Discharge from the Hospital

	Patient and father in outpatient exam room

Continued monitoring for infection

Linda and Karen in the BMT Outpatient Treatment Center

The risk of developing infections lasts for as long as 6-18 months following a bone marrow stem cell transplant. The patient is followed closely by the transplant team along with his or her own doctor. Initially, blood will be drawn 1-2 times per week to monitor the recovering marrow and nutritional state, and the patient will be seen weekly. As the patient’s condition stabilizes, the visits will be extended to monthly for the first six months post-transplant, every 3 months until two years post-transplant, and then every 6-12 months thereafter. The exact schedule for each patient varies depending on the type of transplant and the patient's clinical situation. At regular intervals in the Bone Marrow Transplant Outpatient Clinic at UCSF, blood will be drawn to evaluate the function of the new immune system and the degree of engraftment (percent donor cells).

Monthly IV gammaglobulin and daily antibiotics to help prevent infections will be needed until the new marrow fully recovers. The special precautions at home, including the daily antibiotics, generally are necessary for the first 3-6 months post-transplant. The monthly gammaglobulin is required for 6-9 months and sometimes longer depending upon the type of transplant. Patients who develop GVHD may require antibiotics and gammaglobulin for a longer period.

Each family will be given a detailed discharge handbook that will help with the teaching and serve as a reference at home.