Bone marrow transplantation
Bone marrow is the spongy tissue soft, and called the spinal cord red, and located within the portion bones known bone spongy, and whose main function in the production of blood cells, and consists of cells transformed (into blood cells of any generator of the components of blood hematopoietic cells), and fat cells, tissues and help the growth of blood cells.
And cells called trans at the beginning of training (primary) cells Aboriginal or stem cells (Stem cells), and is the division of self-consistently to reproduce, producing stem cells from new, it remains part of the case as cells structural generator continues to reproduce while the stops the other part for reproduction and pass a series of transformations and divisions cumulative and developmental stages of succession, to mature is turned into blood cells of various (white blood cells and red and platelets), which in turn continues to stages of growth and maturity within the spinal cord before moving on to the circulatory system to perform its functions, (f continue some of the white blood cells known Ballimfawih full development of lymph nodes and spleen and thymus), and no bone marrow in the bones almost all infants, while Prior to puberty, is concentrated mostly in the flat bones, such as skull bone, and shoulders, and ribs, and pelvic bones, and joints of the arms and legs.
And comes the need to perform marrow transplant bone marrow (Bone marrow transplant or bone marrow transplant) and transplant of stem cells generated (Stem cells transplant) when it becomes the bone marrow is unable to perform its functions and the production of blood cells, whether as a result of a hit because of the cancer itself ( which makes it either a product of the cells and throw an abnormal or a product of small numbers of blood cells), or by the effects of drugs, chemical and radiation treatment of severe spinal cord, may be required to eliminate cancer cells, especially when tumors of blood and lymphatic tumors, and some solid tumors, follow the programs therapeutic doses of a powerful and extensive destruction and lead to frustration and spinal lost the ability to perform its functions, and hence the targeting of stem-cell transplant to replace the injured spinal cancer, or frustrating treatments, healthy cells intact and able to grow and multiply, and produce blood cells.
It should be noted that the implants have been used beginning on a pilot basis to treat people who are exposed to radiation as a result of nuclear accidents, and then found to be effective in the treatment of tumors of different, and to point out that agriculture is an intensive process and multi-faceted and extends its influence all the members of the body, and with many complexities and complications and high risk, we may lose the patient, despite the success of the transplant is complete, which depends on several factors, such as the patient's age and general physical condition and the type of tumor and stage, and there are no assurances or predictions about success or failure, although high success rates of transplantation, especially in children.
Sources of stem cells (Stem cells)
Collect stem cells from bone marrow and from circulation, and the newly collected from the umbilical cord of the baby boomers.
From the bone marrow
The bone marrow, the main source of transplants of stem cells, called the process of extracting bone marrow, and collected harvest or harvest (Harvesting) and usually performed under general anesthesia for the donor, which in turn is subject to a number of tests and lab tests, to ascertain the level of his general health and in particular the nature of the case to make sure it is free of infectious diseases, and especially the absence of blood from contagious viruses such as HIV or hepatitis, and is collected about one liter of purified bone marrow directly from the hip using a special needle and under the sterilization full, (and of course fit the amount collected and the size of the patient's recipient, as it requires adults to the amount greater than needed by children), and do not take this process is usually more than one hour, and the donor's body compensation amount learned very quickly because I said it, as it is usual to withdraw a unit of blood donated by a week of the operation, and then transferred him after his donation to offset the shortfall, and leaves the donor hospital, usually the next day, without any complications but feel some temporary fatigue.
And after the combination is to conduct the separation of blood components and impurities bone marrow, and then kept in containers in particular, and is the selection and collection of stem cells at a time, and injected in turn with some of the cells selected for the recipient during a period not exceeding 24 hours, and is worth mentioning that it can save the bone for years, if necessary, and that placing it in preservatives private and frozen using liquid nitrogen to keep the stem cells alive, and the advantage of this method, especially when they are collecting bone marrow from the patient himself, and that Bastkhalas between the two sessions of therapy when stabilization and freedom from Almtsrtunh cells, in order to return the event of any future relapse.
Of circulatory
Circulatory found small numbers of stem cells, called in this case, peripheral stem cells or periodic
(Peripheral stem cells) and are not sufficient to reap usually in patients, and be used for transplantation in practice when there is the possibility to urge the bone marrow of the patient secreted into the blood circulation in sufficient quantities, and there are several ways for that, including the use of incentives for development assistance (Growth factors) individually injected under the skin, or by adding a small dose of chemical drugs.
