Bone marrow donor register at the Pirogov University: first donor-recipient meeting

On June 13, a meeting between a bone marrow donor and a recipient was held at the Pirogov Russian National Research Medical University. Two years have passed since the transplant, the donor was a graduate of the University.

Elena Mokshanova from Magnitogorsk was diagnosed with acute myeloid leukemia in October 2020. With such a disease, the only way to survive is to have a complex high-tech medical procedure - bone marrow transplantation.

“During the COVID-19 pandemic, I visited a therapist. Covid was confirmed, but the results of tests and an examination by an oncologist also showed leukemia. My life has changed dramatically. First I had to get rid of covid, and then I was sent for a course of chemo, the doctors suggested transplantation. My son was supposed to be the donor, but it turned out that his cells were not genetically suitable, we had to look for another person” - Elena Mokshanova.

Elena was treated at the Raisa Gorbacheva Memorial Research Institute for Pediatric Oncology, Hematology and Transplantation of the Pavlov First Saint Petersburg State Medical University. The search for the necessary genetic material led to the Muscovite Karina Rytova. On January 31, 2020 she entered the Register of Bone Marrow Donors of the Pirogov Russian National Research Medical University, which is part of the federal register. The graduate of the Second Medical School did not expect that one day her help would be needed.

“I knew that the transplant procedure required a perfect match between the genetics of the recipient and the donor. That is, the chances of actually becoming a donor for a stranger, a non-relative, are negligible - about 5% of those who have taken blood for genetic analysis become donors” - Karina Rytova says, forensic expert, employee of the Forensic Medicine Bureau of the Moscow Healthcare Department.

In order to obtain the necessary genetic material for transplantation, the donor is subcutaneously injected with a medicinal preparation to stimulate the release of blood stem cells into circulation in order to further collect them with a special apparatus of apheresis - separator. The facilitators of the process conduct preliminary interviews with the participants to ascertain the suitability of the candidate.

Karina Rytova continues, “In my case, a year after I joined the Register, I received a call from the University asking questions about my health. I was directly asked if I was ready for the procedure of giving hematopoietic stem cells by apheresis. I replied that, of course, I am ready, not a nursing mother and will not consult with relatives. The procedure lasted about nine hours, I had to endure, but I am a doctor, and my duty is to save people».

Elena had chemo a few days before the procedure to reduce immunity and destroy her own bone marrow cells, otherwise foreign genetic material would not take root. At this time, the body is extremely weak and vulnerable to even minor infections, so full isolation is observed. During the procedure, the patient is injected intravenously with the bone marrow (hematopoietic stem cells) of the donor - the process is like a blood transfusion.

The transplant took place on July 7, 2021, after which Elena had a long course of rehabilitation. All this time she wanted to meet her savior, but the women knew nothing about each other except age and gender. The day of the transplant was Elena’s second birthday, this year she is going to celebrate it with Karina.

The long-awaited meeting

Tigran Gagikovich Muradyan, Head of the Medical Department, Head of the Register of Bone Marrow Donors of the Pirogov Russian National Research Medical University supervised the procedure on the part of the University. He explains that the patient's recovery after stem cell transplantation takes a long time. In order to avoid moral and ethical conflicts, communication between the donor and the recipient is maximally limited to about two years, since in the medical community such a period is considered optimal, including for understanding whether the transplant helped or not. This explains the time that Elena and Karina had to wait.

Women believe that now they are almost close relatives - sisters. If they met in such an unexpected way, they will no longer part - they will be in constant contact. “A tragedy brought us together,” they share their impressions with tears in their eyes, “but the happy ending made us a family.”

Today’s meeting is important not only for us - it can serve as a clear example for the society, attract even more people willing to help the sick, which will allow to expand the Federal Register. After all, we have a large country, many nationalities, and representatives of all ethnic groups should have a chance to obtain cells for healing. Medical technology allows miracles, and today we see beautiful, wonderful women who in a team coped with a terrible diagnosis and speak about it calmly, even with humor - this is the highest happiness that every person deserves», Sergey Anatolyevich Lukyanov said in his speech, the rector of the Pirogov University.

Staff of the Pirogov University is sure that the first meeting at the University is not the last. New saved lives are ahead, because the recipients are already receiving treatment thanks to donors from the University Register, whose number is increasing year by year.

University Register: Necessity and Effectiveness

The first transplants in Russia began to be carried out in the early 1990s. Today, high-tech medical procedure is widely used for patients with severe oncological, hematological, immunological diseases at the expense of the federal budget. According to statistics, more than 5,000 people in the country need donor assistance.

Pirogov’s University Register of Bone Marrow Donors was created in 2019 thanks to the efforts of the University Administration and the initiative of employees. Today, it has almost 3,000 potential donors, 14 people have already passed bone marrow and hematopoietic stem cells for recipients, and 6 people are at different stages of "activation". The University Register of Bone Marrow Donors is part of the Federal Register, which, in September 2022, consolidated all the separate registers existing in the country and is now an electronic database of 200,000 potential donors.

“We have fully developed technologies to determine the donor’s genotype with high resolution using new generation sequencers. The procedure for obtaining genotype data involves several steps. The lab service cleans DNA molecules, the human genome, forming a fragment library. They isolate only those parts of the genome that contain the information we need. It is analyzed by the sequencer for about 24 hours, sending data to the server, and the Register is loaded with the cipher. The coincidence of the ciphers confirms that the potential donor is suitable for the recipient», - Denis Vladimirovich Rebrikov comments, the vice-rector on the scientific work of Pirogov University, an honorary donor of Moscow.

The effectiveness of the Register is determined not only by the quantity and availability of gene information, but by the ratio of the number of real donors to the number of potential donors in the Register. Last year we were among the first in this indicator. Our laboratory capacity is many times higher than the possibilities of recruitment. More volunteers are needed to make the process more intensive and productive. At the federal level it is very important that people enter the Register», Denis Vladimirovich Rebrikov said.

You may join the Register of bone marrow donors up to 45 years. Genotypes match randomly, at any time - in six months and 25 years. It is important that the potential donor is healthy and does not change his mind. The consent of the donor, according to the doctors, ensures at least 50% success in a complex and long procedure of treatment.

Learn more about bone marrow donation