The period of hospitalisation for recipients of transplantation varies according to their condition, the type of transplant, and protocol. Individual transplant centres vary in their criteria for discharge from the acute care setting.7
Critical verbal and written discharge instructions to the recipient and their carers prior to discharge should include:7
- signs and symptoms to report to the transplant centre
- bleeding precautions
- infection control practices
- central venous access device care
- dietary restrictions
- medical instructions
- follow up care and appointments
- what to do in an emergency.
Transplant recipients still have special health care needs following discharge. A treatment and communication plan is required to ensure appropriate short and long term monitoring.
Recommended screening and preventive practices for transplant recipients have been developed by a consensus panel formed by members of:
- the Center for International Blood and Marrow Transplant Research (CIBMTR)
- the European Group for Blood and Marrow Transplantation (EBMT)
- the American Society for Blood and Marrow Transplantation (ASBMT).
The National Marrow Donor Program (NMDP), in partnership with these organisations, has developed Recommended post-transplant care guidelines.40 Recipients and health care professionals can use these guidelines to schedule long term follow up care after a marrow, peripheral blood stem cell, or cord blood transplant.41
Outline common criteria for discharge following transplantation in your practice setting.
Summarise the advice and information resources you would provide to a recipient and carer regarding the following possible scenarios post discharge:
- Presence of a temperature greater than 38ºC
- Diarrhoea for three days
- Redness and pain at Hickman site.
Identify the recommended tests and procedures for recipients' six-month, one-year, and annual post-transplant check-ups in your facility and compare these to the Recommended post-transplant care guidelines40 for:
- Autologous recipients
- Allogeneic recipients.
Discuss the community and health care facility resources that support the transplant recipient and their carer following discharge.