Bone Marrow Transplant is a complex and major procedure. There are risks and complications associated with the procedure and the procedure is thus recommended to select few patients when other treatments have failed.

Bone Marrow Transplant is recommended if other treatments are not working and there is higher risk of the condition returning without the transplant, and if the physician feels that the benefits of the transplant outweigh the risks associated with the procedure. The best candidates for bone marrow transplant are those in otherwise good health and have stem cells available from a sibling, or another family member.

The procedure needs meticulous planning and the surgeon thoroughly assesses the patient to make sure that he/she is healthy enough to survive and accept the transplant. For this, series of tests are done to assess patient's vital organs like heart, lungs, kidneys, liver to ensure the patient is physically capable to accept the transplant.

If the surgeon thinks that transplant can be done, he proceeds with harvesting of stem cells.

Harvesting stem cells:

If the patient is undergoing allogenic transplant, bone marrow is harvested from the donor one or two days prior to the transplant procedure. The stem cells are collected in two ways;

• Bone marrow harvesting: The donor is given general anaesthesia and the cells are collected using a needle from rear part of the hip bone or the iliac crest where the stem cells are located in abundance.
• Leukapheresis: This is done in cases of autologous transplant in which the blood is drawn intravenously from the patient's body and the machine is used that separates the white blood cells containing stem cells from the blood.

Preoperative regimen:

Before the transplant, the patient undergoes chemotherapy or radiation therapy to kill the cancerous cells and to make room for the new bone marrow cells often known as conditioning of the patient.

Stem cell transplant:

For transplant, the central venous catheter or a port is installed on the upper right portion of the chest wall of the patient and the new stem cells are infused through this port that help them to flow directly to your heart from where they are dispersed all over the body through the blood. Gradually the cells become established in the bone marrow to grow.

The post is kept at same place as the infusion is done in multiple sessions that aid the new stem cells to integrate in the body. This process is known as engraftment. The patient receives the blood transfusion, fluids, antibiotics, platelet transfusion through this port so as to fight the infection and to help your body accept the new marrow.

Monitoring for complications:

After the infusion, you will be closely monitored for any signs of complications or rejection. Precautions are taken to prevent any infections. The patient is constantly monitored to check if engraftment has occurred or not and to monitor organ function. Once the healthy bone marrow begins to produce normal cells, transfusion is stopped.

Recovery after bone marrow transplant is long and stressful process for both the patient and the family. Initial few weeks are very critical as there are high chances of complications and rejections of the transplant.

But, subsequently the patient starts to feel better as the blood count begins to grow and his immune system becomes stronger. Full recovery may take up to an year or two.

It is a complex but lifesaving procedure which has improved in past few years. After a successful bone marrow transplant, you will be able to live normal life once again which was not possible otherwise.

You shall need a total of 16-18 weeks for bone marrow transplant in India after which you can fly back to your country.