Bone marrow transplantation – Hematopoietic stem cell transplantation

Description of the procedure of bone marrow transplantation

Stem cells produce red blood cells (erythrocytes), White blood cells (leukocytes) and platelets.

In some cases, stem cells in the bone marrow can not function normally or to be destroyed, to assist in the treatment of certain diseases. If this happens, your body will need new stem cells.

During this procedure, healthy stem cells are used, are selected from the donor agencies:

  • Bone marrow (bone marrow transplant or RMB);
  • Blood (peripheral blood stem cells or PBSC).

Stem cells will be injected into a vein and travel through the blood to the bones. Transportation of donor stem cells to the bone marrow can take up to a month, then they begin to operate in full screen.

If the transplant is successful, New bone marrow cells will produce healthy erythrocytes, leukocytes and platelets.

To transplant the stem cells can be used:

  • Stem cells, which were taken earlier from the patient's bone marrow or blood and stored in special conditions;
  • Stem cells from the donor.

Местоположение активного костного мозга у взрослых

Reasons for performing stem cell transplantation procedures

This procedure is performed, if the stem cells in the bone marrow do not perform their functions or are abnormal. This may be caused by the following reasons:

Possible complication of hematopoietic stem cell transplantation

Complications are rare, but that does not mean the absolute absence of risk. If you plan to perform a transplant of stem cells, the doctor will review the possible complications, which may include:

  • Infection – donor hemopoietic cells yet not begin to operate in full screen;
  • Rejection of the donor stem cells;
  • Acute reaction “graft-versus-host disease” (When the immune cells from the bone marrow donor attack patient tissue).

Possible complications for the donor include:

  • Bleeding;
  • Infection.

Stem cell transplant is better to avoid the presence of the following diseases:

  • Heart disease, light, liver or kidney problems;
  • Diabetes.

How is stem cell transplantation?

Prior to the transplant

The donor is carefully checked for the presence of any disease.

The patient and the donor is checked compatibility of tissues and cells. For, the transplant was successful, certain markers, found in blood cells and bone marrow cells must match.

The patient is prescribed medication, that suppress the immune system. This is done to prevent the body's rejection of the donor stem cells. A few weeks before transplanting, perhaps, will have to go through the following procedure:

  • Chemotherapy;
  • Radiation therapy.

This process is called “training”. In this body are derived from diseased cells and is cleaned bone marrow cavities for the new donor cells of the bone marrow.

Anesthesia

  • Donor – It uses general anesthesia, to block pain and a donor support in a sleep state. Administered intravenously in the arm or hand;
  • Patient – Anesthesia is not needed.

Description of the procedure

If stem cells are selected from bone marrow donor, Doctor clean the area on his thigh. By means of a hollow needle and syringe is sampled marrow. The doctor will make several small punctures, to collect enough bone marrow for transplantation (about 1-2 l). After selecting the place of injections bandage.

If Stem cells would be taken from the donor's blood, the doctor inserts a needle into a large vein of the donor (usually a vein in the arm). With the help of a special apparatus of the blood stem cells are allocated, and the rest of the blood is returned to the donor. After the procedure, the doctor puts a bandage on the injection site. This procedure may require more than one session, blood sampling.

Donors may also be prescribed pills, which causes increased production of stem cells from bone marrow.

Selected stem cells will be filtered. Further, the doctor inserts through a small cell, flexible tube, called a catheter, in one of the large veins of the patient.

Immediately after treatment

Donor fairly quickly restored.

The patient should be placed in an isolated room. This is to avoid infection before, as the new stem cells to fully restore the bone marrow to develop blood cells to fight infections.

Will it hurt?

Donor:

  • If you do a bone marrow transplant, during the transplant, the donor is under general anesthesia. After, as the anesthesia wears off, may feel some pain and discomfort.
  • If the transplant of blood stem cells, then the donor will have pain from the injection needle into a blood vessel.

Patient:

  • The pain is not felt, but after, as the donor cells and the body's own cells will mix, It may feel nausea. From it you can get rid of with medication.

The average hospital stay

Donor:

  • For a bone marrow transplant – one night;
  • For a stem cell transplant – multiple sessions (each session lasts for a few hours of selection);

A patient can be in the hospital until 1-2 months.

Care after transplantation

Donors can be assigned:

  • Painkillers;
  • Antibiotics to prevent infection.

During the restoration in the hospital the patient may receive the following help:

  • Drugs, that reduce immunity, to reduce the likelihood of graft rejection;
  • Antibiotics to prevent infection;
  • Platelets, plasma and red blood cell transfusions to prevent bleeding and anemia;
  • Frequent blood tests to monitor the introduction of new stem cells in the host organism.

Emergencies after transplantation of bone marrow or stem cell

After discharge from the hospital need to see a doctor in the following cases:

  • There is nausea and / or vomiting;
  • Strong pain;
  • Increased pain in over 24 hours after transplantation;
  • Redness, edema, increased pain, bleeding or discharge from the catheter site;
  • Signs of infection, including fever and chills;
  • Rash;
  • Diarrhea.

In the case of a serious and rapidly deteriorating health should immediately call an ambulance.

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