The transplantation process includes a large number of steps, starting with the initial decision on conducting transplantation and up to pre-precious examinations of the patient, internalization and long-term observation after discharge.
Before the transplant procedure, the coordinator will provide a patient with detailed information with answers to all issues about the process, as well as the date and time of initial evaluation consultation in the clinic. Specialist in transplant informs the patient about the possibility of complications, about the success indicators, as well as the results in the long run. This survey will be the starting point of the transplant process. The patient will ask for written consent to carry out the operation. After that, preparatory research is being carried out.
For the initial assessment, the patient must take advice with a bone marrow transplant specialist doctor in the clinic of the bone marrow transplantation center. Consultation includes:
- Study by the doctor of the history of the disease (anamnesis) of the patient, the treatment passed, discussion of treatment options and providing the patient information on the recommended treatment;
- Inspection of the MCA bone marrow transplantation center accompanied by a coordinator nurse;
- The nurse coordinator sends a patient to a special department for referring to the reception or registration of medical insurance. After signing the consent to conduct bone marrow transplantation, the following steps are being taken:
Choosing an accompanying person: a relative or a close friend is selected in order to help the patient in all situations including observation of health, physical assistance, acquisition and acceptance of medicines, the fulfillment of administrative procedures to the clinic, maintain contact with a doctor and nurse, emotional and psychological support. The center's nurse coordinator will inform the selected face about his / her responsibilities and will conduct training.
Accommodation: The patient will inform about the need to remove accommodation in the immediate vicinity of MCA 1-4 months before transplantation. A team of patient / international patients will help in organizing the process.
Financial training: Financial expenses are planned for the entire transplant process.
2. Preparation for transplantation
Allogenic transplantation: The first step of allogeneic transplantation is the selection of brother / sister or relative with the coinciding HLA.
Outdoor transplantation: the donor is the patient of autologous transplantation itself. Depending on the health and diagnosis of the patient, the team of specialists from the bone marrow transplantation center will establish the type of bone marrow mobilization, as well as the time and method.
Survey of the donor in Anadolu's Medical Center: Donor (patient himself, relative, etc.) is the initial inspection in the clinic.
First Consultation: A doctor and nurse will examine the patient in the clinic of the bone marrow transplantation center in order to learn the history of the disease, conduct a survey and analyzes of blood, to acquaint the patient with the clinic.
Consulting the donor and relatives of the patient: the next day the doctor and nurse appoint a reception to meet with the patient and his family / friend to explain the transplantation process, its advantages and risks, and also answer all the questions.
Examination: Ambulatory surveys will be held within 1-2 weeks. Survey data are aimed at establishing a general health. Additional examinations, such as the aspiration of the bone marrow, the pulmonary radiograph, the ECG is carried out if necessary.
Consultation on the results of the survey: the doctor will report the results of the survey and analyzes to the patient, will answer all the questions you are interested in and will explain the situation.
Training: the patient and the accompanying person will tell about the transplantation process, operations in the clinic and the patient's condition after discharge.
Donor: The donor will also be informed on all issues, as well as he / her will be given the opportunity to ask questions interested in, in case he / she is a relative. If the bone marrow is necessary at the donor, the material will be rebar and frozen in accordance with the previously installed mode.
During autologous transplantation, peripheral blood stem cells will also be taken and frozen in accordance with the established stem cell mobilization mode. The process of bone marrow mobilization lasts from 7 to 20 days depending on the selected mode.
3. Preparatory regime
In the clinic, the patient will host a course of chemotherapy and / or radiation therapy in accordance with an individually composed treatment plan in order to completely (myeloblastic transplantation) or partially (transplantation with reduced intensity or non-loblast) to destroy bone marrow cells. The duration and type of treatment vary depending on the type of disease. Typically, the duration of treatment is from 2 to 8 days. This treatment mode will weaken the immune system, as a result of which the patient will become more vulnerable to infections. Treatment may also entail such side effects as nausea, difficulty swallowing, abdominal pain, fatigue and loss of appetite. In order to minimize discomfort, preventive measures will be taken.
4. Stem cell transplantation
1-2 days after the preparatory mode is completed, stem cell transplantation is made, which is very similar to blood transfusion procedure.
Regardless which transplantation is carried out - allogenic or autologous, frozen bone marrow, or peripheral blood stem cells, polar from the donor, will be dropped and after the necessary preparation is intravenously introduced to the patient through the central catheter.
