Common Transplant Questions 

What are the benefits of kidney transplantation?

People with End Stage Renal Disease (ESRD) may potentially benefit from transplantation. It offers an alternative to dialysis therapy.

Transplantation, in general, offers patients a longer, healthier and better quality of life compared to those on dialysis.

What are the benefits of pancreas or combined kidney-pancreas transplant?

For certain patients with Type 1 insulin dependent diabetes, this type of transplant may be able to significantly reduce or eliminate the need to take insulin. It is particularly beneficial to patients who have a difficult time managing their blood sugar levels. When you are evaluated for kidney transplant, you will be told if you qualify.

How long should I expect to wait to expect to get a transplant?

The wait time can range from several months to years and depends on many factors. Factors include include: a) how long it takes you to complete the evaluation, b) whether or not you have a living person willing to donate to you, c) how healthy you are and, d) your blood type.

What will the evaluation involve?

To ensure transplant is a good option for you, you will meet with the transplant surgeon, transplant nephrologist, transplant coordinator and social worker. Most candidates will undergo extensive medical testing, which may include cardiac testing, dental evaluation, disease screening and other testing depending on your individual condition.

Will my insurance policy cover transplant?

Transplantation is considered “standard of care” and thus, most insurance policies do provide coverage for transplantation. Our expertly trained financial counselors will help guide you through this process and answer any questions you may have.

Will I need to take special medications after my transplant?

Yes. You will have to take daily medications to prevent your body from rejecting your new organ. This a life-long medication regimen.

What if I have trouble affording the medications?

For those who qualify, there are government and private assistance programs available to help you pay for these medications.

What is the surgery like, and how long should I expect to stay in the hospital?

The kidney transplant surgery usually lasts anywhere from 90 minutes to three hours. The average hospital stay is between five to seven days. After your transplant surgery, you will be cared for on our transplant specialty unit by one of our highly-skilled registered nurses. As soon as your first day post-surgery, you may be well enough to get out of bed and start walking. You will get specialized education by our doctors, transplant coordinators and pharmacists concerning your medication and follow-up care.

What should I expect after I leave the hospital?

After you leave the hospital, you will have labs twice weekly and will be seen within 2-3 weeks in our clinic by your transplant surgeon. After three months, you will be seen by our transplant nephrologist. Once your body has adjusted to your new organ and the medication, you will have labs and clinic visits far less often. Our team will frequently discuss your care and progress with your referring nephrologist.

Are there any risks or complications that could occur?

Yes. As with any surgery or medical treatment, certain risks are involved. Your doctor will discuss specific risks and benefits with you during the evaluation process and just prior to surgery.

Will I have any special needs after my transplant?

You will be expected to maintain a healthy lifestyle, including a balanced diet and exercise. You will need to follow medical advice, and take your medications as prescribed.

Can I have pets after transplant?

Yes. However, there are certain pet restrictions. Due to certain infection risks, you may not keep reptiles or birds. Although you may have cats, you should never change their litter. Ask a friend or family member to change it instead.

Who can be a donor?

Donors need to be between the ages of 21-65 and can include parents, children, siblings, other relatives, and friends. Donors do not need to be genetically related. An ideal donor should have genuine interest in donating and a compatible blood type with the recipient. Donors should be in good general health. Typically, someone who has cancer, diabetes, kidney disease, heart disease, liver disease, sickle cell disease, HIV or hepatitis will not qualify to be a donor. However, these diseases are not all absolute contraindications. Every donor will be considered on an individual basis.

Do some donors have trouble making the decision to donate?

The decision to donate can vary from person to person. Some people make the decision instantly with few worries or concerns. Other people require time to think critically and will talk with close friends or family before deciding whether or not to donate. It is normal for some people to be afraid of donating a kidney as well as to experience guilt about not wanting to be a donor. Individuals should not, under any circumstances, feel pressured to donate. The only “right” decision is the one that makes the donor feel comfortable. Potential donors are encouraged to speak with the living donor team if they have any questions or concerns about their decision. A Living Donor Advocate at the Center will work confidentially with the donor to ensure all potential issues are addressed before surgery.

What is the first step to becoming a living kidney donor?

