Bone marrow transplant

From ArticleWorld

Bone marrow transplant is a medical operation than involves transplantation of the HSC (hematopoietic stem cells) from a donor to a receiver. People who need such a transplant are those with severe affections of the blood, bone marrow or special types of cancer. It is generally a very risky operation with a high risk of rejection and is commonly performed only for people with severe, life-threatening affections.

Indications

Most receivers are patients with leukemia or some other type of affection that would be treatable only with high doses of chemotherapy or with extensive (or total) body irradiation. Common patients are also children born with malfunctioning stem cells.

Operation is quite commonly allograft, but some autograft operations have been performed, with stem cells previously stored from the patient while they were still healthy. The stem cells are obtained by extraction from a large bone (usually the pelvis), using a large needle that goes all the way to the center of the bone.

Operation

A catheter is used to inject the HSC into the blood intravenously. After a short circulation through the blood vessels, HSC cells will reach and fixate into the bone marrow spaces, and will soon start producing blood cells. The production of blood cells is continuously monitored, waiting for the parameters to reach normal levels. An extensive post-operatory care is required.

Risks

The risks involved in such an operation are multiple and very severe, with a fair mortality rate of at least 10%. The most common risk is the one occurring because of the regimen. Before performing the operation, aggressive chemotherapy or irradiation is used, which may cause severe liver affections and elevated bilirubin and hepatomegaly levels. It may also affect the mucosal lining of the mouth and throat.

Because of the pre-operatory destruction of the receiver's own bone marrow, there is a great risk of infection. The usual prevention methods involves an aggressive antibiotic treatment, a risk augmented by the post-operatory immunosuppressive treatment performed in order to prevent rejection. The risk of rejection poses a particularly high danger, which is why many transplants must be done between identical twins more commonly than in other transplantation cases.