BONE MARROW TRANSPLANT PROCEDURE

A bone marrow transplant is a procedure that infuses healthy blood-forming stem

cells into your body to replace your damaged or diseased bone marrow. A bone marrow
transplant is also called a stem cell transplant.

Pre-transplant evaluation

 Before a blood or marrow transplant can be approved as a treatment option, you will
have a pre-transplant evaluation. This evaluation includes a complete physical,
consultations with members of the Transplant Team, and a comprehensive series of tests.
A pre-transplant evaluation provides complete information about your overall health and
helps determine if you are eligible for a blood or marrow transplant.

 Before a bone marrow transplant operation, certain tests are required. These include
blood tests, a chest X-ray, PET scan, heart tests, and a bone marrow biopsy. Donors are
also expected to complete certain tests.

During your bone marrow transplant

 Your bone marrow transplant occurs after you complete the conditioning process. On the
day of your transplant, stem cells are infused into your body through your central line
 The transplant infusion is painless. You'll be awake during the procedure.

After your bone marrow transplant

 When the new stem cells enter your body, they travel through your blood to your bone
marrow. In time, they multiply and begin to make new, healthy blood cells. This is called
engraftment. It usually takes several weeks before the number of blood cells in your
body starts to return to normal. In some people, it may take longer.
 In the days and weeks after your bone marrow transplant, you'll have blood tests and
other tests to monitor your condition. You may need medicine to manage complications,
such as nausea and diarrhea.
 After your bone marrow transplant, you'll remain under close medical care. If you're
experiencing infections or other complications, you may need to stay in the hospital for
several days or sometimes longer. Depending on the type of transplant and the risk of
complications, you'll need to remain near the hospital for several weeks to months to
allow close monitoring.
 You may also need periodic transfusions of red blood cells and platelets until your bone
marrow begins producing enough of those cells on its own.
 You may be at greater risk of infections or other complications for months to years after
your transplant. You'll have periodic lifelong follow-up appointments with your doctor to
monitor for late complications.

NURSING RESPONSIBILITY

 BONE MARROW TRANSPLANT

Pre-transplant period
 Identification of the appropriate type of transplant to be done and, if necessary,
finding an appropriate donor;
 Entry of the patient into the transplant unit
 Administration of the preparative chemotherapy/irradiation regime
management of early toxicities
 Pre-transplant supportive care.
Post-Bone Marrow Transplantation Care
 The marrow recipient is kept in isolation during the time to minimize potential
infections.
 The recipient also receives IV antibiotic, antiviral, and anti-fungal medications,
as well as blood and platelet transfusions to help fight off infection and prevent
excessive bleeding.
 Blood tests are performed.
 Daily monitor the patient’s kidney and liver function, as well as nutritional
status.

 BLOOD TRANSFUSION
 During the blood transfusion, a nurse carefully watches the patient, especially for
the first 15 minutes. This is when bad reactions are most likely to occur.
 Explain the procedure to the donor and reassure him/her with confidence and
cooperation.
 Each donor must labeled in clear, readable, bearing the following information to
verified at the time of administration such as name of the donor, donor number,
ABO grouping, Rh typing, date of drawing blood, date of expiry, and results of tests
for hepatitis and syphilis.
 When blood or blood products have to be administered, it is recommended that two
registered nurse or a physician and a registered nurse should independently verify
all identifying information on the report of the cross match, unit label and patient’s
identifications. Any error in the identification, results in the major adverse reactions.
 Should there be any discrepancy, the unit should be returned to the blood bank with
the remarks.
 The following observation are made throughout the procedure:
 Rate of flow
 Signs of circulatory overloaded
 Urinary output
 The needle site of signs of infiltration, hematoma, and dislodgement of needle
 Blood level in the container. Never allow the blood bottle to be completely
empty to prevent the entry of air.
 Reaction to the blood transfusion.
 Patency of the infusion set.
 Keep the patient warm and comfortable with blankets if necessary.
 Offer bedpan before starting the procedure and as necessary.
 After a blood transfusion, vital signs are checked such as temperature, blood
pressure, respiration rate, and heart rate.

https://www.mayoclinic.org/tests-procedures/bone-marrow-transplant/about/pac-
20384854
https://my.clevelandclinic.org/health/treatments/4752-bone-marrow-transplant
https://www.slideshare.net/98567/presentation-of-stem-cell-and-bone-marrow-tranplan-
tation
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2589372/