Premarrow Transplant Evaluation for Risk of Critical Illness

Abstract

Critical illness requiring support in an intensive care unit (ICU) is common after blood and marrow transplantation, occurring in > 20% in some series. Attempts have been made to identify patients at highest risk of respiratory, cardiac, hepatic, and renal failure before trans plantation. Whereas demographic features, such as age and presence of active malignancy, are strongly associated with complications after transplant, only a few specific laboratory studies are useful in identifying high-risk individuals. Pulmonary function testing is associated with fatal pulmonary complications, and hepatic function tests are associated with fatal veno-occlusive disease of the liver. Knowledge of the predictive value of specific risk factors is important to the evaluation of patients considered for transplant.