Stem cell infusion occurs on day 0. The recipient receives hydration and premedication according to their protocol, which may include:7
- lorazepam
- diphenhydramine hydrochloride
- hydrocortisone
- paracetamol
- frusemide
- methylprednisolone.
Frozen stem cells are thawed and quickly infused via a central venous access device. The recipient may experience a number of effects of the stem cell infusion related to the DMSO, lysis of red blood cells, volume of infusate and the coldness of the thawed cells:7
- nausea and vomiting
- haemoglobinuria
- elevated serum creatinine
- elevated serum bilirubin
- cardiovascular effects
- chills and fever
- anaphylactic reaction.
Learning activities
Review an autologous transplant protocol and explain the rationale for processes on day 0 for the recipients.
Review an allogeneic transplant protocol and explain the rationale for processes on day 0 for the recipients.
Review your local protocol for stem cell infusion and conduct a teaching session with a novice nurse using the protocol.
Identify the signs and symptoms of anaphylactic reaction during stem cell infusion.
Discuss interventions to prevent and manage an anaphylactic reaction during stem cell infusion.
Outline the implications of a blood type incompatibility between the donor and recipient and interventions to reduce adverse effects in:
- Minor ABO mismatch
- Major ABO mismatch.
Outline your response as an SCN for a recipient who complains of 'black urine' six hours post stem cell infusion.