What happens on transplant day?

When will my hospital get the stem cells?

If you’re receiving your stem cells from an unrelated donor through Anthony Nolan, one of our volunteer couriers will deliver them directly. Your hospital will receive the cells less than 72 hours after our team collects them.

If you’re having an autologous transplant, then you will have already recently gone through the collection process for your own stem cells.

If you’ve having another type of allogenic transplant, where you receive stem cells from somebody else, then the hospital will already have the stem cells.

To find out more, see our section on different types of stem cell transplants.

What happens before my stem cell transplant?

On transplant day, or ‘day zero’, your nurse will:

• check your heart rate, blood pressure and temperature
• give you an antihistamine and a small dose of steroids via your central line.

This will help to stop any allergic reaction during the infusion of your new stem cells.

What happens during my stem cell transplant?

During your stem cell transplant, the cells will be passed as a fluid through your central line in the same way as a blood transfusion.

You shouldn’t feel any pain and you’ll be awake the whole time. It can take between 30 minutes and a few hours.

When the infusion has finished, your nurse will flush your line through with saline (a type of salty water) to keep it clean. They will then check your heart rate, blood pressure and temperature again. Once they’ve done their final checks, your transplant is complete.

People have lots of different feelings about and experiences of transplant day. For some of us it’s a celebration of a new beginning. For others it can feel like an anti-climax, because something so important is over so quickly and simply.

What medication will I need to take?

You’ll take different medications to help you through your transplant and your recovery. You might take some as tablets, or doctors might give you others through your central line.

These medications often have names which might be difficult to say, and it might be hard to remember each of their purposes. In general, the medication you take should come under one of these five categories:

1. To help engraftment happen more quickly. Engraftment is the forming of your new blood cells. You might hear these types of medication called ‘growth factors’, which you’ll usually get as an injection.
2. To help control your new immune system and reduce the effects of graft versus host disease (GvHD).
3. To protect you from bacterial infections. You might hear these types of medications called ‘antibacterial prophylaxes’.
4. To prevent viral infections, like shingles, for example. You might hear these types of medications called ‘antiviral prophylaxes’.
5. To control other symptoms and side effects. For example, taking medications to protect your kidneys, to prevent nausea and vomiting, or a type of antifungal prophylaxis. You might also need to take other medication depending on blood results during your treatment.

What happens after engraftment?

After the transplant, your new stem cells travel in your bloodstream to your bone marrow. Once there, they attach themselves and start to produce white blood cells that will form your new immune system. You’ll usually hear this called 'engraftment'. It generally means things are going well and your transplant has worked.

Engraftment normally takes around two to three weeks, but can sometimes take longer. The first sign of successful engraftment is often an increase in your white blood cell count.

As your medical team will test your blood regularly, they know when engraftment has started – they should see a steady increase in your white blood cell count. During this time, you might need blood and platelet transfusions a few times a week. This helps ‘top up’ your red blood cells, which may also be low. These extra transfusions are a normal part of recovery and don’t mean your transplant hasn’t worked. If you do have concerns, you should talk to your medical team.