If you are interested in being a living donor, you should contact the Center for Abdominal Transplantation at SSM Health Saint Louis University Hospital (314-577-8867). You will speak with a pre-kidney transplant coordinator who will obtain a brief health history and determine if you meet the minimum criteria to proceed with the initial blood testing. Once your blood type, antigen match, and cross match are known, the living donor nurse coordinator will discuss the results and the donation process with you. The nurse coordinator can answer any questions so that you can make an informed decision about proceeding with donation. This conversation is strictly confidential and is not shared with the recipient. If the donor decides to continue with donation, they must then complete a comprehensive evaluation.

What does the living donor evaluation entail?

You will complete a medical history and receive a physical assessment. A series of laboratory and radiology tests will be completed to screen for kidney function, liver function, hepatitis, heart disease, lung disease and past exposure to viral illness. Urine testing will also be done to make sure that your kidneys function normally. You also will undergo x-ray tests as well as an EKG, and all persons over fifty will be required to perform a treadmill stress test. Radiology tests are also performed to help the transplant staff to determine if your urinary tract, kidneys, and the blood vessels leading to and from the kidneys are normal. In addition, results from your routine annual health maintenance tests (e.g., pap spear, mammogram, colonoscopy, etc.), as well as any necessary medical clearance for pre-existing conditions, will need to be submitted to the living donor team for review. Other tests and physician consultations may be necessary depending on the results of these studies. You will also meet with a transplant surgeon, social worker, dietitian, financial coordinator and living donor advocate to complete your evaluation. Once all results from the entire evaluation process are available, they will be reviewed by a multi-disciplinary committee who decides whether you can safely proceed with the donation. For a complete outline of the evaluation process and tests to be performed, please see Living Donor Kidney Evaluation Process.

Will giving a kidney affect my lifestyle?

A person can lead an active, normal, life with only one kidney. After recovering from surgery, a donor can work, drive, exercise and participate in sports. A donor can continue in all types of occupations. Also, being a donor does not impact a person’s ability to have a child.

How do I prepare for surgery?

Smokers must stop smoking at least 6 weeks prior to surgery. All medications and supplements must be reviewed by the transplant team to determine if they need to be held prior to surgery. Women who are taking birth control pills or hormone replacement therapy are advised to stop taking these medications one month prior to surgery. One week before the transplant, both you and your recipient will come to the hospital for pre-admission testing. You will meet with an anesthesiologist in the Preadmission Testing Center (PAT) and will be provided with specific instructions on how to prepare the night before surgery, such as not eating or drinking anything after midnight. The same day, you will have more lab work completed, and the PAT staff will review what to expect during your stay in the hospital and at discharge.

What happens on the day of surgery?

You will be admitted to the hospital the morning of the surgery. Both you and your recipient go directly to the Ambulatory Care Unit two hours prior to the start of surgery. Once there, the staff starts an intravenous (IV) line where fluids are administered. You will meet with your surgeon who will answer any remaining questions you may have. You will also be asked to sign a consent form for the procedure. Shortly after arriving in the operating room, the anesthesiologist will give you sedation medicine through the IV. Once you are fast asleep, a breathing tube for general anesthesia is placed which connects to a breathing machine. This routine process assists patients with breathing during surgery. A urinary catheter is inserted into the bladder and then the laparoscopic surgery begins.

How is the laparoscopic surgery performed?

During the surgery, a few very small incisions are made in the abdomen to insert laparoscopic instruments. The laparoscope contains a miniature camera that helps guide the surgical team. Then, a 3-4 inch incision is made to allow for the removal of the kidney. These incisions are closed using stitches that absorb on their own so they do not need to be removed.

What happens after the surgery?

You will wake up in the recovery room feeling groggy and perhaps uncomfortable. A nurse closely monitors your vital signs and comfort level. Pain medicine will be given as requested. You will be wearing an oxygen mask and have a catheter that is draining urine from the bladder to a collecting bag in order to accurately measure the kidney's urine output. The catheter is usually left in overnight and removed at the bedside the next morning. You are encouraged to get out of bed as soon as possible – usually the night of surgery. Walking is expected the next day. It is common for donors to experience gas pain and bloating after surgery. Walking will help to expel the gas. You should be released from the hospital 1-2 days following the operation.

What should I expect during recovery at home?

When you return home, your activities will be limited. You should not lift anything that weighs more than 20 pounds for the first four weeks. You may feel tired for the first week or two after the surgery and may need frequent naps. However, donors are encouraged to be active in between their periods of rest. Walking is considered excellent exercise during this time. You may also have some swelling around the incision area and should plan to wear loose, comfortable clothes. You will likely be able to return to work 2-4 weeks after the surgery, depending on the type of work. However some donors require a longer recovery period if their work requires heavy lifting or other physical demands.

