Hardy: HSCT for the intensivist: indications, interventions, & complications

Dr. Nancy Hardy, Director of Allogeneic Transplantation at the University of Maryland, discusses stem cell transplantation, focusing on key points relevant to critical care. She emphasizes that bone marrow transplantation can cure lethal diseases and that the University of Maryland invests heavily in patient care, leading to excellent outcomes. Dr. Hardy distinguishes between autologous and allogeneic transplants, noting the lower mortality rate of autologous transplants and the higher mortality but immunotherapy benefits of allogeneic transplants. She stresses the importance of aggressive diagnostics and treatment due to the potential for rapid deterioration in transplant patients, highlighting the influence of timing on complications and the need for collaboration with the transplant team. Dr. Hardy also outlines the criteria for determining a patient's suitability for transplant, including disease treatability, patient resilience, donor availability, and immune system reconstitution, while addressing potential complications such as splenic rupture, air embolism, citrate reactions, and engraftment syndrome.