Supportive care recommendations specific to HCT for SCD
| Organ system . | Recommendations . |
|---|---|
| Cardiovascular | • Prevention of hypertension (BP within 10% of baseline and <90th% for age/sex83 ) using daily and/or as needed antihypertensives |
| • Consider echocardiogram with acute cardiopulmonary symptoms | |
| Neurologic | • Seizure prophylaxis (preferred levetiracetam) through CNI administration |
| • Prevention of hypomagnesemia with daily magnesium levels and IV magnesium sulfate bolus if <2.0 | |
| Hematologic | • Platelet transfusion if <50 000/μL |
| • Maintain hemoglobin 9 to 11 g/dL (RBC transfusion if <9 g/dL) | |
| Immunologic | • Penicillin prophylaxis from day −1 through 1-y posttransplant, with discontinuation if liver-spleen scan with present or normal function |
| • Consider blood culture in patients with fever ±cardiorespiratory compromise, even if central line removed and off immune suppression | |
| Hepatobiliary | • Consider abdominal ultrasound ±Doppler in patients with change in hepatic function and/or atypical physical exam findings |
| Organ system . | Recommendations . |
|---|---|
| Cardiovascular | • Prevention of hypertension (BP within 10% of baseline and <90th% for age/sex83 ) using daily and/or as needed antihypertensives |
| • Consider echocardiogram with acute cardiopulmonary symptoms | |
| Neurologic | • Seizure prophylaxis (preferred levetiracetam) through CNI administration |
| • Prevention of hypomagnesemia with daily magnesium levels and IV magnesium sulfate bolus if <2.0 | |
| Hematologic | • Platelet transfusion if <50 000/μL |
| • Maintain hemoglobin 9 to 11 g/dL (RBC transfusion if <9 g/dL) | |
| Immunologic | • Penicillin prophylaxis from day −1 through 1-y posttransplant, with discontinuation if liver-spleen scan with present or normal function |
| • Consider blood culture in patients with fever ±cardiorespiratory compromise, even if central line removed and off immune suppression | |
| Hepatobiliary | • Consider abdominal ultrasound ±Doppler in patients with change in hepatic function and/or atypical physical exam findings |