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Bone Marrow Transplantation

Bone Marrow Transplantation. The transfer of living cells, tissues, or organs from a donor to a recipient, with the intention of maintaining the functional integrity of the transplanted material in the recipient. http://www.ctsnet.org/home/eyevstratov. Just Names. E.Donall Thomas

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Bone Marrow Transplantation

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  1. Bone Marrow Transplantation The transfer of living cells, tissues, or organs from a donor to a recipient, with the intention of maintaining the functional integrity of the transplanted material in the recipient http://www.ctsnet.org/home/eyevstratov http://www.ctsnet.org/home/eyevstratov

  2. Just Names • E.Donall Thomas • George Santos • vanBekkum • George Mathe http://www.ctsnet.org/home/eyevstratov

  3. http://www.ctsnet.org/home/eyevstratov

  4. Indications • Acute and chronic leukemias • Aplastic anemia • Congenital immunodeficiency diseases • Lymphomas • Metabolic disease of childhood • Myelodisplasia • Thalassemia http://www.ctsnet.org/home/eyevstratov

  5. Donor Limitations • 25 – 30% of patients have an HLA-identical sibling. • Marrow procured from unrelated living donor • Marrow procured from related HLA-identical or HLA non –identical living donor • Autologous transolantation(marroe procured during remession) http://www.ctsnet.org/home/eyevstratov

  6. Recipient preparation • Cyclophosphamide 60 mg/kg/day During two days and Toal body irradiation • Busulfan 4mg/kg/day for fur days and Cyclophosphamide without irradiation • Etoposide ,Cyarabine as a maximizer antitumor properties,myeloblation,immunosuppression http://www.ctsnet.org/home/eyevstratov

  7. Transplantation Procedure http://www.ctsnet.org/home/eyevstratov

  8. Anesthesic Management • Intravenouse anesthesia sould be procured. • Intravenouse Thiopental,Fentanyl,Vecuronium can be used in common doses • Maintanance can be provide with Propofol and Isoflurane. http://www.ctsnet.org/home/eyevstratov

  9. Nota Bene Nitrouse Oxide should be avoided as an inactivator of Vit B12 wich is an essential coenzyme for methionine synthetase.This enzyme facilitate the conversion of homocystine and methyltetehydrofolate to methionine are essential for deoxyribonucleic acid (DNA) synthesis. http://www.ctsnet.org/home/eyevstratov

  10. Complications • Rejection by hte host of the marow graft • Acute graft-vs,-host disease (GVHD) • Infections • Chronic GVHD • Prolonged immunodeficiency • Disease recurrence http://www.ctsnet.org/home/eyevstratov

  11. Eugene Yevstratov MD Zacarias C.Vargas MD The End. http://www.ctsnet.org/home/eyevstratov

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