What kind of follow-up is needed?

You will have a post-operative appointment with your surgeon 1-2 weeks after the surgery. Additional follow-up appointments will be scheduled 6 months, 1 year and 2 years after your donation. This will allow our team to monitor your kidney function. After your 2 year follow-up with the transplant center, we recommend annual check-ups, which can be completed at your primary care physician’s office.

What emotions do donors feel after the surgery?

Most living donors say they feel great satisfaction with the donation experience because they have helped to improve another person’s quality of life. Even in rare instances where the transplant is not successful, many donors say they feel positive about their decision because they did their very best to help a relative or friend. However, there is a small chance for donors to experience some negative or mixed feelings after the donation. These feelings have been more likely to occur in cases where the outcome of the surgery did not meet the expectations of the donor and/or recipient as well as in cases where the donor was unsure of his or her decision.

Who pays for the medical costs?

Living donors are financially responsible for their routine annual health maintenance testing (e.g., pap smear, mammogram, colonoscopy, etc.) or medical clearance that may be required for pre-existing conditions. However, all other testing required for the living donor evaluation, as well as the hospitalization costs and physician services provided during the donation process are covered either by recipient’s insurance or SSM Health Saint Louis University Hospital. A financial coordinator will help answer any specific questions you may have.

Are there any expenses not covered?

All non-medical expenses such as lost wages, child care, travel costs and daily living expenses that are incurred during the donation process are NOT covered. It is important for donors to consider the financial impact of these possible expenses. There are programs that may pay these expenses and our team will assist with completing these forms.

What is a liver transplant?

People with certain types of advanced liver disease, including liver cancer, cirrhosis and hepatitis may benefit from a liver transplant.

What is involved in the evaluation?

Medical and psychological testing will be completed by our staff to ensure transplantation is in your best interest. Our team of doctors, registered nurses, dietitians and social workers will work closely with you to help prepare you for transplant if you are determined to be a candidate.

How long does it take to get a liver transplant?

It may take anywhere from weeks to years, depending on your individual needs. Those who are the sickest are given priority in the allocation of donor livers. What is the surgery like, and how long should I expect to be in the hospital? The surgery usually last approximately four hours. Most patients can expect to stay in the hospital for one to three weeks.

What can I expect after I leave the hospital?

You will usually have labs drawn once or twice weekly and be seen in our clinic. As your body adjusts to the new organ and medication, you will need fewer lab tests and clinic visits.

Will my insurance cover transplant?

Transplant is considered “standard of care” and thus, most insurance policies do provide coverage for transplant. Our expertly trained financial counselors will help guide you through the process and answer any questions you may have.

Will I have to take special medications after my transplant?

Yes. You will be required to take daily medications to prevent your body from rejecting your new organ. This is a life-long medication regimen.

What if I have trouble paying for my new organ?

For those who qualify, there are government and private assistance programs available to help.

Are there any risks or complications that could occur?

Yes. As with any surgery or medical treatment, certain risks are involved. Your doctor will discuss specific risks and benefits with you during the evaluation process and just prior to surgery.

Will I have any special needs after my transplant?

Yes. You will be expected to maintain a healthy lifestyle, including a balanced diet and exercise. You will need to follow medical advice, and take your medications as prescribed.

Can I have pets after transplant?

Yes. However, there are certain pet restrictions. Due to infection risks, you may not have reptiles or birds. Although you may have cats, you should never change their litter. Ask a friend or family member to change it instead.

What are the risks?

The procedure’s risks are infection and rejection. Rejection happens when the body’s immune system mistakes the new organ as a “foreign” invader and attacks it. To reduce the chances of rejection, doctors try to match the blood and tissue type of the organ donor to the person getting the transplant. After the transplant, doctors prescribe special drugs that suppress the immune system, such as azathioprine and cyclosporine, to help prevent rejection of the new pancreas. However, these drugs make it more likely for transplant patients to pick up infections like colds and the flu. Over time, the drugs may also increase the risk for certain cancers. Because of the higher risk for skin cancer, for example, it’s important to cover up and wear sunscreen. If you get a pancreas transplant, you must take special medications as long as you have the transplanted organ in your body. It’s also crucial to keep all your doctor appointments.

Is there a waiting list?