Bone marrow or peripheral blood stem cells can be taken from the donor and administered to a patient without freezing. In this case, the mobilization mode at the donor will begin before the transplantation. The bone marrow is closed directly on the day of transplantation and intravenously introduced to the patient without freezing.
The bone marrow is closed by the donor in the operating room on the day of transplantation and is immediately introduced to the patient. This method is usually used when working with patients suffering from aplastic anemia and chronic myelolomicosis.
5. The process of adheated
The adhesion is a successful embedding of the transplanted bone marrow in the patient's body, which is expressed in the reproduction of blood elements. This process takes from 10 to 35 days. The most serious complications that may arise during this period are infection and bleeding. The adhesion of neutrophils is an increase in the number of neutrophils to more than 500 in the next two days. Furiousness of platelets is an increase in the number of platelets to more than 20,000 for the next two days. The neutrophil enression time can be reduced by 2-3 days due to the use of growth factor, which is called M-KSF (granulocytic colony-positive factor). During this period, the patient will be hospitalized. After the adheated period, the patient's state and date of the patient will be determined on the basis of such factors as the absence / presence of infections, the assimilation of medicines introduced intravenously and proper independent meals.
6. Recovery after adheated
The first signs of recovery after the adhesive can be noticed in approximately 3 months. This period will need to be held near the clinic in Istanbul. The patient will need to regularly visit the MCC to pass the blood tests (every week or more often). The patient's accompanying person should be prepared to help the patient in this period. Before starting the process, the patient and the accompanying person will be a special training to learn everything. In the event of issues or complications during this period, you can contact your doctor or nurse at any time. Temporary intervals between regular checks will increase as soon as the patient goes on the amendment.
7. Long-term observation after recovery
After completing the adhesion, the process of recovery begins. The patient and his accompanying person will be informed about the need for long-term observation. The patient will be a detailed examination and will receive a conclusion. During the next consultation with the doctor and nurse, the patient and his accompanying person will be provided with comprehensive information on further actions, cases that require special attention, lifestyle, diet and physical exertion. Despite the fact that the patient will have all this information, the doctor will still be to observe the patient's condition for a long time. The first time the patient is usually invited to a survey in three months. For each patient, an individual plan of long-term observation is drawn up depending on the preparations taken, the degree of restoration of the immune system, the reaction of the "transplant against the owner", as well as possible complications. Patients are also invited to participate in the vaccination program by 12 and 24 months after adheated.
Bone marrow transplantation in Anadolu >> Rules for patients during bone marrow transplantation >> Frequently asked questions about Bone marrow transplantation >> Evaluation of the possibility of transplantation >> Hematology in Anadolu >>
All materials on the site are prepared by experts in the field of surgery, anatomy and profile disciplines. All recommendations are approximate and without advising the attending physician not applicable.
Author: Averina Olesya Valerievna, Ph.D., Pathologist, teacher of Pat. Anatomy and pathological physiology, for operation. Info ©
Bone marrow transplant refers to the category of the most complex and very expensive procedures. Only this operation can return the patient with severe blood-formation pathology to life.
The number of transplantations conducted in the world gradually grows, but it is not capable of providing all in need of such treatment. First, transplantation requires a donor selection, secondly, the procedure itself involves high costs and donor, and patient, as well as subsequent treatment and observation. Only large clinics with appropriate equipment and high-quality specialists can offer such a service, but not every patient and his family will "pull" the treatment in financial plan.
Bone marrow transplantation (km) is a very serious and long-term procedure. Without transplanting donor hematopoietic fabric patient will die. Indications for transplant:
- Acute and chronic leukemia;
- Aplastic anemia;
- Severe hereditary forms of immunodeficiency syndromes and some types of metabolic disorders;
- Autoimmune diseases;
- Separate types of extracillary tumors (breast cancer, for example).
The main group of persons in need of transplantation make up patients with tumors of blood-forming fabric and aplastic anemia. The chance of life with leukemia, not amenable to therapy, the transplantation of a donor organ or stem cells is becoming a transplantation, which, with a safe advent of adventure, will become a functioning bone marrow of the recipient. In aplastic anemia, there is no proper differentiation and reproduction of blood cells, the bone marrow fabric is depleted, and the patient suffers from anemia, immunodeficiency, bleeding.
To date, there are three types of transplanting of a hematopoietic fabric:
- Bone marrow transplantation.
- Transplantation of blood stem cells (CCC).
- The transfusion of cord blood.
