Mick Chivers, a 20-year-old pre-med student at Brown University, was committed to helping a man he didn't know.
The plan was to donate his stem cells — but things weren't going as planned. The standard approach wasn't working.
Staff at the Rhode Island Blood Center were trying to extract stem cells from Chivers' blood. They tried 13 times but couldn't get an IV to take to the veins in his right arm.
After so many attempts, most people might call the whole thing off. It was, after all, an anonymous donation for someone he might never meet.
There was another option: place a small tube near the entrance of his heart by inserting it through a vein in his chest or neck to get the blood that way. But there were no facilities in the area with an opening for that particular procedure, called a "central line."
And there was a third method: a bone marrow harvest. But this surgical procedure is more invasive and comes with a longer recovery time compared to the other methods. It involved extracting bone marrow from his pelvis — a thought that scared him a little.
But Chivers was determined. He had signed up to be a donor in the spring of 2021 and was found to be a match for a patient in February. He wanted to see it through.
"I want to think I'm a good person, like, I am a good person, right? That's what I tell myself. This was a case where that was being tested," Chivers says. He thought about the patient, an elderly man battling leukemia, waiting for his last, best chance at survival. "There's one right thing to do. You've got to do that."
Stem cell transplants rely on the kindness of strangers
Stem cell transplants, also known as bone marrow transplants, are used to treat patients with leukemia, lymphoma, sickle cell anemia and other disorders. Studies are looking at their potential to treat Alzheimer's and spinal cord injuries as well. Stem cells are the base-model for virtually every cell in the human body.
So stem cells and stem cell donors are in high demand. Chivers signed up with the National Marrow Donor Program, better known as Be the Match, which partners with other organizations and connects doctors to potential donors.
When the need for stem cells arises, patients first look to family members in hopes of finding a match, ideally a brother or sister. Since children inherit half their genes from each parent, a mother or father can only be a 50% match, known as a haplocompatible donor. And matching with a family member only happens about 30% of the time, says Jamie Margolis, senior vice president of donor services at the National Marrow Donor Program.
The other 70% of patients rely on the kindness of strangers, individuals who volunteer their body and their time in hopes of saving someone they may never meet.
"We see the best in humanity every day. It's pretty incredible," Margolis says.
Be the Match especially pushes for young people between the ages of 18 to 35 to donate. The group says cells from younger donors are more likely to lead to successful transplants. And there's also a special need for non-white people to donate: a successful stem cell match typically comes from a donor with the same ethnic background. For white patients, the odds of finding a donor on the registry is 79%. That drops as low as 29% for Black people, according to Margolis.
"We don't want to turn any patient away. We want to be able to provide a donor for every single patient," she says.
Donation day arrives
Chivers wasn't going to be swayed by any setbacks. Long before he was born, cancer took the life of his mother's brother, Jason Keating, shortly after his 13th birthday. Keating didn't have a donor. So Chivers wanted to donate stem cells in his uncle's memory.
"Growing up I was aware of how his death had caused my mom and her family lasting trauma," Chivers says. "I joined the registry in hopes of sparing someone else's family that same suffering."
Chivers told the Be the Match staff he would do whatever was necessary to save the life of this stranger. In return, he requested the organization do whatever they could to try and find a facility to do the central line procedure. If their efforts were unsuccessful, he would go through with the bone marrow harvest.
The bone marrow harvest involves removing up to 2 quarts of bone marrow by sticking a needle into each hip bone two or three times while under general anesthesia. Donors may experience discomfort during it. And the recovery time often takes about three weeks.
"Whatever the cost [was] going to be, the reward [was] still going to outweigh that," he explained.
As fate would have it, he would be able to avoid the bone marrow harvest. Chivers was working in the library when Be the Match texted him.
"Hi need to speak with you ASAP. GOT A CENTRAL LINE SET UP FOR TOMORROW," the text read.
The procedure was set to take place the morning of April 13 in Providence. Beforehand, Chivers had to get a COVID PCR test and then a battery of blood tests. Additionally, he received a round of shots to boost his stem cell production before the procedure the next morning.
At 6:30 a.m., Chivers headed back to the Rhode Island Blood Center, where he was given one more set of stem cell boosters for good measure. His father picked him up from there and drove him to the Roger Williams Medical Center for the procedure.
The central line procedure is the less-common method of extracting stem cells. The vast majority of donors undergo the simple apheresis set up in the left and right arm: blood goes out of one arm, stem cells are drawn out of the blood, and blood goes back in the other arm.
Chivers was doing the same thing, but instead of poking his arms, they went through his neck.
Doctors inserted a tube through his jugular in the right side of his neck and guided it into the heart. Chivers' blood left his body and ran through an apheresis machine, which separated and removed approximately 2 pints of stem cells, before returning to the body through the same vein.
After several hours, the procedure was complete. A courier picked up the stem cells and rushed to the airport to deliver a second chance at life to the recipient, who was scheduled for transfusion the following day.
Stem cell recipients call it their "second birthday"
Patients who receive stem cell transplants often refer to it as their second birthday — a second chance at life.
NPR was unable to speak with the stem cell recipient in Chivers' case because of patient confidentiality rules, but had extended an opportunity to do so through Be the Match.
However, Donna Demus, 59, a cancer survivor and Be the Match's 100,000th stem cell transplant recipient, says stem cells saved her life. She was diagnosed with myelodysplastic syndrome, a type of cancer caused by bone marrow abnormalities, in 2017.
She had to receive monthly blood transfusions to manage her symptoms. And as a Black woman, she was worried that she wouldn't find a suitable match. But after two years of searching, a donor was found.
Her second birthday was Dec. 10, 2019.
"I appreciate every day a whole lot more. I don't let things bother me at all," Demus says. "If it wasn't for some young lady who, for whatever reason, thought to give, I probably wouldn't be here."
Doing a small amount of good
After his donation, Chivers says he quickly recovered and resumed his regular activities. In addition to his pre-med studies, he has work, a home life, and spends lots of time surfing and in the art studio. Less than 24 hours after leaving the hospital, he spent nine hours working on a sculpture for school. He hopes the work with his hands will help him later on if he lands his dream job as a trauma surgeon.
Looking back on it all, he says he would do it all again. Chivers says he takes pride in knowing he was able to do some good in a world that, at times, seems to be tearing itself apart.
"This whole world sucks. There's so much wrong with it. But every now and then an opportunity arises where we can do a small amount of good," he says. "... We should jump on those opportunities because that's what counts ... that's what we're here for."
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