Joseph M. Sanzari Children's Hospital

What to Expect After Your Transplant

Infection
Infections can be of bacterial, viral or fungal in origin. Antibiotics, antivirals and antifungals are given to prevent/treat these types of infections.

Pain
Pain can occur at any time during the transplant process. It can be related to mouth sores, gastrointestinal irritation, and other sources. Many modalities including pain medications as well as psychosocial interventions are utilized to ensure patient’s comfort during this time. A dedicated Pediatric Pain and Palliative Care physician is on staff to manage your child’s pain.

Low blood counts
While waiting for the new bone marrow to engraft, the patients need multiple red cells and platelets transfusion to prevent complications such as bleeding, dizziness, or respiratory distress. Blood counts are monitored daily.

Gastrointestinal problems
These may include nausea, vomiting, diarrhea, liver-related complications, as well as mucositis (inflammation and soreness in the mouth, throat, esophagus, and stomach).

Graft-versus-host disease (GVHD)
With GVHD, the newly transplanted donor cells attack the transplant recipient’s body. Manifested symptoms may range from mild to severe. There are several modalities we utilize in treating GVHD, including medications as well as a procedure called photopheresis.

Graft failure
Graft failure is a potential complication.

Pediatric Intensive Care Unit (PICU) monitoring and care is utilized if necessary.

Patient Stories from Pediatrics:

Juliette’s Story 

At the time of discharge, your school district will be notified and home instruction services will be initiated

This support will remain in place until your child is medically cleared to return to school. Assistance will also be offered in regard to planning for your child’s transition back to school.

Treatments for Post-BMT Complications

Extracorporeal Photopheresis (ECP)
A treatment modality for chronic graft versus host disease (GVHD) following unrelated bone marrow transplants. We utilize Therakos® Cellex® system. It uses UVA light in combination with a photosensitizing agent to treat the patient’s t-lymphocytes. When the treated lymphocytes are re-infused, they stimulate an immune response in patient’s body to fight the development or progression of GVHD.

We offer photopheresis to pediatric patients in our outpatient clinic. It is performed by a dedicated pediatric photopheresis team, trained in both regular saline prime procedures for patients >30kgs as well as blood prime photopheresis procedures for patients weighing less than 30kgs. The treatment has proven successful in eliminating or reducing multiple GVHD symptoms as well as limiting use of steroids and immunosuppressive drugs.

Endocrine Clinic
Monthly clinic with participation of BMT doctors, APNs, an endocrinologist, and a nutritionist for evaluation and treatment of post-transplant endocrine disorders

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