When transplantation of stem cells, the latter are selected from the peripheral blood of the donor during the relevant procedure and preparation. Cord blood - a good source of stem cells, donor preparation and complex measures for the fear of the material in this form of transplantation is not required. The very first way of transplanting the hematopoietic fabric was the bone marrow transplantation, so often the other types of operations are called this phrase.
Depending on where stem cells come from, a transplant is distinguished:
Outworm transplantation It is to transplant "native" stem cells of the patient prepared in advance. This treatment option is suitable for persons whose bone marrow was originally amazed by a tumor. For example, lymphoma grows in lymph nodes, but over time, it is capable of incurred into the bone marrow, turning into leukemia. In this case, it is possible to take intact bone marrow fabric for subsequent transplantation. The CCM transplantation planned in the future allows you to resort to more aggressive chemotherapy.
Outworm bone marrow transplantation
Allogenic transplantation means a bone marrow transplant from the donor, be it a relative or someone else's person. This type of operation is shown by patients with leukozes and aplastic anemias, when "mined" his healthy bone marrow does not seem possible. Volunteers wishing to share their fabrics for the rescue of life to help with such patients.
What should know the donor of the hematopoietic cloth
The main type of transplantation today is the transplant of the donor bone marrow obtained from an unauthorized person. The donor is a person who voluntarily agreed to share his hematopoietic fabric or CCM. This is a serious step, so most potential donors are aware of the entire degree of responsibility and their commitments.
A donor may be anyone who has achieved majority and up to 55 years, never suffered with hepatitis B and C, which is not a carrier of HIV infection and not suffering from mental illness, tuberculosis, malignant tumors. Today, registers of donors of KM, consisting of over 25 million persons. The most of their number is the inhabitants of the United States, among the countries of Europe leads Germany (about 7 million people), in neighboring Belarus there are already 28 thousand, and in Russia the donor bank is only about 10 thousand people.
Donor search is a very complex and responsible stage. When selecting a suitable donor, the first business is examined by the nearest relatives, the degree of coincidence with which the most high histocompatibility antigens. The probability of compatibility with brothers and sisters reaches 25%, but if these are not either they cannot become donors, the patient is forced to contact international registers.
The racial and ethnicity of the donor and the recipient is of great importance, since Europeans, Americans or Russians have a distinguished spectrum of histocompatibility antigens. Small peoples are almost unrealistic to find a donor among foreigners.
The principles of the selection of the donor are based on the coincidence on the antigens of the HLA histocompatibility system. As is known, leukocytes and many other organism cells carry a strictly specific set of proteins that determine the antigenic individuality of each of us. Based on these proteins, the body recognizes "its" and "alien", provides immunity to alien and its "silence" against its own tissues.
HLA leukocyte antigens are encoded by DNA areas located on the sixth chromosome and the components of the so-called main histocompatibility complex. At the moment of fertilization, the fruit receives half of the genes from the mother and half of the Father, therefore the degree of coincidence with close relatives is highest. Single-time twins have an equal set of antigens at all, so they are considered the best pair of the recipient donor. The need for transplants between the twins occurs very rarely, and the absolute majority of patients have to look for an irrelevant bone marrow.
The selection of the donor implies the search for a person as much as possible by the HLA antigens with the recipient. Known antigens, which are very similar among themselves in structure, they are called cross-reacting, and they increase the degree of coincidence.
Why is it important to choose the most suitable version of the donor bone marrow? It's all about immune reactions. On the one hand, the recipient body is able to recognize the donor cloth as an alien, on the other, the transplanted fabric may cause an immune response against the recipient tissues. And in that, and in another case, the reaction of the rehabilitation of the transplanted tissue will arise, which will reduce the result of the procedure to zero and may cost the recipient life.
bone marrow fence at donor
Since the bone marrow transplantation occurs complete elimination of its own hematopoietic fabric and the oppression of immunity, then the transplant against the host is more likely to be more likely. The recipient's body does not occur the immune response to the alien, but the transplanted active donor bone marrow is able to develop a strong immunological response with a transplant rejection.
Potential donors are tested by HLA antigens, conducted using the most complex and expensive tests. Before the transference procedure, these tests are repeated to make sure the donor and recipient compatibility. The determination of the so-called preexisting antibodies is considered to be considered, which could be formed from a potential donor at preceding blood transfusions, women's pregnancies. The presence of antibodies even with a high degree of coincidence of histocompatibility antigens is considered to be contraindicated to transplantation, as it causes acute rejection of the transplanted tissue.