While the collection of stem cells of regular donors, collected from the blood circulation of the donor and by passing the blood through the machine filter especially the separation of these cells from cells of other blood, and return the blood to the blood circulation at the same time, and the process takes usually between one to two hours for two consecutive terms during two days, and is the process of safe, painless and does not require anesthesia, and without any risk of infection where the use of all pipes and connections for one time only.
On the other hand spent most of the patients after the cultivation of cells of origin of periodic and less time in hospital, and reduced the incidence of complications, including complications of transplantation and, as the censuses of white blood cells and platelets due to quantum normal more quickly.
From the umbilical cord of infants (Umbilical cord)
Contains the umbilical cord of infants for the huge numbers of stem cells, and conducted medical studies in order to be used in transplants, and it is hoped that the reduced risk of complications of transplantation or a rejection, where not exposed such cells to external stimuli, and to point out that most of the implants of this The source was made for the children of siblings born to donors, and research is still underway to use this infinite source in adult patients and for patients without relatives, which may solve the problem of finding the corresponding donor.
Donor selection
May be the patient's own source of stem cells, or a relative, usually one of his brothers, or the donor is not relevant to some, and are selected donor right after an analysis of tissue specific blood, known as analysis of proteins characteristic contrary to leukocyte (HLA - Human leukocyte antigen), and aims of this analysis match the blades genetic proteins personality of the white blood cells, which reside on the surface as characteristics discriminatory, and thus determine the extent of interaction immune possible about it, and the success of transplantation over the tissue compatibility between donor and recipient, and a perfect fit is, which brings together six categories of such proteins, and most require transplant centers match at least five of them, in anticipation of the rejection is likely to happen, whether of the body toward the transplanted cells, or cells that may attack the tissues of the body as alien to them.
Types of implants
Self-transplantation (Autologous)
You can use bone marrow or stem cells holds the same patient in some cases, and of the conditions to be offered here that the population of stem cells healthy enough for transplantation, and that the patient is in a state of stability and freedom from tumor cells by a large margin, and are transplants self that derive stem cells and treated carefully to eliminate tumor cells remaining cleansing operation completely, and then returned to the body, (and in this case there is no risk of rejection in practice), and is cleansing to follow one of two ways, either by using drugs and anti-foreign particles (or Alddat antibodies) for the isolation of stem cells and then returned fertilized to the body and is known as a way of selection of positive, or by using anti-particles against tumor cells and removed from the bone marrow extracted and then returned stem cells into the body, and this is known as a way of selection the negative, and Recent developments have helped in the analysis and lab tests, that can accurately define the remainder of the small numbers of cancer cells in the maximum benefit from the cleansing process.
Gay culture or plant lineages (Allogeneic):
Known types of transplants, where comes the bone is the patient any of the donors, transplant like me or a relative or dynastic, and supports the success of the implant to match the tissue above-mentioned, as bearing all the tissues of the body codes genetic determined by the immune system, the identity of tissue or cells that were self-or extraneous (such as bacteria), and the immune system attacking the transplanted stem cells and were not rejected by the fabric is identical in whole or in part, the opposite may also occur any immune reaction to transplanted cells against the tissues of the recipient.
And is the brother healing symmetric donor perfect, and if the transplant twins rarely, and there are no problems in terms of interaction immune system in such a case, and if the implant may fail for other reasons, of course, and donated the next best is the full brother the corresponding whole, whether was male or female, and the proportion of the opportunity in the presence of this donor 1: 4 Usually the average size of families.
As for the donor is of kin, was located a donor with a tissue match with the same codes required, or may be tolerated for non-conformity of some of the codes when having the absence of a donor match in full, and we refer to the existence of several blood banks in the world to register millions of donors and retain their tissue analyzes its records, which can find a donor with a corresponding non-kin when not provided by the surroundings of the family.
Principal areas of planting
Is the treatment of tumors of different (especially tumors of blood not responding to treatments standard) the main reason for transplantation, in addition to the setbacks and the return of such tumors seconds after the success of processors standard initial periods of time varying term, and dependent eligibility for transplantation primarily on the general level of health of the patient, which should be in the range capable of carrying high doses of anti-cancer drugs and radiation therapy, and in this regard is the age of the patient a significant factor, with more than success rates of implants in young age significantly than that of adults, and for this reason requires some centers implant to the patient below the age group fifty years to make any transplant.
