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Evaluation for Transplant

Your primary oncologist will initiate conversations with you about whether transplant is an appropriate option. He or she may recommend that you be evaluated further by a transplant physician and a transplant nurse coordinator. The transplant physician will review your medical history, previous treatment, type of cancer and make a recommendation regarding your qualification as a transplant candidate. You may already be undergoing chemotherapy to treat your cancer. You may need further treatment from your primary oncologist prior to transplant.

You will also discuss which transplant location is the best choice for you. Transplantation can occur at our stem cell outpatient clinic or as an inpatient at Inova Fairfax Hospital. This decision is based on a number of criteria, including insurance requirements, the availability of a dedicated caregiver, and pre-existing medical conditions. Your transplant medical team will provide the same level of excellent care regardless which location is selected. 

Once you and your doctors decide you are a possible candidate for a transplant, you will continue to receive transplant education and orientation, as well as a pre-transplant evaluation. At the same time, our transplant financial coordinator will work with your health insurance company to determine your transplant benefits. She will provide you with a summary of your transplant benefits so that you are aware of any out-of-pocket expenses for which you are responsible. 

Pre-transplant orientation and education

You and your family will undergo extensive orientation and education from a transplant nurse coordinator so that you will know what to expect before, during and after your transplant. You will receive written education materials and a treatment calendar with the entire transplant process mapped out day by day. Your transplant nurse coordinator serves as your contact person throughout the transplant process, planning your evaluation, stem cell collection, and consenting and monitoring your progress throughout the transplant. Your treatment options will be reviewed again – especially what to expect from the transplant therapy – and you will be given consent forms for the transplant treatment to review. Feel free to talk with your nurse coordinator about any questions or concerns you have. She is here to help you and your family through the transplant process.

Pre-transplant evaluation

You will undergo numerous tests to determine the current status of your disease and your overall physical well being. Both are critical to the success of the transplant. Transplant is most effective when the disease is least detectible or in remission. In order to determine the status of your disease, a restaging evaluation will be done.

Restaging
These tests will evaluate the current stage of your cancer so that your response to your initial cancer treatment can be assessed. Depending on the type of cancer you have, these tests may include:

  • X-rays
  • CT/PET scans
  • MRIs, bone scans
  • Blood tests
  • Urine tests
  • Bone marrow biopsy

Organ function testing
Other tests will be done to evaluate your general physical condition as the high-dose chemotherapy given as part of your transplant places extra stress on your body. These tests will include:

  • MUGA scan (heart function test)
  • EKG
  • Pulmonary function tests (lung function test)
  • X-rays
  • Blood tests
  • Urine tests

In addition, all transplant candidates meet with an oncology social worker who helps prepare the patient and family for the procedure from a psychosocial perspective.Once these tests have been done, your physician or nurse coordinator will notify you if any abnormal results make transplantation inadvisable or increase the risks associated with the transplant. You will come back a few days before the transplant procedure begins to review the results of all of the pretesting. You will sign your transplant consents with the transplant physician and nurse coordinator and will have an opportunity to ask questions.