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Bone Marrow/Stem Cell Transplant Frequently Asked Questions
Helpful information for patients, caregivers and families
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10. How do I choose a transplant center?

Selecting a transplant center will be a big decision. Talk to your doctor and check with your insurance company to learn about your coverage. Factors such as living arrangements, proximity to family, and follow up care may influence your choice of whether to select a transplant center close to home or further away.

Signing on to stem cell transplant bulletin boards or newsgroups on the Internet can be another useful way to get information from other patients who have had their transplants at different centers. It may be helpful to get personal accounts and recommendations, but beware that this can also result in "misinformation." Your health care team should be relied upon for the most accurate medical advice.

Visiting the transplant center before the transplant to familiarize yourself with the transplant setting and its staff is often useful. While you are at the center, you might inquire if you can speak to patients who have undergone transplants to get their impressions, feedback, and tips.

Foremost, choose a center that has a good amount of experience with your type of disease and in performing transplants. Do your research and ask questions. For example:

  1. How many transplants has the center completed for people with your specific condition? Ideally, you should undergo a transplant at a center that has done at least 20 transplants of the type that you need. In general, the more transplants a center performs, the more experienced the staff typically is. In pediatrics, a moderately sized transplant center does around 20 transplants per year.
  2. Are you going to have the same staff treating you throughout the transplant? Most transplant centers have doctors, nurse practitioners, physician assistants, etc. who rotate on a regular basis.
  3. Will you have access to a social worker or counselor during the transplant?
  4. What is the average amount of time that the nurses have worked in the BMT unit?
  5. How experienced are the physicians at the center, and are there specialists (such as pulmonary and infectious diseases) available to handle complications should they arise?
  6. Is there a support group for patients or their families?
  7. What is the survival rate for patients with your condition in your age group undergoing your type of transplant?
  8. Could someone who has undergone a transplant at the center contact you to tell you about their experience?
  9. What is the visitor policy? How flexible is it? (Having your caregiver stay at the hospital overnight can be very comforting). Are children allowed to visit?
  10. What living arrangements can be made for you and your family if you need to move away from your home to the transplant center? How much can your family expect to pay for living expenses?
  11. Can the center provide any assistance to defray some of the family's expenses?
  12. Does the center have a long-term follow-up clinic that is easily accessible and will respond to questions once you leave the transplant center? This is particularly important if the oncologists near your home have very little experience with transplants.
  13. Individuals undergoing a transplant from an unrelated donor should also inquire whether the center has a donor search coordinator and a quality tissue typing facility.
  14. In addition, you may want to make a list of questions that are personally important to you. For example, "Will I be allowed to go outside, walk in the halls, or will I be confined to my room?" "Can the hospital accommodate my dietary needs?" "Can I ask for food at any time of the day, or do I have to order it a day in advance?" "Am I allowed to eat raw fruits and vegetables?" (Sometimes certain foods are restricted to reduce the risk of infection after transplant. Having a flexible eating schedule can be helpful as you may be nauseated at times and may not want to eat during conventional mealtimes.)

There are distinct advantages to having the transplant at an experienced medical center with an excellent track record. If there is no center near your home, or if you have concerns about the reported outcomes or the degree of experience at the center near you, you might consider moving your care to a larger more well-regarded center farther from home. Weighing the advantages of staying close to home where you have an extensive support network versus moving to a larger transplant center is difficult.

Be the Match has a Transplant Center Access Directory which has information about all U.S. transplant centers that perform allogeneic transplants. This information includes the number and type of transplants performed at each center, as well as some statistics about survival rates. Additionally, BMT InfoNet offers a comprehensive listing of transplant centers on their website, and the website of the Health Resources and Services Administration (HRSA) also offers comprehensive information. (See Resource Listing)

Please call the nbmtLINK at 800-LINK-BMT (800-546-5268) or e-mail info@nbmtlink.org for additional information.

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