And review the following profile tumors and diseases of the blood and the immune system that benefits the treatment of planting:
When acute leukemia may not be required a transplant of the cases which showed a good response to the plans therapeutic standard, and are planting a limited way with very little children, cases of leukemia, lymphoma acute in this category, given the potential for control of tumor chemotherapy alone, while others may be recommended planting the category of children with poor response and in adults, when access to the stage of stability and inertia first full (first complete remission), which is achieved in the absence of blood and bone marrow cells Almtsrtunh, and on the other hand recommended planting at the time of relapse in children while receiving treatment cycle provided to stabilize again.
While the cases of leukemia, acute myeloid (Acute myeloid leukemia), which are classified into three categories depending on the pattern of response to treatment standard, the category of the response is good or standard or weak, can predict the course of treatment according to this classification, as have the cases of a response a good chance high healing treatment standard and is not a candidate for transplantation, while in most cases, run instances to respond to the weak (and who usually do not achieve periods of stability long), and the cases respond to the standard is difficult to predict the extent of their need for transplantation and makes the decision depending on the personality factors of each case.
And it is unusual to recommend planting in cases of chronic leukemia is common in children, due to the slow evolution, when only cases of chronic leukemia medullary not responding to chemotherapy or vital for long periods, or in some cases, accelerated and acute phase of this leukemia.
On the other hand, and in cases of illness related to leukemia, such as cystic spinal (myelofibrosis), or the ills of poor growth of myeloid (myelodysplastic syndromes), they are not candidates for transplantation, only in cases of severe aplastic anemia and cytopenia (aplastic anemia), which operations achieved good results in implant treatment.
With regard to cases of lymphoma, is not recommended for planting is usually when the tumors, Hodgkin's, only for cases resistant to treatments, and in this case is usually recommended planting self-view of the results very encouraging, while the cases of lymphoma Allahoddgkin not recommended usually culture-self, and prefer to transplant stem cells who achieved stable periods of time without achieving a full recovery.
And still clinical studies underway to evaluate the effectiveness of planting at the cases of solid tumors in children, especially tumors Jveat retinal eye (Retinoblastoma), and tumors priorities nerve (Neuroblastoma), and may recommend planting in cases of solid tumors resistant to treatments, which require treatments intensive doses high to control them, such as tumors of the muscles Algarnih planned
(Rhabdomyosarcoma).
The transplant procedures
Preliminary analysis
Before the period of two to four weeks before planting, place the patient tests and laboratory testing of different and inclusive of all the body, and in particular tests the heart and lungs, kidneys and liver in addition to the mouth and teeth, and are arranged plan implant based on the results of this analysis, Add-to-date disease and treatment sessions received, and, of course, continue to the various tests and analysis, and comprehensive, from blood tests and X-rays and photos to explore the bone marrow and other throughout the treatment period, and it is obvious that the patient is isolated in a protected environment chamber in particular, with take all necessary precautions to isolate it from the external environment, especially the precautions to prevent infection, for example, wearing the family and the medical team masks when entering the patient room, and they sterilize their hands always, and prevents bring fresh fruit or flowers, and so on, and prevent the visits of strangers and especially people with flu-like diseases, for example.
Catheter implant tool
Necessary before starting the process of transplant surgery to install a tool catheter (catheter) boride key and usually region-Sadr, the need for use in injection of different drugs and antibiotics, and vehicle support, as well as the transplant itself, and to withdraw samples of tests throughout the treatment period, usually remains a tool catheter planted their position for several months, and parents are taught how to take care of it after leaving the clinic, and sterilized to avoid the emergence of infections or infection which.
Initialization process (Conditioning)
Subject the patient to the process of creating an intensive preparation for planting, and envisaged configurations twice, thwarting the immune system to reduce the chances of rejection of cells transplanted, and extensive treatment to eliminate any cells of a tumor remaining to reduce the chances of tumor recurrence later, and at the same time destroy the initialization process marrow cells of sound, leaving space for the transplanted cells occupies a special place and they needed to Tstekin and grow.
And are configurations using high doses of chemotherapy drugs, in addition to the use of radiation therapy to the entire body (Total - body irradiation) or without it, and there are several treatment plans record followed in configurations, vary according to the types of tumors and the types of transplantation, and in general processing systems are used, either together with other chemotherapy drugs, such as real estate Saakulovosvamaid
(Cyclophosphamide) or Basulvan (Busulfan), or Saetharaben (Cytarabine) or Aitoboseid (Etoposide), and using either one drug with radiation of the entire body, and no longer use radiation therapy to the entire body essential for all cases, and are different doses depending on the situation and the pace change from the scheme of treatment to another, and are often in the treatment sessions per day and for several days, and in small doses to reduce the risk of complications and side effects.