Currently, more people are in need of a healthy pancreas than can be provided for with donors. The wait for a pancreas can be quite long – on average, 300 to 400 days. When a donor pancreas is not available, a partial pancreas from a living relative can be donated. Surgeons may plan to do a pancreas transplant at the same time as a kidney transplant, to help control blood glucose levels and reduce damage to the new kidney. The chance of rejection is less if doctors ensure that the living donor’s blood proteins are compatible with those of the patient.

What is the outlook after a pancreas transplant?

The long-term outlook for people who receive a pancreas transplant is quite good. A recent report in the Review of Diabetic Studies found that the five-year survival rate for pancreas transplant patients during the past 25 years is greater than 83 percent. People who receive simultaneous kidney-pancreas transplants also tend to have less chance of rejection.

What is a bone marrow transplant?

Bone marrow transplant (BMT) is a special therapy for patients with certain cancers or other diseases. A bone marrow transplant involves taking cells that are normally found in the bone marrow (stem cells), filtering those cells, and giving them back either to the donor (patient) or to another person. The goal of BMT is to transfuse healthy bone marrow cells into a person after their own unhealthy bone marrow has been treated to kill the abnormal cells. Bone marrow transplant has been used successfully to treat diseases such as leukemias, lymphomas, aplastic anemia, immune deficiency disorders, and some solid tumor cancers since 1968.

What is bone marrow?

Bone marrow is the soft, spongy tissue found inside bones. It is the medium for development and storage of most of the body's blood cells. The blood cells that produce other blood cells are called stem cells. The most primitive of the stem cells is called the pluripotent stem cell, which is different than other blood cells with regards to the following properties:

Renewal: It is able to reproduce another cell identical to itself.

Differentiation: It is able to generate one or more subsets of more mature cells.

It is the stem cells that are needed in bone marrow transplant.

Why is a bone marrow transplant needed?

The goal of a bone marrow transplant is to cure many diseases and types of cancer. When the doses of chemotherapy or radiation needed to cure a cancer are so high that a person's bone marrow stem cells will be permanently damaged or destroyed by the treatment, a bone marrow transplant may be needed. Bone marrow transplants may also be needed if the bone marrow has been destroyed by a disease. A bone marrow transplant can be used to:

• Replace diseased, nonfunctioning bone marrow with healthy functioning bone marrow. This is commonly done for conditions such as leukemia, aplastic anemia, and sickle cell anemia. Regenerate a new immune system that will fight existing or residual leukemia or other cancers not killed by the chemotherapy or radiation used in the transplant.
• Replace the bone marrow and restore its normal function after high doses of chemotherapy and/or radiation are given to treat a malignancy. This process is often called rescue (for diseases, such as lymphoma and neuroblastoma).
• Replace bone marrow with genetically healthy functioning bone marrow to prevent further damage from a genetic disease process (such as Hurler's syndrome and adrenoleukodystrophy).

The risks and benefits must be weighed in a thorough discussion with your doctor and specialists in bone marrow transplants prior to procedure.

What are some diseases that may benefit from a bone marrow transplant?

The following diseases are the ones that most commonly benefit from bone marrow transplant:

• Leukemias
• Severe aplastic anemia
• Lymphomas
• Multiple myeloma
• Immune deficiency disorders
• Some solid-tumor cancers

However, patients experience diseases differently, and bone marrow transplant may not be appropriate for everyone who suffers from these diseases.

What are the different types of bone marrow transplant?

There are different types of bone marrow transplants depending on who the donor is. The different types of BMT include the following:

Autologous bone marrow transplant

The donor is the patient himself or herself. Stem cells are taken from the patient either by bone marrow harvest or apheresis (a process of collecting peripheral blood stem cells), frozen, and then given back to the patient after intensive treatment. Often the term rescue is used instead of transplant.

Allogeneic bone marrow transplant

The donor shares the same genetic type as the patient. Stem cells are taken either by bone marrow harvest or apheresis from a genetically-matched donor, usually a brother or sister. Other donors for allogeneic bone marrow transplants may include the following: A parent - A haploid-identical match is when the donor is a parent and the genetic match is at least half identical to the recipient. These transplants are rare.

Unrelated bone marrow transplants (UBMT or MUD for matched unrelated donor)

The genetically matched marrow or stem cells are from an unrelated donor. Unrelated donors are found through national bone marrow registries.

Umbilical cord blood transplant

Stem cells are taken from an umbilical cord immediately after delivery of an infant. These stem cells reproduce into mature, functioning blood cells quicker and more effectively than do stem cells taken from the bone marrow of another child or adult. The stem cells are tested, typed, counted, and frozen until they are needed for a transplant.

