Bone Marrow

Transplantation

Autologous bone marrow transplantation has been performed at Shaare Zedek for many years. This year, we have also started performing allogeneic bone marrow transplantations. The latter involves donors who are suitable matches, such as family members or unrelated donors. Innovative treatment approaches are implemented in the field of transplantation to provide the best possible care for recipients.

The transplantation process is lengthy and complex, encompassing preparation for the procedure, the hospitalization and transplantation period, and subsequent follow-up and outpatient care.

1. Preparation for Transplantation:
Patients arrive at different stages of their illness, and a personalized treatment plan is established based on the nature of the disease, the urgency of transplantation, and the specific needs of each individual. During the preparation for transplantation, the patient and their family will meet with the department manager and the bone marrow transplantation coordinator to receive detailed explanations about the transplantation process and the necessary preparations.

The preparation process includes comprehensive blood tests, bone marrow evaluation, imaging tests to assess the patient's condition before transplantation, tissue typing, peripheral blood stem cell collection (for autologous transplantation candidates), assessment of cardiac and respiratory function, dental evaluation, endocrine tests, and fertility preservation measures. The preparation process follows accepted guidelines and complies with the recommendations of the EBMT, ABMTR, and NMDP.

2. Transplantation:
During this stage, patients receive new, healthy stem cells to replace their defective ones. If the transplantation is allogeneic (from a donor) or autologous (from the patient's own cells), the stem cells are collected from the donor's peripheral blood or from the patient's own blood, processed and prepared, and then infused into the recipient through a central venous catheter, similar to a blood transfusion. An increase in blood counts is usually observed within two to three weeks, indicating the successful engraftment of the new stem cells and their proper production.

3. Post-Transplantation Care and Follow-Up:
The follow-up process after transplantation is an extended one, including monitoring the patient's hematological status, graft engraftment, infection prevention, preventive treatment against graft-versus-host disease (GVHD), and monitoring for GVHD signs. This multidisciplinary follow-up involves various departments and is conducted with close guidance and support from the medical and social work teams, providing counseling and guidance to the patient.