38230 Bone marrow harvesting for transplantation; allogeneic

Name of the Procedure:

Bone Marrow Harvesting for Transplantation; Allogeneic

• Common Name: Bone Marrow Donation
• Technical Term: Allogeneic Hematopoietic Stem Cell Transplantation

Summary

Bone marrow harvesting for allogeneic transplantation is a medical procedure where healthy stem cells are collected from a donor's bone marrow. These collected stem cells are then transplanted into a recipient whose bone marrow is not functioning properly.

Purpose

This procedure is used to treat patients with conditions such as leukemia, lymphoma, aplastic anemia, and other blood disorders. The goal is to replace the recipient’s diseased or damaged bone marrow with healthy stem cells from a donor, enabling the production of new, healthy blood cells.

Indications

• Conditions: Blood cancers (e.g., leukemia, lymphoma), bone marrow failure syndromes, aplastic anemia, and certain genetic disorders.
• Criteria: Matching donor-recipient compatibility, assessed through tissue typing (HLA matching).

Preparation

• Pre-procedure: The donor may need to fast for a few hours before the procedure.
• Medications: Adjustments may be needed as advised by the healthcare provider.
• Tests: Blood tests, tissue typing, and a detailed medical evaluation are required.

Procedure Description

1. Donor receives general or regional anesthesia to ensure they do not feel pain during the procedure.
2. A needle is inserted into pelvic bones (iliac crests) to withdraw liquid bone marrow.
3. Multiple punctures may be made to collect the required amount of bone marrow.
4. The collected marrow is filtered and processed for transplant.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Conducted in a hospital setting, often in a specialized surgical suite.

Personnel

• Surgeons
• Anesthesiologists
• Nurses
• Hematologists

Risks and Complications

• Common Risks: Pain at the collection site, bruising, fatigue.
• Rare Complications: Anemia, infection, bleeding, or reactions to anesthesia.

Benefits

The primary benefit is potentially life-saving for patients with otherwise fatal blood disorders. Healthy blood cell production typically resumes within weeks to months after transplantation.

Recovery

• Immediate Care: Donor is monitored for several hours post-procedure.
• Pain Management: Pain relief medications may be prescribed.
• Restrictions: Avoid strenuous activities for a few days.
• Follow-up: Short-term follow-up to monitor recovery and manage any side effects.

Alternatives

• Peripheral Blood Stem Cell (PBSC) Donation: Less invasive but may involve medication to mobilize stem cells.
• Cord Blood Donation: Another source of stem cells; suitable for certain patients depending on the match and condition.
• Pros and Cons: PBSC involves daily injections but less pain compared to bone marrow harvesting; cord blood has lower risk of complications but may not provide enough stem cells for adults.

Patient Experience

• During Procedure: With anesthesia, the donor will not feel pain during the harvesting.
• After Procedure: Some soreness and fatigue for a few days; pain management will be provided to ensure comfort.
• Overall: Most donors can return to normal activities within a week, contributing to a potentially life-saving treatment for the recipient.