, say so. Your center can help you clarify.

You'll be asked about your family history: have relatives had cancer, blood clots, heart disease, or bleeding disorders? Certain hereditary conditions make donation riskier. You'll be asked about past surgeries, anesthesia experiences, and how you recovered. This helps your team anticipate how you'll handle bone marrow collection anesthesia.

• Answer all questions honestly and completely
• Medical history is confidential
• Family history helps predict risks
• Prior surgery and anesthesia experience matters
• Hidden information delays evaluation

Blood tests and physical exam

Initial laboratory assessment

Initial blood tests check your complete blood count (ensuring you have enough healthy red cells, white cells, and platelets), a chemistry panel (checking kidney and liver function), and infectious disease screening. You'll be tested for HIV, hepatitis B and C, syphilis, and other pathogens. Blood is also taken for HLA confirmation and crossmatch testing with the recipient.

Tests performed include:

• Complete blood count (CBC) with hemoglobin, white cells, and platelets
• Chemistry panel evaluating kidney, liver, and electrolyte function
• Infectious disease serology for HIV, hepatitis, syphilis, and other pathogens
• HLA confirmation using high-resolution DNA typing
• Crossmatch testing to verify compatibility with recipient

Physical examination

A physical exam evaluates your heart, lungs, blood pressure, and overall health. Your doctor listens to your heart and lungs, checks your lymph nodes, and assesses your general fitness. If bone marrow collection is planned, you might have an electrocardiogram (EKG) to check your heart rhythm and ensure anesthesia is safe.

All these tests are standard screening. Many results come back the same day; others take a few days. Your coordinator will call with results and let you know if anything needs further evaluation.

• Complete blood count and chemistry panel
• Infectious disease testing (HIV, hepatitis, syphilis, others)
• HLA confirmation and crossmatch testing
• Physical examination by center physician
• EKG if bone marrow collection planned

What could change your eligibility?

Several results might put donation on hold or end it. If infectious disease testing is positive, you typically can't donate because of the risk of transmitting infection to the patient. Certain active cancers disqualify you. Significantly abnormal heart rhythm or serious heart disease might prevent anesthesia safety.

Treatable conditions might delay donation temporarily. If you have anemia, your team might ask you to increase iron intake or take supplements for a few weeks. If you have a urinary tract infection, you'll need to be treated first, then retested. If you've recently had surgery, you might need to wait for healing.

Understanding disqualifying conditions

Screening identifies issues that might prevent safe donation. Permanent disqualifications typically include:

• Active or recent malignancies (cancer) due to immunologic concerns
• Uncontrolled HIV, hepatitis B, or hepatitis C infection
• Serious cardiac arrhythmias or severe heart disease preventing anesthesia
• Bleeding disorders or clotting abnormalities that pose surgical risk
• Severe kidney or liver disease indicating organ dysfunction

Very commonly, nothing changes your eligibility. Most healthy donors pass initial screening without issues. If something does come up, your coordination center explains it clearly and tells you what happens next.

• Positive infectious disease results typically disqualify
• Active cancer prevents donation
• Serious heart rhythm problems might prevent anesthesia
• Infection might delay donation temporarily
• Anemia might require treatment before collection

Your right to withdraw

At any point during screening, evaluation, or even after you've been confirmed as a match, you can change your mind. There's no penalty, no guilt, no judgment. Donors withdraw for many reasons: they realized they're not ready emotionally, they developed health concerns, they need to prioritize family or work, they simply changed their mind.

If you withdraw early in screening, another donor search begins. If you withdraw after confirmatory testing, the patient's team will pursue backup plans. Medical teams understand that coercing donors leads to worse outcomes. They want donors who truly want to donate.

Withdrawing doesn't mean you're weak or selfish. It means you're being honest about your capacity. That's exactly what the system needs.

• You can withdraw anytime before collection
• No penalty or judgment for withdrawal
• Patient teams have backup plans
• Your autonomy is respected
• Honesty is better than commitment you can't keep