The transplant
The marrow transplant bone marrow or stem cells are simple in itself, it looks like blood transfusions normal, where the injected intravenously or via a catheter, and are monitoring the patient in anticipation of the symptoms of allergies or skin rash, or fever or low blood pressure, and is not facing patients usually no trouble when the injection.
And what to enter the stem cells into the circulation until their way into the bone marrow and settle in the blanks bones (large, especially) and begins to organize itself and Tstekin to initiate production of blood cells, and from the usual to start the effects of the initialization process and drug chemical to emerge during the second or third day of transplantation (especially frustration effects of the bone marrow), which requires keeping the patient under close surveillance.
And is called the start of production phase Alttam (Engraftment) and occurs most often within two weeks to six weeks after transplantation, and the usual tests to determine blood count start of production of white blood cells and platelets and then red blood cells, which will assure the success of the transplant, and Of course the patient during this period, various tests and laboratory tests and imaging to check the efficiency of the main vital organs the body, such as heart, lung and kidneys, and the patient receives the necessary nutrition intravenously to make sure enough food.
On the other hand may take a full recovery periods ranging from a year to two years, and doctors perform various tests of blood and an exploration of bone marrow on a regular basis to investigate the efficacy of bone marrow transplant.
Intensive Care
Longer intensive care and the body of the assignment of operations staff is very important in transplantation, and is the primary objective in the management of complications and side effects of multiple high doses of chemotherapy or radiation, both to take special measures to avoid it or reduce its effects or processing.
These effects include thwarting the immune system, anemia, easy bleeding, because of the decline rates of the different blood cells, in addition to the complications of the mouth, and problems with nausea and vomiting, and complications of food and loss of appetite, because of the sensitivity of the digestive system, and finally problems and shortcomings in the functions of major organs such as lung, liver, and kidney and heart due harmed.
And is thwarting the immune system one of the most serious complications, where the body loses its defense against any infection, and is intensive care in this case put the patient in the vicinity of protected well and in total isolation from exposure to infectious agents, and then you start taking antibiotics and anti-infectives viral, in addition to anti-fungal in anticipation of any infection is possible, in addition to immunotherapy, which is to carry out the separation and collection of anti-foreign particles (Antibodies) from the blood of the donor and then injected into the patient in the extra effort to support the immune and begin such care from the moment of frustration marrow until the patient and ensure the ability of transplanted bone marrow to produce sufficient numbers of white blood cells.
In most cases, are given incentives development assistance (stimulating growth factors), and to accelerate Alttam and the start of production and to reduce the risk of infection or the risk of failure of the implant, as is support the body processes blood transfusions periodically, to treat anemia and thrombocytopenia, (after exposing the blood transfused to the doses of radiation, which destroys the cells, particularly lymphocytes, which may attack the cells of the patient's body).
On the other hand, is a feeding system of the very important factor in intensive care, and the habitual use of nutrition parenterals to give the patient needs food intravenously and doses are calculated, and for two main reasons: first, that the chemotherapy and radiation cause nausea and vomiting, and infections of the mouth which makes the process of eating itself painful, and second, that the program requires treatment to stop eating for a while, and to allow members of the digestive system to recover after receiving high doses of chemical drugs.
And lives most of the patients the clinic for a month to two months after the implant to the need to ensure the success of the process, and to address any complications may appear, and allowed to leave the patients usually when exceeding the cell count neutral white blood cells to an average of 500 in the census record for blood, for two consecutive days, taking into account many of other factors, such as enumerating red blood cells and platelets and the absence of any infection, in addition to the general level of health of the patient, and the usual that patients need blood transfusions periodically after the departure, which calls for keeping the tool catheters their position for periods ranging from three to six months, and of course, are tests periodically on the patients and schedule a specific time, are also examining the patient every day after leaving the clinic and throughout the first two weeks, then conducted tests each week throughout the first months, to make sure the body's production of blood cells, normal rates, in addition to the investigation for lack of any precancerous again, especially to explore the bone marrow periodically to monitor.
