TRANSPLANT REFERRAL PROCESS
Hematopoietic Progenitor Cell (Bone Marrow/Stem Cell)

REFERRAL PHASE

The work-up and preliminary insurance authorization takes time to complete.Thus as soon as transplant is being considered as an option, contact a Transplant Program physician or the case coordinator and have a consult appointment scheduled:

• Richard Mercier MD, Medical Director @ 715-387-5134
• Doug Reding MD @ 715-387-5134
• Stuart Tipping MD @ 715-387-5425
• Darlene Bortz RN, Case Coordinator @ 715-387-7980
• Appointment Coordinator @ 715-387-5416

Information that will be needed includes:

• Recent H/P
• Initial diagnostic pathology report and any subsequent reports
• Recent hematology and chemistry lab reports
• Past chemotherapy regimens, dates, and response, including reports of scans
• Contact person for case coordinator (RN, MA, or MD)
• E-mail, phone number, and FAX number
• The Transplant Program physician will contact the Case Coordinator to participate in the consult visit.
• Presented at Transplant Committee meeting.
• Discussed at affiliate patient case conferences

WORK-UP & HARVEST PHASE

Once the patient and physicians have determined that transplant is an acceptable treatment option, the Transplant Case Coordinator will work with the referring and transplant physician on the next steps.

• Eligibility criteria for research protocol will be assessed as applicable
• Patient Financial Counselor for Oncology will contact the insurance provider to obtain preliminary authorization for transplant
• Referring physician, transplant physician, case coordinator, and patient will collaboratively determine potential harvest dates and pre-harvest activities.
• Work-up for harvest including infectious disease screening, metabolic panel, CBC, recent EKG, and pregnancy test (if female)
• Venous access device placement, usually Pheres-flow triple lumen (need dialysis-size catheter for harvest)
• Mobilization regimen and schedule (Growth factor dosing with/without chemotherapy)
• Follow-up labs (CBC and CD-34)
• Progenitor cell harvest
• Case coordinator communicates with referring physician re: progress of harvest activities.

MYELOABLATIVE AND INFUSION PHASE

Referring physician, transplant physician, case coordinator, and patient will collaboratively determine potential admission dates for high-dose therapy, infusion, and related pre-transplant activities.

• Work-up includes pre-harvest work-up if longer than 8 weeks from work-up, cardiac function, pulmonary function, liver panel, scans, x-rays, or tumor makers of measurable disease, and any additional assessments required by clinical trial guidelines, insurer, or clinical status.
• Placement of multiple lumen vascular access device (if the patient does not have one)
• Case coordinator and/or transplant physician will routinely communicate patient progress with the referring physician or contact person.
• Transition to outpatient status if tolerating treatment and staying within 35 miles of Marshfield.The patient must stay within 35 miles of Marshfield until engraftment occurs.
• Case coordinator will collaborate with referring physician and transplant physician for follow-up care and testing.This includes Day +100 appointment with transplant physician.