The first line treatment for very severe aplastic anemia in the young person is a hematopoietic cell transplant if an appropriate donor is available. Although blood transfusions will be necessary for this patient, this information is less important than the appropriateness of available bone marrow donors. Bacterial infections must be treated aggressively due to the immunocompromised nature of the patient both before and after treatment. The ability to gain central venous access is of less concern due to the availability of surgical interventions.