How are a donor and recipient matched?

Matching involves typing human leukocyte antigen (HLA) tissue. The antigens on the surface of these special white blood cells determine the genetic makeup of a person's immune system. There are at least 100 HLA antigens; however, it is believed that there are a few major antigens that determine whether a donor and recipient match. The others are considered "minor" and their effect on a successful transplant is not as well-defined. Medical research is still investigating the role all antigens play in the process of a bone marrow transplant. The more antigens that match, the better the engraftment of donated marrow. Engraftment of the stem cells occurs when the donated cells make their way to the marrow and begin producing new blood cells. Most of the genes that "code" for the human immune system are on one chromosome. A full sibling of a patient in need of a transplant has a one-in-four chance of having gotten the same set of chromosomes and being a "full match" for transplantation. 

How are stem cells collected?

A bone marrow transplant is done by transferring stem cells from one person to another. Stem cells can either be collected from the circulating cells in the blood (the peripheral system) or from the bone marrow.

Peripheral blood stem cells

Peripheral blood stem cells (PBSCs) are collected by a apheresis, a process in which the donor is connected to a special cell separation machine via a needle inserted in arm veins. Blood is taken from one vein and is circulated though the machine which removes the stem cells and returns the remaining blood and plasma back to the donor through another needle inserted into the opposite arm. Several sessions may be required to collect enough stem cells to ensure a chance of successful engraftment in the recipient. A medication may be given to the donor for about one week prior to apheresis that will stimulate the bone marrow to increase production of new stem cells. These new stem cells will be released from the marrow and into the circulating or peripheral blood system; from there they can be collected during apheresis.

Bone marrow harvest

Bone marrow harvesting involves collecting stem cells with a needle placed into the soft center of the bone, the marrow. Most sites used for bone marrow harvesting are located in the hip bones and the sternum. The procedure takes place in the operating room. The donor will be anesthetized during the harvest and will not feel the needle. In recovery, the donor may experience some pain in the areas where the needle was inserted.

If the donor is the person himself or herself, it is called an autologous bone marrow transplant. If an autologous transplant is planned, previously collected stem cells, from either peripheral (apheresis) or harvest, are counted, screened, and ready to infuse. What is the bone marrow transplant procedure? The preparations for a bone marrow transplant vary depending on the type of transplant, the disease requiring transplant, and your tolerance for certain medications. Consider the following:

Most often, high doses of chemotherapy and/or radiation are included in the preparations. This intense therapy is required to effectively treat the malignancy and make room in the bone marrow for the new cells to grow. This therapy is often called ablative, or myeloablative, because of the effect on the bone marrow. The bone marrow produces most of the blood cells in our body. Ablative therapy prevents this process of cell production and the marrow becomes empty. An empty marrow is needed to make room for the new stem cells to grow and establish a new blood cell production system.

After the chemotherapy and/or radiation is administered, the marrow transplant is given through the central venous catheter into the bloodstream. It is not a surgical procedure to place the marrow into the bone, but is similar to receiving a blood transfusion. The stem cells find their way into the bone marrow and begin reproducing and growing new, healthy blood cells.

After the transplant, supportive care is given to prevent and treat infections, side effects of treatments, and complications. This includes frequent blood tests, close monitoring of vital signs, strict measurement of fluid input and output, daily weigh-ins, and providing a protected and clean environment.

The days before transplant are counted as minus days. The day of transplant is considered day zero. Engraftment and recovery following the transplant are counted as plus days. For example, a patient may enter the hospital on day -8 for preparative regimen. The day of transplant is numbered zero. Days +1, +2, etc., will follow. There are specific events, complications, and risks associated with each day before, during, and after transplant. The days are numbered to help the patient and family understand where they are in terms of risks and discharge planning. During infusion of bone marrow, the patient may experience the following:

• Pain
• Chills
• Fever
• Hives
• Chest pain

After infusion, the patient may:

• Spend several weeks in the hospital
• Be very susceptible to infection
• Experience excessive bleeding
• Need blood transfusions
• Be confined to a clean environment
• Take multiple antibiotics and other medications
• Be given medication to prevent graft-versus-host disease--if the transplant was allogeneic. The transplanted new cells (the graft) tend to attack the patient's tissues (the host), even if the donor is a relative.
• Undergo continual laboratory testing
• Experience nausea, vomiting, diarrhea, mouth sores, and extreme weakness
• Experience temporary mental confusion and emotional or psychological distress

After leaving the hospital, the recovery process continues for several months or longer, during which time the patient cannot return to work or many previously enjoyed activities. The patient must also make frequent follow-up visits to the hospital or doctor's office.

