In this video, Dr. Sunil Bhat highlights the essential preparatory steps for both patients and their families before undergoing bone ...

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Part 5 | What Are the Preparations That the Family &amp; the Patient Have to Go Through Before BMT?

[Music] Hello friends my name is Dr Sunil but I am the director and clinical lead of Patric Hematology Oncology and Bone M transplant at the Naran H Street Bangalore um as you know I have been bringing out this series on various exp of thalmic care to you um through this small videos um now this today's videos videos going to be the continuation of what we talked about bone merrow transplant in talisma measure we have discussed in the last video about different types of donors which can be used for transplantation now in today's video I'm going to be discussing with you what are the preparations the family and the patient has to go through before coming in for the transplantation Thalia is a very very interesting disease because talisia probably is the only disease wherein the age or the condition of the patient plays a very very important role in our chances for cure the better the child is or the patient is managed for his talisia before coming for transplantation better the outcomes right so by this what do I mean so there are three things which are important when we consider Thalia as a transplantation one is age of the patient second is how good their iron levels or iron overload is managed and number three how well they are transfused and the transfusion you know efficacy we measure in the terms of liver size how big the liver is right so these are the three things which are important so more age of the patient worse is the outcome younger the patient better is the outcome right second as I said is iron cation so better iron culation better the outcome and third is better transfused lesser liver size better outcome so I'll take the one one by one age when do we start transplant forthal age patients we usually transplant Thalia patients only after 1 and a half to 2 years of age and after that earlier the better we usually not transplant THM is less than one and a half year but after that you know actually usually you start at 2 years and younger the patient after that the better is outcome it has been seen that patients who are more than 7 years of age their outcomes are less you know better they're inferior to patients less than 7 years of age so younger the patient the better it is that's number one number two is iron overload so if you got a high iron no which measured as fertin or even T2 MRI worse is going to be the outcome so it's important for preparing these patients for months and sometimes years together before transplantation to get their iron overload as less as possible get the fertin as low as possible so when I talk about fertin as low as possible it's better to be around 1,00 ,000 or you know you ideally less than 1500 and same thing on MRI also the less iron load is the better outcome it is now the third important aspect is efficacy of transfusion how effective your transfusion is you are giving them for for for thalis measure if if you maintain good levels of 9.5 to 10.5 before giving blood your liver is not increased in size your splen is not going to increase in size so hence a big liver is always a problem so we want the liver size to be lesser then so again we can work on these patients for months and years together before the transplantation so that we can reduce their liver size reduce their fertin and we can at the same time you know prepare them for the transplant in these various aspects so that is what a patient you know condition is important to for the chances of cure they have so as a doctor as a primary referal we need to tell the family that yes transplant is possible but we need to prepare this patient in these through two three aspects and that can take sometimes weeks and months together before we treat take them for transplant that's number one how to prepare the patient number two it's very very important for family to understand that what a transplant would enter would would entail what is there for them to go through this process as I said earlier on transplanted talism is an option it's not a compulsion so it always comes the risk and the risk depends on various factors I'm going to get into that now at in this current video but the fam understand that if we if we choose a transplant as an option it will come with its own problems and one of the problems also risk you know which which with the transplant encounters so it's very important to make family understand the whole transplant process which includes pre-transplant preparation transplant admission for a month and post transplant followup which which continues for a few months very strictly and then after almost up to a year after transplant also and that whole lot of activity has to be explained to the patients you know um in in in great detail one of the very important questions with the patients the families have sometimes is that can a carrier be a donor yes carrier can be a donor there's no problem about if about it the other question they have is is it harmful for the donor no it is not harmful for the donor we you know uh donors you know are very well anal you know assessed tested before they donate and when they are deemed to be healthy and they are fit to be healthy donation they will be taken for donation and and there has been thousands and millions of you know transplants that happen all over the world it has been seen that the donation process for the donors have been is on on relatively very very safe and I don't think we need to worry too much about the donor as an option so as a as a parent we when we're going for a transplantation we need to you need to maintain these patients in relatively good State you know complete the vaccinations which are supposed to be given for these for these patient and in fact the siblings also should have the vaccinations done you know um look look at the fertin levels which need to be reduced as much as possible look at the liver size and other things which need to be reduced as much as possible before transplantation which is called as down risking so that we optimize the patients before the Comfort transplant and families also need to be make understood that for for few months post transplantation these patient need to be keep in isolation environment and they need to understand what and we'll discuss that in a little bit great detail later on of what is the post transplant care required for a patient with Thalia so in the short video I try to explain you what is a preparation required for a thalmic patient before we going for the transplantation why some of these things are important to be done before uh we embark on a transplant Journey thank you very much [Music]

Dr.

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