Bone Marrow Transplant

Bone Marrow Transplantation

Is a therapeutic possibility for some patients with hematologic disorders specifically severe aplastic anemia, some forms of leukemia, and thalassemia. Success of the treatment depends on tissue compatbability and the patient tolerance of immunosuppression if the donor cells are not autologous. Patients require intensive nursing care that is directed towards prevention of infection and assessment for early signs and symptoms of complications

Types of Bone Marrow Transplant

Allogenic: from a donor other than the patient; donor may be a related donor ( family donor) or a matched unrelated donor ( national bone marrow registry, cord blood registry) Autologous: from the patient Syngenic: from an identical twin

Obtaining Bone Marrow

Typically harvested directly from the red marrow in the iliac crest, the patient is usually under general anaesthesia. Procedure is minimally invasive and does not require stitches afterwards Depending on the donor's health and reaction to the procedure, the actual harvesting can be an outpatient procedure, or can require 12 days of recovery in the hospital

Good Source of Bone Marrow

Implementing Pretransplantation Care

 All patients must undergo extensive Pretransplantation evaluation to assess the current clinical status of the disease.

 Nutritional assessment, extensive physical examinations, organ function tests, and psychological evaluations are conducted.

 Blood work includes assessing past antigen exposure (hepatitis virus, cytomegalovirus, herpes simplex virus, human immunodeficiency virus (HIV) and syphilis)

 The patients social support systems and financial and insurance resources are also evaluated.

 Informed consent and patient teaching about the procedure and pre transplantation and post transplantation care are vital

CARING FOR THE DONORS

Donors commonly experience: a} mood alteration b} decrease self esteem c} and guilt from feelings of failure if the transplantation fail Family members must be educated and supported to reduce anxiety and promote coping this difficult time. Family members must also be assisted to maintain realistic expectations of themselves as

CARING FOR THE DONORS

Family members must be educated and supported to reduce anxiety and promote coping this difficult time. Family members must also be assisted to maintain realistic expectations of themselves as well as of the patient. As BMT becomes more prevalent .many moral and ethical issues become apparent, including those related to informed consent allocation a resources and quality of life

Providing care during treatment

Nurses also provide ongoing education for the patient and their family and caretakers. Early intervention and treatment of common complications/side effects of transplant including mucositis myelosuppression hemorrhagic cystitis sepsis

Include comprehensive care and assessment such as pain, nausea/vomiting, temperature imbalance treatment of fluid and electrolyte abnormalities administration of prescribed medication should be strict such as (antibiotics, antivirals, antifungals)

Providing for post transplantation care (care for recipients)

The patient will be isolated because of the increased risk of infection
The health care team will closely monitor your blood count and vital signs.

While you are in the hospital you may:

The patient will receive prescribed medications Need many blood transfusions Be fed through a vein (IV) until you can eat by mouth and stomach side effects and mouth sores have gone away Be given medications to prevent graft-versus-host disease