When does engraftment occur?

Engraftment of the stem cells occurs when the donated cells make their way to the marrow and begin producing new blood cells. Depending on the type of transplant and the disease being treated, engraftment usually occurs around day +15 or +30. Blood counts will be checked frequently during the days following transplant to evaluate initiation and progress of engraftment. Platelets are generally the last blood cell to recover. Engraftment can be delayed because of infection, medications, low donated stem cell count, or graft failure. Although the new bone marrow may begin making cells in the first 30 days following transplant, it may take months, even years, for the entire immune system to fully recover.

What complications and side effects may occur following BMT?

Complications may vary, depending on the following:

• Type of marrow transplant
• Type of disease requiring transplant
• Preparative regimen
• Age and overall health of the recipient
• Variance of tissue matching between donor and recipient
• Presence of severe complications

The following are complications that may occur with a bone marrow transplant. However, each individual may experience symptoms differently. These complications may also occur alone, or in combination:

Infections: Infections are likely in the patient with severe bone marrow suppression. Bacterial infections are the most common. Viral and fungal infections can be life threatening. Any infection can cause an extended hospital stay, prevent or delay engraftment, and/or cause permanent organ damage. Antibiotics, anti-fungal medications, and anti-viral medications are often given to try to prevent serious infection in the immunosuppressed patient.

Low platelets and low red blood cells: Thrombocytopenia (low platelets) and anemia (low red blood cells), as a result of a nonfunctioning bone marrow, can be dangerous and even life threatening. Low platelets can cause dangerous bleeding in the lungs, gastrointestinal (GI) tract, and brain.

Pain: Pain related to mouth sores and gastrointestinal (GI) irritation is common. High doses of chemotherapy and radiation can cause severe mucositis (inflammation of the mouth and GI tract).Fluid overload - Fluid overload is a complication that can lead to pneumonia, liver damage, and high blood pressure. The primary reason for fluid overload is because the kidneys cannot keep up with the large amount of fluid being given in the form of intravenous (IV) medications, nutrition, and blood products. The kidneys may also be damaged from disease, infection, chemotherapy, radiation, or antibiotics.

Respiratory distress: Respiratory status is an important function that may be compromised during transplant. Infection, inflammation of the airway, fluid overload, graft-versus-host disease, and bleeding are all potential life-threatening complications that may occur in the lungs and pulmonary system.

Organ damage: The liver and heart are important organs that may be damaged during the transplantation process. Temporary or permanent damage to the liver and heart may be caused by infection, graft-versus-host disease, high doses of chemotherapy and radiation, or fluid overload.

Graft failure: Failure of the graft (transplant) taking hold in the marrow is a potential complication. Graft failure may occur as a result of infection, recurrent disease, or if the stem cell count of the donated marrow was insufficient to cause engraftment.

Graft-versus-host disease: Graft-versus-host disease (GVHD) can be a serious and life-threatening complication of a bone marrow transplant. GVHD occurs when the donor's immune system reacts against the recipient's tissue. As opposed to an organ transplant where the patient's immune system will attempt to reject only the transplanted organ, in GVHD the new or transplanted immune system can attack the entire patient and all of his or her organs. This is because the new cells do not recognize the tissues and organs of the recipient's body as self. Over time and with the help of medicines to suppress the new immune system, it will begin to accept its new body and stop attacking it. The most common sites for GVHD are GI tract, liver, skin, and lungs.

What is the long-term outlook for a bone marrow transplant?

Prognosis greatly depends on the following:

• Type of transplant
• Type and extent of the disease being treated
• Disease response to treatment
• Genetics
• Your age and overall health
• Your tolerance of specific medications, procedures, or therapies
• Severity of complications

As with any procedure, in bone marrow transplant the prognosis and long-term survival can vary greatly from person to person. The number of transplants being done for an increasing number of diseases, as well as ongoing medical developments, have greatly improved the outcome for bone marrow transplant in children and adults. Continuous follow-up care is essential for the patient following a bone marrow transplant. New methods to improve treatment and to decrease complications and side effects of a bone marrow transplant are continually being discovered.