Photopheresis, extracorporeal
CPT4 code
Name of the Procedure:
Photopheresis, extracorporeal
Common name(s): ECP, Photopheresis
Summary
Photopheresis is a medical treatment that involves drawing blood from a patient, treating the blood with a photosensitizing agent and ultraviolet light, and then returning it to the patient. This process is intended to modulate the immune system.
Purpose
Photopheresis is used to treat autoimmune diseases, transplant rejections, and certain blood cancers. The goal is to induce an immune response that helps the body fight the particular condition or disease.
Indications
- Chronic graft-versus-host disease (GVHD)
- Cutaneous T-cell lymphoma (CTCL)
- Heart or lung transplant rejection
- Autoimmune diseases not responding to other treatments
Preparation
- Patients may be advised to fast for a few hours before the procedure.
- Regular medications can generally be continued, but certain blood thinners may need to be paused.
- Blood tests might be required to assess overall health and suitability for the procedure.
Procedure Description
- The patient is connected to a photopheresis machine through an intravenous (IV) line.
- Blood is drawn from the patient and separated into its different components.
- The white blood cells are treated with a photosensitizing agent called 8-methoxypsoralen.
- These treated cells are then exposed to ultraviolet (UV) light.
- The treated blood is returned to the patient through the IV line.
- The process is typically repeated multiple times over several cycles.
Duration
The procedure usually takes about 2 to 4 hours per session.
Setting
Performed in a hospital or specialized outpatient clinic.
Personnel
- Hematologist or oncologist
- Trained nurses or specialized technicians
Risks and Complications
- Low blood pressure
- Infection at the IV site
- Thrombosis (blood clots)
- Redness or sensitivity of the skin due to UV exposure
- Allergic reaction to the photosensitizing agent
Benefits
- Reduced symptoms of autoimmune diseases
- Improved organ function in cases of transplant rejection
- Potential remission in certain blood cancers
- Benefits may be seen within a few treatment sessions but vary by individual.
Recovery
- Minimal downtime, with patients often able to resume normal activities the same day.
- Hydration and rest are generally recommended after the procedure.
- Regular follow-up appointments to monitor the condition and effectiveness of treatment.
Alternatives
- Immunosuppressive medications
- Chemotherapy
- Radiation therapy
- Pros and cons of these alternatives involve differences in side effects, efficacy, and duration of treatment.
Patient Experience
- Most patients experience minimal discomfort during blood draws.
- Possible feeling of fatigue or light-headedness post-procedure.
- Pain management if necessary, but usually not required.
- Guidance provided by healthcare professionals to ensure patient comfort and safety throughout the process.
These comprehensive details aim to give an overview of what a patient can expect from photopheresis, extracorporeal, ensuring they are well-informed about the procedure.