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Preparation

To begin the transplant approval process, patients undergo a variety of diagnostic tests and physical examinations. Patients are required to learn more about the transplant procedure and what will be required of them.

Patients who are approved for a transplant may then be put on a waiting list to receive bone marrow, and/or begin the process of finding a suitable donor. Depending on the patient's specific condition, possible bone-marrow donors are the patient himself or herself, or a living relative who has matching tissue (usually a sibling) or an unrelated donor with matching tissue. A blood test helps determine matches.

If a patient uses his or her own marrow or stem cells, the patient will either undergo leukapheresis (in which stem cells are taken from the blood) or surgery (in which bone marrow is taken from the top of the hip bone).

If the donor is a relative or other person, the marrow will be removed from the top of the hip bone while the donor is under general anesthesia.

The donor marrow or stem cells may be used immediately, or frozen and used at a later date.

Procedure

Before the new marrow or stem cells can be put into the patient's body, the patient must undergo chemotherapy or radiation. This process will destroy the abnormal blood cells or cancer. It will also help dull the patient's immune system so that his or her body is less likely to reject the donated marrow or stem cells.

The donated marrow is then delivered into the patient's veins through an IV line. The patient's blood carries the new marrow into the bone cavities.

Recovery

After the transplant surgery, patients stay in the hospital while the new bone marrow begins to grow. This period can last between two weeks to three months. UT Southwestern Medical Center has special facilities that are kept as sterile as possible to help reduce the risk of infection. The facilities include a dedicated 13-bed, HEPA-filtered unit. Patients are cared for by experienced hematologists and oncologists as well as ancillary personnel who work toward optimal management of all aspects of patient care.

Follow-up visits are required, especially during the first two to three months. A full recovery from the transplant usually takes between six to 12 months. Patients who received marrow or stem cells from a donor will need to take immunosuppressive (anti-rejection) drugs.