DONOR DONOR HOLDERAL FACABILITY
When a suitable donor is found, he will have a fence fabric for transplanting recipient. In itself, the bone marrow donation implies complex and even painful procedures , Therefore, potential donors, being informed about the upcoming development of events, are already aware of the importance of their participation and the degree of responsibility in the process of transplantation, and there is practically no refusal of refusal.
The refusal of donation is unacceptable at the stage when the patient has already passed the stage of air conditioning, that is, 10 days before the planned transplantation. Having lost its own hematopoietic fabric, the recipient without a transplant will die, and the donor should clearly realize.
For the withdrawal of blood-made tissue, the donor is placed in the hospital for 1 day. The procedure is carried out under general anesthesia. The doctor with the help of a special needle punctures the iliac bones (there is more than the bone marrow fabric), the places of injections can be up to one hundred and more. For about two hours, it is possible to get about the liter of bone marrow fabric, but this volume is able to give life to the recipient and provide it with a new blood formation organ. With autologous transplant, the material obtained is pre-frozen.
After receiving the bone marrow, the donor may feel pain in the bone puncture sites, but it is safely removed by the intake of analgesics. Remote blood-made tissue is replenished over the next two weeks.
When transplanting the CCM, the method of obtaining the material is somewhat excellent. For five days before the planned seizure of cells, the volunteer takes drugs that increase their migration into the vessels - growth factors. At the end of the preparatory stage, the procedure of the Aphereris occupying up to five hours is appointed when the donor is on the device, "filtering" its blood, selecting stem cells and returning back all the others.
Procedure of Aferesa
During the apheresis, up to 15 liters of blood flows through the device, it is possible to obtain no more than 200 ml containing stem cells. After the pitaise, it is possible soreness in bones associated with stimulation and an increase in the volume of own bone marrow.
CM transfer procedure and preparation for it
The CM transplantation procedure occurs like a conventional blood transfusion: the recipient is injected with a liquid donor bone marrow or CCM, taken from peripheral or umbilical blood.
Preparation for SM transplantation has certain differences from other operations and is the most important event aimed at ensuring the enrollment of donor tissue. At this stage, the recipient passes conditioning which includes aggressive chemotherapy necessary to complete the destruction of its own km and tumor cells in it during leukemia. Air conditioning leads to the suppression of possible immune reactions that prevent the advent of donor tissue.
Total elimination of blood formation requires a mandatory subsequent transplant, without which the recipient will die, which is repeatedly preventing a suitable donor.
Before the planned bone marrow transplantation, the patient is subject to a thoroughly survey, because the outcome of the treatment of its organs and systems depends on the state of the function of its organs and systems. The transplant procedure requires good, as far as possible in this situation, the health of the recipient.
The entire preparatory stage takes place in the transplantation center under the constant control of highly qualified specialists. Due to the suppression of immunity, the recipient becomes very vulnerable not only to infectious diseases, but also to ordinary microbes that each of us wears on yourself. In this regard, for the patient, the most sterile conditions are created, excluding contact even with the most close members of the family.
After the air conditioning stage, which lasts only a few days, proceed to the transplanting fabric itself. This operation is not similar to the surgical intervention familiar to us, it is produced in the ward, where the recipient is poured into liquid bone marrow or stem cells intravenously. The patient is under the control of the staff, which monitors its temperature, fixes the appearance of pain or degradation of well-being.
What happens after bone marrow transplantation
After bone marrow transplantation The adhesion of donor tissue begins, which is stretched for weeks and months, requiring persistence. For the adheated of the hematopoietic fabric you need about 20 days, throughout which the risk of rejection is maximum.
Waiting for donor fabric engradment is a heavy stage not only physically, but also psychologically. The patient is actually without immunity, a very subject to different kind of infections, prone to bleeding turns out to be in almost complete isolation, without having to communicate with the most close people to him.
At this stage of treatment, unprecedented measures are taken to prevent patient infection. Drug therapy consists in the appointment of antibiotics, platelet mass for the obstacle bleeding, medicines that prevent the "transplant against the host" reaction.
All the staff, which enters the ward to the patient, washes hands with solutions of antiseptics, puts on clean clothes. Blood tests are made daily in order to control the enression. Visits to relatives and the transfer of things is prohibited. If necessary, leave the ward, the patient puts on a protective bathrobe, gloves and a mask. It is impossible to transfer food food, flowers, household items, in the ward there is only the most essential and safe.
