Evaluation Process
Blood & Marrow Transplant

Once a doctor refers a patient to Blood and Marrow Transplant Services, the patient goes through a pre-transplant evaluation process to determine that a transplant is the best choice and to ensure there are no additional health conditions that would create a risk. Blood and marrow transplants are most successful for patients who have good heart, lung, kidney and liver function, and whose condition would improve greatly with this treatment. The evaluation process includes:

1. Transplant Physician Appointment:
   The transplant physician takes a medical history and performs a complete physical to identify problems and determine if a transplant is the best option. If an allogeneic transplant is a possibility, the doctor also identifies potential donors.
   
2. Blood Tests:
   Blood tests are conducted to determine any pre-existing health conditions and matching criteria, i.e., infectious disease panel, chemistry panel, type and antibody screen, and human leukocyte antigen (HLA) matching.
   
3. Diagnostic Testing:
   To assess cardiovascular health, the patient undergoes chest X-rays, pulmonary-function tests (PFTs) and a scan to measure how well the heart pumps blood through the body.
   
4. Social Work Consultation:
   A trained social worker will discuss the mental and emotional issues, coping mechanisms, and other issues the patient may face.
   
5. Transplant Teaching:
   Staff explains the transplant process, what to expect, and the patient, caregiver, and/or family responsibilities before, during and after the transplant. The patient, caregiver and family tour the infusion center, apheresis area, and the blood and marrow transplant unit.
   
6. Additional Testing or Evaluation:
   The transplant physician may recommend additional tests, including bone scan, CT scan, bone marrow biopsy, dental exam, or consultation with a radiation oncologist (in case of total body irradiation).

The patient’s oncologist or primary care physician may perform some of these tests before the patient sees the transplant physician.

If an allogeneic transplant is determined to be the best choice, potential donors will need laboratory tests to determine if any are a match. Potential donors will undergo further lab tests and chest X-ray before stem cell collection.