Bone marrow acts as a source of stem cells which in turn produce neutrophils, and other biological factors, to combat infection…
Organ Transplant and Bone Marrow Stem Cell Transplant Units
There are circ 4500 organ transplants in the UK per year and nearly 30,000 in the USA. The majority tend to be kidney (circ 55%, followed by liver and then heart). About 13% of all patients transplanted between 1996 and 2000 in the US required hospitalization for bacterial infections in the first 3 years compared to 6% for viral infections. Infections can depend on country but Gram-negative infections are a major concern, particularly those resistant to antibiotics.
Increasing risk of transplant infections tend to occur in three distinct areas:
- Pre-surgery (where the donor or recipient may have contracted an infection)
- During the operation (where infection is introduced during surgery possibly from latent infection of the body surface, from heathcare workers or from the environment)
- Post-surgery (where there are three distinct phases: >1month where infection is common from surgical complications; 1-6 months where infection is as a result of immunosuppressants and latent infectious agents, 6-12 months where infection is more community-acquired due to low immune response and weaker defences.
Costs associated with transplants
Transplant costs are highly variable but tend to be high with often the need to utilise intensive care unit beds which tend to be among the most expensive beds – on a fully costed basis – within a hospital. Moreover, transplant patients who become infected with a noscomial pathogen on an ICU tend to have a significant extended length of stay – which, in turn, gives rise to substantial costs.