Risks and complications of transplantation
Can be classified as risks and complications relating to implant into two parts: early complications or in the near term
And late or over the long term:
Risks and complications in the short term
Early minor complications
Patients often several complexities and complications following the transplant, some temporary and simple, and some of them considered life-threatening, and it depends how serious serious complications on many factors, such as the patient's age and his general health before the transplant, and the usual show complications minor and temporary and common when receiving chemotherapy and radiation treatments, which include hair loss, nausea and vomiting, and fatigue and physical fatigue, and loss of appetite and ability to eat, and infections of the mouth, and skin sensitivity and skin.
It is worth noting the presence of side effects of some drugs used to treat complications mentioned, from which intestinal problems, high blood pressure, and in some cases appear Seizures or impaired vision, for example, as well as the command with the stimuli development assistance, which in turn cause side effects include pain bone, muscle and flu-like symptoms, and to point out that the severity of these effects varies from person to person.
Bug vaccinated against the host (Graft versus host disease)
The bone marrow produces immune system cells, which develop from stem cells, and that means that the cells of the immune system of the patient will be produced from stem cells grafted from the donor, and in all cases, except the planting of identical twins, the tissue compatibility in part and is a holistic, which means that the risk lies in the possibility of attacking the transplanted immune cells grafted cells and tissues of the patient's body as foreign objects.
And you know this case illness vaccinated against the host (Graft versus host disease) are considered severe and life-threatening if it came and significantly over the percent on the first following the transplant, and is considered severe that occurred after that, and created interaction immune this when the immune cells cultivated, especially T lymphocytes (T lymphocytes), examined the patient's cells in search of genes and variations as attacking enemy objects, if any significant differences, and here lies the importance of histological analysis of the genetic codes referred to above to find a matching donor.
Than usual and to show the first signs of acute palms of the hands and soles of the feet, the sensitivity and itching and burning, redness, and then spread over all the skin and skin, and may show some small pimples and Altakecrat, and the symptoms that follow the emergence of nausea and vomiting and intestinal spasms, loss of appetite, diarrhea, and on the other hand is a yellowing of the skin and intestinal pain, evidence of the affected liver, which in turn may swell, and these symptoms may be mild or severe intensity and life-threatening when the complexity, making it difficult to control.
In the developed non-acute or chronic (Chronic), which usually appears after the third month of transplantation (and may not develop until later years), most patients suffer from skin problems and skin, and start itching and allergies, and skin may become Mahrishva and measured, and a dark color, and may be accompanied by hair loss, and may experience the mouth and esophagus to the drought of acute inflammation and may arise sores, (and may be affected lung is also a result of drought), and may hurt the liver and occurs failure in the performance of its functions, and lead the flow of bile into the blood, in turn, give rise to jaundice.
There are several drugs and depressing the immune system are used to prevent the emergence of this illness, or to mitigate their effects, including drug Metcrksat
(Methotrexate) and drug Saiklosboren (Cyclosporin), and from the usual to anticipate the severity of this illness by direct planting and reduce the intensity by using techniques designed to separate large numbers of T cells (T lymphocytes) from the marrow donor, it is these cells moving first in the emergence of this illness, although this method also carries the risk of implant failure and the occurrence of relapse, especially in cases of leukemia, and on the other hand is addressed steroidal compounds such as drug prednisone to alleviate symptoms.
Capture the risk of infection
As noted above target processor intensive thwart the immune system and destroy the cells Almtsrtunh by the direct operations of the implant, and of course withstand the frustration of white blood cells, which holds the resistance and infection control, a high risk of exposure to various types of infections, whether bacterial, viral or fungal or of different parasites, and found an abundance of these microorganisms on the skin and inside the mouth and digestive tract in the main, also found naturally in the air and in cooked foods (such as fresh fruits and vegetables), and normally resists the body easily, and these organisms is not affected by where the immune system with high efficiency, and the tissues of the skin, mouth and digestive tract in conditions of sound, while hang the immune system of transplant in whole, for periods vary from patient to patient, and the longer these periods, a critical and will almost inevitably be exposed where the body of the infection, which calls to take maximum precautions, the beginning of isolation and sterilization of the vicinity of the sick and the sterilization of food, and ending with receipt of antibiotics and antimicrobial and fungi, and analysis of periodic frequent intervals to detect any signs of infection, and continue such actions usually until the emergence of enough evidence to re-production of white blood cells at rates sufficient.
In the following set of precautions taken to prevent infection:
Isolate the patient in a room ventilated purified.
