Frequently Asked Questions

Your body is unique and has a set of proteins called human leukocyte-associated (HLA) antigens, on the surface of your body cells. We identify this set of proteins from samples drawn from your blood or buccal swab smears. We have the expertise and facilities to evaluate bone marrow morphology and immunohistochemistry at our state-of-the-art lab. The other relevant specialised tests include flowcytometry, cytogenetics and molecular genetics. In most cases, the success of allogeneic transplantation depends on how well the HLA antigens of the donor and recipient’s stem cells. Higher the number of matching HLA antigens, greater are chances of your body accepting the donor’s stem cells. You are less likely to develop graft-versus-host disease graft-versus-tumour effect post allogeneic transplant: when white blood cells from the donor attack the cells in the patient’s body after the chemotherapy and/or radiation therapy, if the stem cells are closely matched. It is estimated that only 25 to 35 percent of patients have a HLA-matching sibling. The chances of obtaining matching stem cells from an unrelated donor too vary, so finding the right donor is the key to a successful BMT or PBSCT.

With advance in technology, obtaining cells from a donor or harvesting has become relatively simple. Bone marrow is harvested using needle from the hip or at times breastbone area, after inducing general or local anaesthesia. The harvested bone marrow is processed to remove blood and bone fragments, combined with a preservative and frozen at sub-zero temperatures to keep the stem cells alive but dormant until required. This technique is known as cryopreservation. We have a cryopreservation unit where we can cryopreserve stem cells for many years. In order to harvest PBSCs, the donor is given medications to produce and release excess stem cells into the blood stream. Called apheresis, blood is drawn from the donor and subject to a process that removes only the stem cells. The blood is then returned to the donor and the collected cells, stored in the cryopreservation unit. This usually takes 4 to 6 hours. We also obtain stem cells from umbilical cord on consent, to treat children and adults. We can cryopreserve these cells or even the entire cord for years.

If you are the bone marrow donor, you might feel tired and lethargic after donating the cells. However you will return to normalcy in a few days or sometimes, in a few weeks. As it is a procedure done under anaesthesia, you might need to do all relevant health checks before donating. Aphersis, however is easier, except for occasional giddiness, headache and some discomfort caused mainly due to the medicines given for increasing stem cells.

You will be infused with healthy, transplanted cells in the BMT unit through an IV line – just like you’d be on drips. As there will be no disease -fighting white blood cells and blood-clotting platelets after the conditioning, your susceptibility to infections will be extremely high. You’ll need to be extremely careful so that you don’t contract any infection and follow the doctor’s advise meticulously to avoid any complications. Since the stem cells used for autologous transplantation should relatively be free of cancer cells, the harvested cells can sometimes be treated before transplantation in a process known as “purging”. This process removes maximum cancer cells from the harvested cells and minimise the chance of reoccurrence.

The post-conditioning period and 3-4 weeks post infusion are the most crucial for BMT and PBSCT patients as the chances of infection are at an all time high. Our entire medical team is trained to observe international standards when it comes to hygiene and infection control, so that you are ensured a safe, sterile environment to recuperate. The stem cells, after entering your bloodstream, travel to the bone marrow and begin to produce new white blood cells, red blood cells, and platelets in a process known as “engraftment.” This usually occurs within about 2 to 4 weeks after the transplantation. Complete recovery of your immune function will take longer - up to several months for autologous transplant and 1 - 2 years for allogeneic or syngeneic transplants. We will evaluate your blood health through various tests including bone marrow aspiration to confirm whether new blood cells are being produced and there’s no relapse.

Apart from susceptibility to infection and bleeding, you may experience short-term side effects such as nausea, vomiting, fatigue, loss of appetite, mouth sores, hair loss, and skin reactions. There are also potential long-term issues that your doctor will explain in detail to you before beginning the treatment.

Called a non-myeloablative or reduced-intensity transplant, a mini uses lower, less toxic doses of chemotherapy and/or radiation to prepare you for an allogeneic transplant. ​ Called a non-myeloablative or reduced-intensity transplant, a mini uses lower, less toxic doses of chemotherapy and/or radiation to prepare you for an allogeneic transplant.

Heart transplant means replacing one’s diseased heart with a healthy donated heart. An extremely complicated procedure, is suggested only when the heart failure is so severe that it cannot be managed with medication or any other mode of treatment. Cardiac care has evolved phenomenally in the recent times, enabling us to treat complex heart problems effectively - medically and surgically. However, if the condition of the heart is such that no medications or surgical solution can bring any sort of relief, we have no choice but choose heart transplant as the way ahead. Heart transplant is done in both adults and children; and Aster Centre of Excellence in Multi-Organ Transplant has a great team of doctors comprising adult and paediatric transplant experts.

Children and infants are also highly susceptible to heart disease and might require heart transplant due to severe cardiomyopathy (weak heart muscles) and congenital heart disease that cannot be medically managed. Some children who have already undergone corrective cardiac surgeries might also require heart transplant due to re-occurrence of problems (continued cardiac problems).

If your doctor recommends a heart transplant, there are many formalities and tests you will need to complete before you undergo the surgery. You will need to go through an extensive screening process involving Radiological and Pathological Investigations. Our transplant team comprising Cardiac Surgeons, Cardiologists, Cardiac Anaesthesiologists, Pulmonologists and Pathologists will thoroughly review your reports to ensure that you’re medical fit for the surgery. We will then enlist you on the Heart Transplant List till we get notified of a suitable donor. Remember, waiting for a heart transplant might be a long drawn one for getting a donor – a suitable donor – is not easy. We will continuously monitor your health during this waiting period through regular check-ups and investigations. As soon as we get information that there is a donor heart available, we will contact you and if all factors are favourable, the transplant will be performed.