Evaluation and Preparation for Stem Cell Transplant

You will first be evaluated to find out if you are eligible for a transplant. A transplant is very hard on your body. For many people, transplants can mean a cure, but complications can lead to death in some cases. You will want to weigh the pros and cons before you start. Transplants can be hard emotionally, too. They often require being in the hospital, being isolated, and there is a high risk of side effects. Many of the effects are short-term, but some problems can go on for years. This can mean changes in the way you live your life. For some people it’s just for a while, but for others the changes may be lifelong. It’s also very hard going through weeks and months of not knowing how your transplant will turn out. This takes a lot of time and emotional energy from the patient, caregivers, and loved ones. It’s very important to have the support of those close to you. You will need, for instance, a responsible adult who will be with you to give you medicines, help watch for problems, and stay in touch with the team after you go home. Your transplant team will help you and your caregiver learn what you need to know. The team can also help you and your loved ones work through the ups and downs as you prepare for and go through the transplant. Many different medical tests may be done, and questions will be asked to try to find out how well you can handle the transplant process. These might include: •HLA tissue typing, including high-resolution typing •A complete health history and physical exam •Evaluation of your psychological and emotional strengths •Identifying who will be your primary caregiver throughout the transplant process •Bone marrow biopsy •CT (computed tomography) scan or MRI (magnetic resonance imaging) •Heart tests, such as an EKG (electrocardiogram) or echocardiogram •Lung studies, such as a chest x-ray and PFTs (pulmonary function tests) •Consultations with other members of the transplant team, such as a dentist, dietitian, or social worker •Blood tests, such as a complete blood count, blood chemistries, and screening for viruses like hepatitis B, CMV, and HIV You will also talk about your health insurance coverage and related costs that you might have to pay. You may have a central venous catheter (thin tube) put into a large vein in your chest. This is most often done as outpatient surgery, and usually only local anesthesia is needed (the place where the catheter goes in is made numb). Nurses will use the catheter to draw blood and give you medicines. If you are getting an autologous transplant, a special catheter can be placed that can also be used for apheresis (a-fur-REE-sis) to harvest your stem cells. The catheter will stay in during your treatment and for some time afterward, usually until your transplanted stem cells have engrafted and your blood counts are on a steady climb to normal.