I've been a blood donor for over twenty years. The other day a doctor called me and asked me if instead of my normal quarterly donation, I'd be willing to give a few extra hours of my time along with a chunk of white blood cells. I said yes.
There's this transplant patient at a hospital in Stockholm. Like all such patients this person, let's call her Joan (I have no idea what her real name is), is on immune suppressant drugs to keep her body from tossing out the transplanted organ. She now seems to have contracted a difficult infection. Unfortunately she's developed antibodies against run-of-the-mill donated blood that would work in most cases. So in order to give Joan white blood cells to beat the infection, you can't just look at the AB and Rh factors, you need to look at tens of genetic markers until you find a rare match. Me, in this case.
For me, it's three visits to the hospital. Monday morning, they first checked my health, which turned out to be very good. Then they drew some of my blood and mixed it with Joan's in a tube to see if it would provoke an immune response. When it did not, they injected me with filgrastim. This is a synthetic analogue of the hormone G-GSF, granulocyte-colony stimulating factor. In the body, G-CSF is secreted here and there, and it causes the bone marrow to make granulocytes and stem cells and release them into the bloodstream. Granulocytes are a category of white blood cells, the immune system's foot soldiers.
After the doctor and nurse had seen that the injection didn't cause me to keel over, they sent me off with some dexamethasone pills to take Monday evening. This is a steroid similar to the hormone cortisone, which has a wider range of functions, one of which is apparently to get those granulocytes out into my blood quicker.
The doctor warned me that I might feel a little creaky in the evening from the sudden flooding of my system with unneeded white cells. And I did, like if I had the flu coming on distantly. But I consoled myself with the thought that I was still in much better shape than Joan. This morning I was back at the hospital and got hooked up to a centrifuge. They're taking blood out of my left arm, spinning it up in the centrifuge until it separates into layers by density, grabbing the bottom part of the layer of white blood cells (the youngest ones), and then sending the rest back into my right arm. They'll keep at this for two hours, then shoot me up with more filgrastim and send me off with some more dexamethasone, for the whole procedure to be repeated tomorrow morning.
Why am I a blood donor? Why am I doing this complicated thing for Joan, whom I'll never meet? Well, because I've been helped many times by modern medicine, I believe in solidarity and I've been taught to feel good about myself when I'm altruistic. And really, it doesn't cost me much to help out here.
If you want to be all Darwinist, then you can actually say that I'm acting in my evolutionary self-interest. Joan and I are genetically similar. In helping her stay alive, I improve the chances of my genes spreading in the population. Joan is a transplantee and might neither have any kids nor be in any shape to bear them in the future, what do I know. But maybe she has nieces and nephews, whose evolutionary environment will be a bit less harsh if their aunt is around to help feed, protect and raise them. And then they may go on to have five kids each who share a lot of my genes. Anyway, me and Joan are blood kin now.
I am in the camp that believes that humans are a naturally altruistic species, and that we would never have evolved the way we have if we were not.
To me, this is no big deal. What amazes me are the number of people who do not believe that true altruism exists, and that ultimately, everything a person does has some self-interested motive, if only you look closely enough.
I don't buy that. I have seen and felt enough true altruism to know that it exists.
I fell in love with my wife when I saw her performing an act of pure altruism, when she thought no one could see her. Up to then I was strongly attracted to her, but that was the moment I fell in love with her.
As to what you are doing, it is honourable and deserving of admiration, and I greatly respect you for it.
Also, when I hear of elaborate procedures like this, I am awed by how far we have come in understanding all the basic biology, biochemistry and immunology behind the treatment.
Joan has been lucky not only that there was a compatible (and willing) donor and a health system to provide the treatment, but also to live in an age when tens of thousands of hours of science had been done to enable it.
Human G-CSF wasn't isolated and identified until 1986! This treatment has been possible for less than 30 years.
Congratulations! Leukapheresis is not used very often, due to the short life span of granulocytes, but things could change in the future.
Good on you for donating leucocytes.
I don't know what the Red Cross is doing nowadays, but when I donated a decade ago, I was just prescribed three Prednisone tablets and spent two hours hooked up to the apheresis machine.
This takes commitment, so again, good on you.
"...developed antibodies against run-of-the-mill donated blood..."
Rather more likely that donated blood simply doesn't have a high enough concentration of White blood cells to make up for her immune-suppressed condition.
Nope, actually antibodies. I asked in general terms what might cause this, and the doctor mentioned pregnancy.
Martin: A real live leukapheresis! I use this product all the time in my work (it's how our cancer treatment works) but I've never seen a photo before. That looks like a nice machine, is it a Cobe Spectra or an Optia? (I'm curious what's common in Europe).
Did you get the low-calcium tingling lips? Did they offer you antacids or chocolate milk?
You are a very generous person for doing this.
Sorry Tech, I didn't notice the make of the machine. I did get the tingles in lips and hands! They gave me calcium chewies for them.
There are, alas, a lot of people who say "I've got mine,fuck you"..
At the time I conceived Cell Inflation Assisted Chemotherapy, in 2009, it was Cobe Spectra machines. I think that now most machines are made by Terumo BCT.
"...doctor mentioned pregnancy."
That's a specific Rh or ABO related condition which most likely has no comparison to what Joan is going through - nor does it involve "run-of-the-mill donated blood" (whatever that means).
medical stuff (swedish-language article) Finding antibodies against ALS (aka Lou gehrig's disease) Antikroppar mot ALS på gång http://linda.vll.se/nattidningen/artiklar/forskning/antikroppar-mot-als…
Good for you! Proud of you, and slightly jealous. I've been on the bone marrow donor list for over 20 years now, but i've never been called.
I also currently can't donate blood, since my state does not have licensing for tattoo artists that still allow blood donations. I only have to wait until next May, however, and i can go back to my normal every 56 day cycle :)
Cool, I've never even heard of this. A godless society will have to invent new motivations for altruistic behavior and maybe your vague genetic advantage is one possible foundation. Now just ritualize it so public recognition and praise strengthens the incentive and now we're going somewhere.
"He who saves one life, it is as if he saved the entire world."