1. http://www.ctsnet.org/home/eyevstratov Bone Marrow Transplantation The transfer of living cells, tissues, or organs from a donor to a recipient, with the intention of maintaining the functional integrity of the transplanted material in the recipient http://www.ctsnet.org/home/eyevstratov

2. Just Names E.Donall Thomas George Santos vanBekkum George Mathe

3. http://www.ctsnet.org/home/eyevstratov

4. Indications Acute and chronic leukemias Aplastic anemia Congenital immunodeficiency diseases Lymphomas Metabolic disease of childhood Myelodisplasia Thalassemia

5. http://www.ctsnet.org/home/eyevstratov Donor Limitations 25 – 30% of patients have an HLA-identical sibling. Marrow procured from unrelated living donor Marrow procured from related HLA-identical or HLA non –identical living donor Autologous transolantation(marroe procured during remession)

6. http://www.ctsnet.org/home/eyevstratov Recipient preparation Cyclophosphamide 60 mg/kg/day During two days and Toal body irradiation Busulfan 4mg/kg/day for fur days and Cyclophosphamide without irradiation Etoposide,Cyarabine as a maximizer antitumor properties,myeloblation,immunosuppression

7. http://www.ctsnet.org/home/eyevstratov Transplantation Procedure

8. http://www.ctsnet.org/home/eyevstratov Anesthesic Management Intravenouse anesthesia sould be procured. Intravenouse Thiopental,Fentanyl,Vecuronium can be used in common doses Maintanance can be provide with Propofol and Isoflurane.

9. http://www.ctsnet.org/home/eyevstratov Nota Bene Nitrouse Oxide should be avoided as an inactivator of Vit B12 wich is an essential coenzyme for methionine synthetase.This enzyme facilitate the conversion of homocystine and methyltetehydrofolate to methionine are essential for deoxyribonucleic acid (DNA) synthesis.

10. http://www.ctsnet.org/home/eyevstratov Complications Rejection by hte host of the marow graft Acute graft-vs,-host disease (GVHD) Infections Chronic GVHD Prolonged immunodeficiency Disease recurrence

11. http://www.ctsnet.org/home/eyevstratov Eugene Yevstratov MD Zacarias C.Vargas MD