Video: An example of a chamber for bone marrow recipient
After transplantation, the patient spends about 1-2 months in the clinic, After which, in the case of successful adheated donor tissue, he may leave the hospital. It is not recommended to leave far away, and if the house is in another city, it is better to rent an apartment near the clinic in the near future, so that at any time it was possible to return there.
During the bone marrow transplantation and the patient's period, the patient feels very patient, is experiencing severe fatigue, weakness, nausea, lack of appetite, probably fever, violation of the stool in the form of diarrhea. Psycho-emotional state deserves special attention. The feeling of depression, fear and depression are frequent satellites of transplanting donor tissues. Many recipients note that psychological stress and experiences were for them a heavier test, rather than the physical sensations of unhealthy, so it is very important to ensure the patient maximum psychological comfort and support, and possibly the assistance of a psychologist or psychotherapist will be required.
Almost half of patients in need of a CM - children, patients with malignant blood tumors. In children, bone marrow transplant implies the same stages and events as in adults, but treatment may require more expensive drugs and equipment.
Life after bone marrow transplant imposes certain obligations on the recipient. In the next six months after surgery, he will not be able to return to labor activity and the usual way of life, a visit to crowded places will be avoided, since even a campaign to the store may be dangerous due to the risk of infection. In the event of a successful graft of the graft, the lifespan after treatment is not limited. There are cases when after the bone marrow transplant in children, small patients grew safely, created families and started children.
About a year after the bone marrow transplant procedure, the patient is under the supervision of doctors, regularly redeem blood tests and other necessary surveys passes. This period is usually necessary in order for transplanted tissue to work as its own, providing immunity, proper blood coagulation and other organs.
According to the reviews of patients who have undergone successful transplantation, their life has become better after the operation. It is quite natural, because before treating the patient was in a step from death, and the transplant allowed to return to normal life. At the same time, the feeling of anxiety and anxiety can still not leave the recipient due to the fear of the development of complications.
The survival rate of patients undergoing bone marrow transplantation is influenced by the age, the nature of the main disease and its duration before the operation, the floor. In patients up to 30 years old, female, with a disease duration of no more than two years before transplanting, survival rate for more than 6-8 years reaches 80%. Other source characteristics reduce it to 40-50%.
Bone marrow transplant is quite expensive. The patient will have to pay for all the preparatory stages, medicines, the procedure itself and subsequent observation. The cost in Moscow begins from 1 million rubles, in St. Petersburg - 2 million and higher. Foreign clinics offer this service for 100 and more than thousand euros. Trust uses transplantology in Belarus, but also there is treatment for foreigners at a cost compared to those in European clinics.
Free in Russia, transplants are carried out insignificantly little due to the limited budget and the absence of suitable donors from among compatriots. When searching for foreign donors or direction on a transplant to another country, it is only paid.
In Russia, the CM transplantation can be made in large clinics of Moscow and St. Petersburg: the Institute of Children's Hematology and Transplantology. R. M. Gorbacheva in St. Petersburg, Russian Children's Clinical Hospital and Hematology Scientific Center of the Ministry of Health of the Russian Federation in Moscow and some others.
In Russia, the main problem of bone marrow transplantology is not only a small number of hospitals conducting such treatment, but also a huge lack of donors and the absence of its own register. Typing costs does not bear the state, as well as to find suitable candidates abroad. Only active attraction of volunteers and a high level of consciousness of citizens can to some extent to improve the situation of donation.
Video: On the conduct of bone marrow transplantation
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Bone marrow transplantation - what is it?
Bone marrow transplantation (TKM) is the implantation procedure of healthy hemopoietic cells into the patient's body in order to resume the blood formation process.
Explanation for transplantation:
Contraindications for transplant:
- Heavy liver and kidney pathologies
- Infectious diseases
- Physical weakness of the body (elderly age, concomitant diseases)
Bone marrow transplant Children is carried out according to the same testimony and contraindications as adult patients.
What are the types of transfers?
It is customary to distinguish between bone marrow transplant types:
- Outworm transplantation - an operation in which the patient implanted its cells
- Allogenic transplantation from relative
- Allogenic transplant from a donor who is not a relative
- Gaploident transplantation is a transplant type, in which the relative bone marrow is used partly compatible. The survival rate of the graft after such a procedure occurs only in 25% of patients
How is the preparation for transplantation?
Preparation of the patient for transplant
The most important stage of preparation for transplantation - air conditioning. This therapy, which is carried out in cancer diseases. It lies in the reception of chemotherapeutic drugs and immunosuppressors. This oppresses the immunity of the patient in order not to be rejected by the transplanted material. Also, the method helps to destroy cancer cells and frees the place for the transplant.
