The combined adult and paediatric Bone Marrow Transplant Unit (BMTU) at the Bristol Royal Hospital for Children offers extensive training opportunities to one haematology STR working with three clinical fellows. The BMTU is a state-of-the-art 14 bedded unit which performs allogeneic stem cell transplants from sibling and alternative donors. Indeed, the unit has extensive experience in transplanting using alternative donors and started the first cord blood and haploidentical transplant programmes in the United Kingdom. Around 45 adult allogeneic stem cell transplants will be performed in 2008/9. The BMTU is situated in the purpose-built Bristol Royal Hospital for Children, part of University Hospitals Bristol NHS Foundation Trust and located in the heart of Bristol. The BMTU comprises 7 non-isolation rooms and 10 HEPA-filtered isolation cubicles. Following discharge, patients are reviewed on the Oncology Day Bed Unit at the Bristol Royal Hospital for Children.
There are three adult (2 substantive and 1 locum) and four paediatric Transplant Consultants in Bristol. The adult consultants work on a weekly attending basis covering the care of adult in-patients on the BMTU. It is a consultant led service with consultants doing 3 rounds per week but being available to discuss patients every day of the week. Out-of-hours and weekend consultant cover is provided by the on-call Haematology/Transplant consultant. On-call commitment for the BMT STR is on the adult Haematology rota, covering the BMTU, AHU and providing general haematology advice for University Hospitals Bristol.
The three month BMT STR post involves a rotation through care of adult in-patients on the BMTU, follow-up of out-patients on the Oncology Day Bed Unit, and Medical BMT co-ordinating. Rotating through the slots maximises the educational opportunities and experiences offered by the post. On the BMTU, the STR is supported and supervised by the attending consultant, whilst in Oncology Day Beds, the named consultant can be contacted for advice on individual patients. Two BMT Nurse Co-ordinators offer support to the Medical Co-ordinator. Other members of staff include three Transplant clinical nurse specialists and a team of experienced transplant nurses.
Weekly educational opportunities include BMT STR/fellow teaching, BMT journal club, Paediatric Haematology/Oncology teaching, Paediatric Academic Research meeting and review of BMT patient bone marrow aspirates. There is a weekly infectious disease multidisciplinary team meeting and BMT planning meeting, supported by Radiotherapy, NHSBT Stem Cell and Histocompatibility & Immunogenetics Laboratories, and Quality Management. There is an extensive clinical trials portfolio and involvement is encouraged.
The training provided on the BMTU at University Hospitals Bristol offers extensive exposure to all aspects of stem cell transplantation, from basic care of neutropenic patients to management of complex post-transplant complications. For more advanced trainees and those wishing to pursue sub-specialisation in stem cell transplantation, there are opportunities to develop individual clinical and research interests.