Sterilization of all up to the patient and comes into contact with him.
Prevent contact with visitors to a minimum.
Wearing of masks by the medical team and visitors and parents.
Check the hand-washing and sterilization by the medical team and parents.
Check the cleanliness and sterilization of the position of the implanted catheter.
The lack of fruits and vegetables or cooked, and the authorities are not carrying surfaces of bacteria or fungi.
And add to the above precautions are taken normal to prevent infection after the return of the patient's home, including the reduction of visits, and lack of contact with domestic animals or flowers, and stay away from human populations, and it should be noted in this regard that the use of incentives for development mentioned above has helped much to reduce the critical time after the transplant and restore the immune systems ability to produce white blood cells. (And please go to a page that chemotherapy and blood cell count for more details on how to deal with white blood cell deficiency and infections).
Easy bleeding
May cause the problem of ease of serious complications of bleeding, especially during the first month, where, and of course low rates of production of platelets, and bleeding often arises nasal mucous membranes, mouth, and may arise under the skin or in the tissues of the digestive system, and are traditionally the transfer sheet When you see any signs of bleeding to maintain platelet count at the maximum appropriate to prevent the emergence of bleeding, and platelets may be donated by the same donor corresponding to the patient.
Anemia
Is inevitable during the process of planting that the body can not produce sufficient quantity of red blood cells, and thus the emergence of anemia, and is monitored periodically population, and treatment is traditionally transfers of regular blood.
Failure Alttam
The immunization or transplantation in the event of failure, while the bone marrow does not restore its full role in the performance of its functions after the first implant, and implant failure due to a two reasons:
The emergence of a condition known to refuse Alttam, ie, the recipient's body rejected the transplanted marrow, and it shows especially when you transplant from a donor.
The lack of Alttam itself, or it occurs for a short period without having to prove, and continue, and be the result of the failure of stem cells cultivated from submissiveness within the tissues of the bone and not being able to multiply and grow, and then a failure in the production of cells of new blood, and may occur in any of the types of transplantation.
And there are a number of factors that may contribute to the emergence of this rejection of the transplant, the most important of having to cultured marrow from a donor is not fully match, as is failure often in patients who did not receive radiation full body within the configuration program, where the remains of the immune system maintains some activity leading to the refusal of vaccination.
On the other hand may not succeed Alttam result of some viral diseases, or the result of the influence of drugs depressing the immune system such as the drug methotrexate (Methotrexate), and may not happen Alttam the cases of leukemia as a result of re-emergence of cells Almtsrtunh, which in turn prevents the transplanted cells from growing, and It should be noted that in some cases does not know the specific reason can lead to the failure of the implant.
Complications to vital organs
May develop in patients with complications and complexities of some members of the vital body, especially the liver and kidneys and lung and heart, and due to take these organs essential to the burden of the largest and it has been damaged seriously when planting, is to ensure the safety and efficiency of these members before embarking on transplantation.
And there are several factors contributing to the emergence of liver disease and various ailments, some of which may be caused by chemotherapy and radiation treatments of the sediment Taatlev minute intravenously, causing blockage obstructing the blood flow out of the liver, leading to the emergence of venous occlusions bug
(VOD venocclusive disease) and retention by the liver and symptoms include yellowing of the skin and liver enlargement, and abdominal cramps and weight gain, and the functions of liver failure, and also the risk of emergence of hepatitis C, and bacterial infection or resulting from fungi, as well as damage to liver as a result of the use of certain drugs, treatment of infection.
With regards to the kidneys, may cause different treatments in some cases in the incidence of renal failure as a result of the use of chemical drugs and radiation therapy and antibiotics in addition to depressed immune system, especially drug cyclosporine, and then a kidney failure, and lower rates of diuresis and accumulate waste of vital blood and the body becomes susceptible to infection and bleeding and poisoning, drug, and from normal to take several measures at the development of renal insufficiency, including close monitoring of the rates of body fluids, and modify the system of nutrition, including nutrition, non-intestinal, and may be modified dosage , and some patients may need to conduct purification, and is usually the use of certain drugs to reduce the possibility of the emergence of renal failure.
And some complications may arise such as the lungs and pulmonary infections, pneumonia bug (and often the result of the emergence of infection), in addition to the effects of chemotherapy and radiation treatments that may cause lung damage, as some patients may suffer from pulmonary fibrosis, and from the usual number of precautions to take To avoid such complications, including receiving antibiotics, and wear a special armor covering the chest area during exposure to radiation for the full body.