In the case of transplantation of own cells, the fence is first made, and after the material freezes until the end of the course of chemotherapy.
Diagnostic procedures before the bone marrow transplant operation:
- Consultation of specialists, incl. Dentologist
- MRI and CT, PET-CT (if we are talking about oncological disease)
- Naliz of blood (incl. for HIV, hepatitis, etc.)
- Biochemical blood test is carried out in order to make sure that the liver and kidneys are working. Otherwise the transplant can be contraindicated
- Trepan biopsy and bone marrow aspiration. This is puncture of bone tissue and bone marrow, followed by cytogenetic analysis
If necessary, the patient takes treatment at the dentist. It is necessary to completely exclude infections, because after the transplantation, their presence is deadly.
Preparation for donation
The donor passes the routine diagnostics to exclude any diseases that can transmit the recipient.
If the fence is made from peripheral blood, the donor is prescribed special drugs that must be taken within 5 days. They contribute to the active output of cells in the bloodstream.
Possible side effects of the reception of these drugs. It is usually a short bone pain.
How is transplantation?
Stage 1. Fence
The bone marrow takes under general anesthesia. At first, the doctor makes a small incision, and then with a wide needle makes puncture of material from the femoral bone.
Also, the donor can choose a variant of the intake of cells from peripheral blood. For this donor, a few hours are connected to the apparatus that swings blood. Through a special separator of the bone marrow cell separated from the blood and are collected in a separate reservoir.
Stage 2. Transfer
The bone marrow is transplanted by intravenous injection. The procedure lasts up to 2 hours.
3 stage. Period of engraft
The introduced cells over time are coming and begin to produce new healthy blood cells.
Hospitalization lasts about 3 months.
Who can become a donor for bone marrow transplant?
The relative donor can be a native brother or sister of the patient. However, even such a donor is compatible. In rare cases, a haploidental transplant is carried out. The donor can be a father or mother of the patient.
For non-relevant transplantation, the selection of the candidate occurs through the database of the bone marrow donor bank. The search usually takes about 2 weeks. The largest banks of the US bone marrow donors, European and German banks. Typically pick 2-3 people, since a potential candidate may have temporary contraindications, refuse the procedure or may not be in the country.
It is worth noting that there are cases when finding a suitable candidate cannot be found.
Contraindications to donation are:
- Infectious diseases
- Autoimmune diseases
- Mental disorders
- Age under 18 and older than 55 years
What complications may be after the procedure?
The most serious complications after bone marrow transplantation are the rejection of the transplant organism and the attack of transplanted cells on the patient's body (the "transplant against the host" reaction). In order to prevent both of these reactions, immunosuppressors are prescribed to the patient - drugs, overwhelming immunity.
Such therapy, in turn, exposes the body of the patient risk of infection with infection. In order to minimize this risk, the patient is placed in sterile boxing. This is an isolated sterile chamber equipped with antobacterial filters.
For a donor, there is no risk of complications in bone marrow transplantation. However, there are minor side effects. There is a feeling of weakness, nausea hospitalization of the donor lasts one day. Paints in the place of puncture pass a few days later. The volume of donor bone marrow cells is resumed after 2 weeks.
The consequences of the patient's transplantation depend on a number of factors:
- Initial diagnosis
- Dormor compatibility degree
- Relative physical health
- Compliance with the insulation mode during adheated
- Competent protocol of treatment
If all the necessary precautions were observed, and the treatment was carried out in a well-equipped center under the guidance of an experienced doctor, the chances of recovery are high. This applies to patients with malignant diseases.
How is the rehabilitation after transplantation of blood-forming cells?
Conclusions about the success of transplant can only be done after a few weeks after surgery. During this time, the transplant is caring in the patient's body. For the grave of the graft, the patient is prescribed supporting therapy in the form of antiviral and antifungal drugs, as well as antibiotics.
Bone marrow transplant requires restoration not only physical, but also psychological. The patient for a long time is experiencing severe weakness. This condition affects his mental well-being, so it is extremely important to receive professional assistance from a psychologist during this period. It is also necessary that the patient's relatives support it at this time.
Life after bone marrow transplant
The life of patients who transferred a change is not much different from the daily life of an ordinary person. For a while, the prescriptions of the doctor must be observed, but it does not significantly affect the quality of life.
What is the forecast of life after transplantation?
