A successful transplant requires that the patient be healthy enough to undergo the rigors of the transplant procedure. Age, general physical condition, diagnosis, and the stage of the disease are all taken into consideration when determining whether a person can undergo a transplant. Many tests and consultations may be needed before, during, and post-transplant. Prior to transplant, a battery of tests is carried out to ensure that the patient is physically capable of undergoing the transplant. Tests of the patient's heart, lungs, kidneys, and other vital organs are also used to develop a patient baseline against which post-transplant tests can be compared to determine if any body functions have been impaired. The pre-transplant work-up tests are usually done on an outpatient basis. The transplant coordinator will give you instructions regarding these tests, which may include the following:
About 10 to 15 tubes of blood will be drawn to establish a baseline for you and also detect any abnormalities that could be a problem for you during or after transplant.
A chest x-ray and sinus x-rays will be done to see if you have any active infection or other abnormality. If you have not recently seen a dentist, you will also have x-rays of your teeth to check if you have any cavities or an abscess that needs to be taken care of prior to transplant.
Pulmonary Function Tests (Breathing Tests)
These are performed as a baseline study, and to determine if previous chemotherapy or radiation has affected your lungs. Since the transplant preparative therapy may do some damage to your lung function, it is important to know that enough reserve capacity is present.
Muga Scan & EKG (Heart Tests)
These will be done to see if you have any heart condition or have had any damage to your heart muscle from previous chemotherapy.
Bone Marrow Aspirate and Biopsy
These may be done as part of your pre-transplant evaluation; or, if they are not done at that time, they may be done on admission to the hospital just before the start of the transplant process.
If radiation therapy is to be a part of your treatment for transplant, you will be seen by a radiation therapist prior to transplant. Your body will be measured precisely to make sure that you will receive exactly the prescribed dose of radiation.
All patients who receive allogeneic stem cell transplants will also be followed by an Infectious Diseases specialist during the actual transplant episode.
Stem cell transplant is an intensive therapy during a time when you are already under a lot of stress because of your disease and concerns about the future. Whenever indicated, IBMT utilizes consultants in psychology and psychiatry to assess how we may best help you. Social workers and chaplains are also available for assistance.
Additional tests (24-hour urine, CT scan, bone scan, Gallium scan, etc.) may be done as needed.
Social Work and Care Management
During your work-up, you will meet the transplant social worker and the care manager. They will be available as a resource to assist you with insurance questions, financial problems/assistance, housing concerns, and general support.