On the other hand affect the certain drugs and chemical on a particular drug doxorubicin (Doxorubicin) on the heart, and cause some complications or imbalance in the performance of its functions, and may be highly dangerous, and in any case, suffer a very small percentage of patients with transplants of the complexities of the heart.
Risks and complications in the long run
Cataract (Cataracts)
Than usual to show bug cataracts, or bung eye over a period ranging from 3 to 6 years after exposure to radiation of the entire body, and develops opacity to about 70% of patients where the program includes planting with the use of radiation full, while the ratio drops to less than Twenty percent of patients who receive radiation in part, or do not receive any radiation treatments, and are processed traditionally bung eye corrective surgery to restore normal vision.
Infertility
Cause Alalajan chemotherapy and radiation often the problems and complications related to devices genitals either temporarily or permanently, and adopt the severity of these complications on the patient's age, sex and the dose received and the time period of the processors, and statistics indicate medical injury to most males who have undergone radiation of the entire body ( within the scheme of preparing for the transplant) infertile after the operation, except for a few cases been able to conceive naturally, while the females often occurring disorders menstrual after taking high doses of drugs, chemical, and despite the fact that menopause may be due to the pace normal within two years of transplantation in young women However, that may arise stopped early menstruation before the age of natural with patients who are over twenty-five years, and may be recommended to use processors hormonal To avoid this, and of course should be for those who wish to have children consult a doctor after the transplant, as may be involved in pregnancy risk .
Problems of natural growth
Some studies suggest the emergence of disability growth in some children, while patients treated in the full radiance of the body, because of the low rates of production of the body's natural growth hormones, which directly affects bone growth, and may result in delayed growth, estimated at about two years, and may need to be addressed hormonal.
The risk of developing secondary tumors
Was unable to medical studies after you select all complications of transplantation in the long run, because of the proximity of the Covenant in such operations and that did not start only a few decades ago, but fears many of the increased risk of developing secondary tumors is tumor of origin that were transplants for which, due to the use High doses of two treatments chemotherapy and radiation, and drugs depressing the immune system and drugs that are installed for the activity of stem cells, or due to factors other than well-defined and related operations of the implant, and research suggests the differences in the probability of developing secondary tumors, depending on several factors, the most important age the patient and his general health, and medical history and exposure to radiation therapy and chemical types of drugs used and the dosage received.
About nutrition and diet regime
Particularly important to monitor the patient's diet full control, and should consist diet mainly of fresh food and cooked perfectly, and does not contain any spices or Mthblat pungent taste of pepper and otherwise, and of acceptable foods and ready-made sterile packaged well, such as butter and cheese processing or biscuits, as well as toasted bread, not fresh and canned fruits open to the just, and cold meats and different authorities is cooked and fresh fruits should be avoided, as completely prevent eating normal drinking water from the tap or mineral water, and are Drinking water sterilized and reliable source only, which is also used to cook foods the patient or the preparation of drinks and so on, as well as sterilized milk, and shall not be the case opened for more than one day and reserved the refrigerator all the time, and may be easing the food at the expiry of the first six months, and the expansion of eating different foods depending on the patient's progress.
Leave the hospital
According to systems used in most centers, transplant, recovering most of the patients enough to allow their departure to the hospital during a period of three to five weeks, and has traditionally been recommended to leave when the bone marrow to produce quantum enough blood cells healthy and well-being completely, and there are no complications after transplant, and of course, vary the period of recovery from one patient to another, and from normal to feel sick improvement is clearly upon the return of blood cell production to normal, and start some of the symptoms to stop, such as infections of the mouth, diarrhea, nausea or vomiting, and stop symptoms of fever, improved appetite for food, and in this regard, it is necessary to ensure the recovery of the ability to eat before you leave and get the body enough of the nutrients and fluids.
And continue the patient's convalescence at home, and are provided with family guidance for continuing care, such as monitoring symptoms that require a rapid return to the clinic with fever or diarrhea or pain, as well as is illustrated tables review weekly and monthly and so on, and in most cases require recovery period of six months to a year-to-back production of blood to normal, and should be during this period to prevent the patient from being present whereabouts gatherings such as markets and others, or friction patients others have infectious diseases such as influenza, to avoid becoming infected, and should prevent the sick children of mixing with other children who have received vaccinations just live vaccines, and take all precautions to avoid injuries or continuous exposure to sunlight.
