Transplant day normally happens the day after the chemotherapy and radiotherapy has finished; people often call it ‘day zero.’
If you’re receiving your new stem cells from an unrelated donor through Anthony Nolan, then they’ll be hand-delivered by an Anthony Nolan Volunteer Courier and arrive at your hospital in a bag.
Your nurse will give you some medication – an anti-histamine and a small dose of steroids – through your central line (a thin tube going into your vein). These will help stop any possible allergic reaction during the infusion of your cells.
The transplant cells will be passed as a fluid through your central line in the same way as a blood transfusion. This will take between thirty minutes and several hours depending on the amount that you’re being given.
The transplant isn’t painful and you’ll be awake the whole time, just like having another drip or blood transfusion. When the infusion has finished your nurse will flush your line through with saline and then take it down.
You’ll have your blood pressure, pulse and temperature checked again, and then the transplant will be complete.
People have different experiences of transplant day. For some it’s a celebration of a new beginning, a second birthday…while for others it’s a bit of an anti-climax. Share your experiences of day zero on our online transplant community.
‘In a way the transplant seemed just like a blood transfusion. It looked to me like a bag of blood. There was a lot of it, which was good, and it took a long time to slowly drip in. It was very uneventful.’
Fran had a transplant in 1995; watch her video about life after transplant
You’ll be taking a number of medicines to support you through your transplant. They’re normally in tablet form at first, and later on you may be given them through your line or as injections. The medicines perform different functions, including:
After your transplant, the stem cells make their way to your bone marrow. Once there they will start to grow into normal blood cells – this is called engraftment.
This normally happens in the two to three weeks after your transplant, but it can sometimes take longer. Often the first sign is a rise in your white blood cell count.
While your white blood cell count improves, your team will monitor you carefully. You’ll also have blood and platelet transfusions a few times a week, because you will have low red blood cells.
During the early stages after your stem cell transplant, you’ll be at increased risk of developing an infection because you’ll have a low number of white blood cells.
When your white blood cell count drops below 1.0, you’ll need to be in a germ-free environment – called protective isolation.
Protective isolation is done differently in different hospitals, but where possible you’ll be in a single room with the door closed. There is normally a special air conditioning system, making the air in your room very clean and reducing the risk of infections.
You won’t go outside your room much and, while you can have visitors, it’s important that you don’t have too many and that no one with a suspected infection comes in. Find out more about dealing with infections.
The length of time that people spend in isolation after a transplant varies from days to weeks. Talk to your doctor about how long you might be in isolation. They might not be able to give you an exact time-frame, but even having a rough idea can help you feel more prepared.
Download our booklet Dealing with isolation, which has practical tips to help you through this time. You can also get support from others on our transplant community, or contact us for more information.