Survival after bone marrow transplant depends, first of all, from the initial diagnosis. Also, the experience of an oncohematologist, which transplants cells. Thus, in German and Turkish clinics, the average survival rate of patients after transplant is more than 90%.
It is impossible to determine the lifespan after the bone marrow transplantation, since this indicator depends on many factors. A person is considered completely crushing, surviving the frontier 5 years after the procedure.
Recurney after bone marrow transplantation
The probability of recurrence after the bone marrow transplant exists. This figure varies significantly depending on the clinic in which the procedure is carried out. Thus, in foreign bone marrow transplant centers, the statistics for the emergence of relapse is much less than the same indicator in the CIS clinics.
The longer the time passed after the transplant - the lower the likelihood of recurrence. If the disease returns, transplantation is reused. The risk of unrecognizable survival after re-transplantation depends on the period of time between the first transplant and the first recurrence. If this period lasted more than a year, the chances of recovery are high.
Where do bone marrow transplant surgery?
Booking Health has allocated 2 best for you in our opinion clinic for bone marrow transplant in leading countries.
The leading German clinic in the field of transplanting blood-forming cells is the University of Ulma's university clinic. The separation of hematology, oncology, palliative medicine, rheumatology and infectiology is part of the center of integrated treatment of Cancer ULM and is certified by the German oncological society and the German organization to combat cancer.
One of the leading Turkish clinics in the field of oncohematology - the clinic Memorial Sischi, Istanbul. In the department of children's hematology and bone marrow transplants, the clinic memorial has been held all types of bone marrow transplant in children. The chief physician of the department, Professor Atatla Tanail, consists of European bone marrow transplantation society and the Jacie organization for accrediting medical institutions involved in bone marrow transplant.
How much does bone marrow transplantation cost?
Prices for transplanting in German clinics start from € 212,000. At the same time, the transplant from an unrelated donor will cost more, since the donor search separately is paid.
Prices for transplanting in Turkey begin from € 97,000. The price depends on the type of transplant, diagnosis and the general condition of the patient.
The price of bone marrow transplant to children in any of the countries can be somewhat different. In addition, some foreign centers are transferred to children only after a complete prepayment of the medical program.
Bone marrow donation - price
There is a misconception that donor services are paid. In fact, the donor does not receive any material remuneration. Donation is based on altruistic motivations. An attempt to buy / sell any organs, including bone marrow, is regarded as a criminal offense in any country.
Meanwhile, a separate payment requires the search for a donor through one of the registers. Usually the selection of the candidate is worth about € 12,000.
Organization of bone marrow transplant abroad
If it is necessary to carry out a bone marrow transplant, a number of issues arise. In which country to make a transplant? Do you need a visa? Does the prepayment need? Is it possible to urgently go to the treatment? Where to find a donor? How to get to the better specialist?
In order to solve all these questions, contact the Booking Health manager. Our experts will select the best solution for you.
- Individual selection of clinic
- The ability to choose the best doctor
- Service services: transfer and translator, registration of medical records
- Insurance that will ensure the preservation of the stated price. All unforeseen expenses will cover
Choose treatment abroad and you will undoubtedly get an excellent result!
Authors: Dr. Valery Kourilina, Alexander Solovy
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The bone marrow is a soft fabric located inside the bones.
In the bone marrow of a person, new blood cells are formed instead of the die - erythrocytes, leukocytes and platelets. After ripening, they fall into the blood and circulate by the body.
In medicine, it is customary to share a red bone marrow and yellow bone marrow.
Red - responsible for the production of blood cells.
Yellow is a cluster of passive fat cells that can be transformed into stem if necessary. He plays a role of a certain "reserve".
Stem cells are unique in that they are able to self-renew and turn into cells of different organs and tissues. Hematopoietic cells contained in the bone marrow are responsible for the process of blood formation.
Why is the bone marrow called the brain?
The bone marrow is in no way connected with the head or spinal. There is a version that he got a name from the verb "Cuspius" - "Mortuary to a fragmentation", "plush" because of its soft consistency. In English, the bone marrow call Bone Marrow, and the head - Brain. It is easy to see that these words have nothing to do.
Bone marrow transplantation. Why and who needs it?
Since all blood cells are developing from bone marrow cells, they can be transferred from healthy people to those who have such diseases like blood cancer.
It is possible to identify these diseases with the help of a bone marrow puncture - a small puncture with a fence of material for analysis.
Healthy stem cells are introduced the patient, which gradually restore blood formation in the body. In 1990, American doctors Edward Donnall Thomas and Joseph Murray received the Nobel Prize for this discovery.
