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Monday, 21.08.2017, 00:02
Main » Organ transplantation » Complications of bone marrow transplantation 
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Complications of bone marrow transplantation


Complications of bone marrow transplantation

In the period from 3 weeks to 3 months after bone marrow transplantation is the most frequent complications of graft rejection, acute reaction "graft-versus-host disease", and pneumonia.


Rejection in allotransplantation of bone marrow (bone marrow transplants between incompatible donor-recipient pairs) is associated with antigenic differences between donor and recipient.

Acute reaction to "graft-versus-host" more often with incomplete compatibility of HLA-antigens. Age is a risk factor for this complication. At the same time affects the skin, liver and intestines. On the skin of a massive eruption with a tendency to spread to the extremities to the chest, back, prone to suppuration and necrotisation. Local treatment includes the use of ointments with prednisolone. Signs of liver damage occur simultaneously or somewhat later cutaneous manifestations. The basis for this phenomenon is the degeneration of small bile ducts, which develop on the background of hepatic necrosis. The defeat of the gastrointestinal tract manifested by diarrhea sometimes with blood, and abdominal pain. Therapeutic measures consist of antimicrobial therapy and increasing immunosuppression. In the later period may result in lacrimal and salivary glands, esophagus. Eye involvement is manifested in the development of keratokonyunktivita, foreign body sensation. From the observed narrowing of the esophagus and fibrosis.

Inhibition of the patient's own bone marrow, conducted in preparation for bone marrow transplantation, leads to a lack of immunity. Immediately after the transplant recipient is highly susceptible to various infections. Restoration of immunity similar to the process of maturation in the newborn, with the difference that the patient could be a carrier of asymptomatic "latent" infections before surgery. The maximum risk is cytomegalovirus infection. Deaths caused by cytomegalovirus infection in the development of pneumonia. The signs of the disease are shortness of breath, fever, nonproductive cough. When X-ray of the chest reveals characteristic changes. From prevention and treatment is prescribed to ganciclovir.

Due to the toxic effect on kidneys drug may develop acute renal failure. To prevent this condition by monitoring the concentration monitor these drugs in the blood.

One of the complications of late postoperative period may be carcinogenesis, due to immunosuppressive therapy.



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