Bone Marrow Transplant Care

The donor will be carefully tested to check for diseases. Both you and the donor will be tested to ensure that your tissues are compatible. In order for the transplant to be successful, certain markers, called HLS types, on the blood cells and bone marrow cells must match.

As the recipient, you will be given medicines to suppress your immune system. This is to prevent your body from rejecting the donor stem cells. In the weeks prior to the transplant, you may have to have:

• Chemotherapy
• Radiation therapy

This process is called "conditioning." It will rid the body of diseased cells and clear the bone marrow cavities for the new bone marrow.

• Donor- general anesthesia to block pain and keep the donor asleep through the procedure; given through an IV in the hand or arm
• Recipient-will not need any anesthesia

If the stem cells will be from the donor's bone marrow (BMT), the doctor will clean an area of the donor's hip. A hollow needle and syringe will be used to remove the bone marrow. The doctor will make several small punctures. This is to harvest enough bone marrow for the transplant (1-2 quarts). Lastly, the wounds will be covered with bandages.

If the stem cells will be from the donor's blood (PBSC), the doctor will stick a needle in the donor's large vein or veins in the arms. A machine will receive blood from the vein. This machine will spin the blood so that the stem cells are concentrated. The rest of the blood will be given back to the donor. The doctor will cover the puncture wounds with bandages. This procedure may require more than one blood donation. The donor may also be required to take pills that cause more stem cells from the bone marrow to go into the blood.

The donated stem cells will be filtered. Next, the doctor will administer the cells through a small, flexible tube, called a catheter, into one of your large veins.

The donor will recover quickly. You, the recipient, will need to be placed in isolation. This is to avoid infection until the new stem cells in the bone marrow begin to produce infection-fighting cells.

• Donor
  • BMT-About 30 minutes
  • PBSC-several hours
• Recipient-several hours

• Donor:
  • If the procedure done is a BMT, then the donor will have general anesthesia during the transplant. There may be pain and discomfort after the anesthesia wears off.
  • If the procedure done is a PBSC transplant, then the donor will have pain from the needle sticks.
• Recipient-There will not be pain while the stem cells are infused. You may have some nausea. This can be treated with medicine.

• Donor
  • For BMT-overnight
  • For PBSC-several donations (each donation lasts a couple of hours)
• Recipient-1-2 months

The donor may receive:

• Pain medicine
• Antibiotics to prevent infection

While you are recovering at the hospital, you may receive the following care:

• Medicines that keep your immune system low to decrease the chance of transplant rejection
• Antibiotics to prevent infection
• Platelets, plasma, and red blood cell transfusions to prevent bleeding and anemia
• Frequent blood tests to monitor whether the new stem cells in the bone marrow are taking hold or being rejected