Edward Donnall Thomas. Source: Wikipedia. https://img.nerews.com/media/gallery/111228595/731036038.jpg
Joseph Murray. Source: Wikipedia https://img.nerews.com/media/gallery/111228595/103550979.jpg
This procedure may be needed at high chemotherapy doses. The fact is that chemotherapy affects not only the tumor, but also on healthy organs and cells. One of the most vulnerable is the bone marrow. In order for the patient to not destroy aggressive treatment, it may be necessary for a bone marrow transplant.
There are two types of bone marrow transplantation: autologous and allogenic.
In case of autologous transplantation, the patient transplant its own pre-prepared and frozen cells, and with an allogeneic - patient (recipient) transplanted donor cells.
RIA Novosti / Evgeny Biyatov https://img.news.com/media/gallery/111228595/428960910.jpg
How to become a bone marrow donor and who can do it?
A competitive person from 18 to 55 years old can become a bone marrow donor, never suffered hepatitis in or with, malaria, tuberculosis, oncology, diabetes, mental disorders and is not a carrier of HIV.
Allogeneic transplants are three species, depending on who gives their own cells: compatible related, compatible non-compatible and partly compatible related donor. With a probability of 25% compatible donors for a person, his native brothers or sisters can be - when they need a donor exactly they are examined first.
But the bone marrow donor is not so simple, because the probability that the bone marrow of the donor is suitable for the patient - one to ten thousand. If we are talking about relatives, then the chance is higher.
To become a donor and be enrolled in a special register, you need to go through the typing procedure. When typing, a potential donor takes 5-10 milliliters of blood from Vienna to determine the phenotype - a special genetic formula that is entered into a special register. With the help of a phenotype, you can reveal with whom from the recipients of the donor will arise compatibility of tissues. The Rusfond website has a list of laboratories where you can hand over blood to get into the national register.
In the register, all the names of potential donors are encrypted in a special way and cannot be disclosed.
It may happen that donor cells will not suit the transplantation to anyone.
RIA Novosti / Vladimir Trefilov https://img.nerews.com/media/gallery/111228595/305315636.jpg
One of the main problems of bone marrow transplant in Russia is a small number of donors in the register - about 90 thousand people. For comparison: there are about 10 million of them in the USA, and in Germany - about 7 million.
The likelihood that a person can find a suitable donor in the Russian register is extremely small, so patients have to go to international. "In the Russian register, the search for a donor costs 150-300 thousand rubles, and in foreign cars - 18 thousand euros. The state does not pay such a search, pay funds, "wrote the site" such cases. "
There is another problem: it is almost impossible to find a donor for representatives of small peoples whose ancestors of the centuries lived apart, for example, in the Caucasus.
How is the bone marrow transplant?
If the appropriate donor is found, then a week before the transplantation, the patient is carried out by the air conditioning procedure - highly visible chemotherapy. Air conditioning is needed to destroy as many tumor cells as possible and suppress the immune system, in order to reduce the risk of rejection of donor cells. Then the patient is transfused donor cells - this procedure is similar to blood transfusion.
There are two ways to take stem cells from the donor: you can sacrifice a small amount of bone marrow from the pelvic bone under anesthesia. This procedure takes about half an hour. Another way is to hand over the cells from peripheral blood. The donor drinks a special preparation that causes stem cells to get out of the bones in the blood, and then gives blood from the vein. Blood from Vienna passes through a special device that separates stem cells, and then returns blood back to the bloodstream. The procedure lasts about five hours - long, but without anesthesia.
After two or four weeks, doctors check whether the cells have taken place and new leukocytes, red blood cells and platelets appeared in the patient's blood.
During a couple of days after the procedure, the donor may feel easy malamination and reduced hemoglobin due to blood intake. About two weeks, the donor bone marrow is completely restored.
RIA Novosti / Alexey Kudenko https://img.news.com/media/gallery/111228595/804038333.jpg.
Complications in bone marrow transplantation. "Transplant against host"
Unfortunately, donor cells are not always coming. It happens that the transplanted donor cells produce lymphocytes that react to the tissue of the new owner hostile, hitting the skin, mucous membranes, intestines and liver. Such a reaction is called the "transplant against the owner" (RTPH). This reaction is treated with drugs depressing immunity, because of which the patient becomes vulnerable to any viruses. Sometimes in the development of rejection, donor cells are additionally introduced or is looking for another donor. In this case, the probability of death for the patient is approximately 50%.
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