On Tuesday, school officials announced that Nelson, who had been on medical leave since the February procedure, had died over the weekend. Family members told NJ.com that he had lapsed into a coma after the surgery and never recovered.
"After the procedure he did, he couldn't speak and was lying in the bed," his father, Willie Nelson, 81, told the site. "His eyes were open and he realised who we were. But he couldn't move. He never spoke again."
The exact cause of his son's death on Monday remains unknown, the elder Nelson added. "We really don't know the full story of what happened," he told NJ.com. "We were expecting him to come out of the coma he was in. But he didn't make it."
In his February interview with the student newspaper, Nelson referenced multiple health issues that made his plan to donate stem cells to the teenager more complicated.
Because he had sleep apnea, which he had developed while serving in the military, doctors felt it would be unsafe to put him under general anesthesia while they extracted his bone marrow, he said. They initially decided to use intravenous therapy to harvest the stem cells instead.
At his final physical examination on January 21, however, that plan fell apart when Nelson was asked if he had sickle cell anemia. "I said well I don't have sickle cell, but I have the sickle cell trait," he told the student paper, recalling that the doctors had told him, "Well if you have the trait, you can't do stem cell."
Within a day, the doctors had come up with a new plan, which involved putting him under a local anesthetic that would allow him them to monitor his breathing while they extracted his bone marrow, he said.
Statistically speaking, donating bone marrow is considered extremely low-risk.
According to the National Marrow Donor Programme, only 2.4 per cent of donors experience serious complications, which typically come either from the use of anesthesia or from damage to bones, nerves or muscles in the hip region.
A 2009 study in Haematologica, the journal of the European Hematology Association, found that out of more than 51,000 stem cell transplants that took place over a 12-year period, only five donor fatalities were reported.
As with any surgical procedure, though, there's always the possibility that something could go wrong or the patient could have an adverse reaction. In one rare case, Lina Joy, a dental office manager in California, contracted a staph infection and fell into a coma after donating bone marrow in 1997. The near-death experience left her with lifelong health problems, the Los Angeles Times reported, and she later filed a medical malpractice suit against the hospital and doctors that was settled for an undisclosed sum.
In Westfield, a suburban community located less than 50km from Manhattan, the beloved principal's untimely death inspired an outpouring of tributes this week from students, community members and state leaders.
Described by one local politician as "a truly selfless leader," Nelson had started teaching in New Jersey public schools in 2002 and worked his way up to becoming the principal of Westfield High School in 2017. He also spent more than 20 years in the Army Reserves while earning his master's and doctorate degrees in education administration, and at one point was deployed to the Middle East, according to school officials.
"His final act was one of selflessness," wrote Governor Phil Murphy, a Democrat, who said that Nelson had "embodied all that makes New Jersey great."
To one student, Nelson was someone who "always tried to lift people up instead of bringing them down" and "was always there for support rather than discipline even though that was part of his job."
"He was the type of man that used authority but was still such an approachable man," another student recalled. "I can't name a single person that didn't like him."
Westfield Superintendent Margaret Dolan said that she had heard from everyone from parents to custodians to nurses after learning about Nelson's death. "Many had stories of how he had helped them as they dealt with an illness," she wrote. "Others recalled his infectious laugh or his commitment to his students. I remember how he was forever taking on a new challenge, working to better understand a new curriculum, looking for ways to improve a complex high school schedule."
In addition to his parents, Nelson's survivors include a fiancee and a 6-year-old daughter, local media outlets reported. His fiancee, Sheronda Braker, described him in a statement to WABC as "a tremendous father to our beloved daughter Morgan and the best companion and life partner I could have ever asked for," adding that he had loved his family almost beyond belief.
"His last kind and generous act on this earth in giving so someone else might live is a true testament to who he was and how he should always be remembered," she wrote.
