38208 Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing, per donor

Name of the Procedure:

Transplant Preparation of Hematopoietic Progenitor Cells; Thawing of Previously Frozen Harvest, Without Washing, Per Donor

Summary

In this procedure, stem cells that were previously collected and frozen are thawed for use in a stem cell transplant. This process is crucial for treatments such as bone marrow transplants where the patient's blood-forming cells have been destroyed by disease or medical treatments.

Purpose

This procedure is designed to prepare stem cells for transplant into a patient. The goal is to restore the body's ability to produce healthy blood cells, particularly after treatments like chemotherapy or radiation have depleted the patient's own blood-forming cells.

Indications

• Patients undergoing chemotherapy or radiation therapy for cancer.
• Patients with certain blood disorders, such as leukemia or lymphoma.
• Individuals with bone marrow failure syndromes.
• Patients who have had significant loss of blood-forming cells due to disease.

Preparation

• Patients may need to complete a series of blood tests to ensure compatibility and readiness for the procedure.
• Pre-procedure instructions typically include following specific dietary and medication guidelines.
• Patients might undergo conditioning treatments (e.g., chemotherapy, radiation) to prepare their bodies for the transplant.

Procedure Description

1. The previously harvested and frozen stem cells are removed from storage.
2. The cells are then thawed at a specific temperature using a specialized warming device.
3. Unlike some methods, this procedure skips the washing step to preserve the integrity of the cells.
4. After thawing, the stem cells are ready for infusion into the patient.
   • Tools: Thawing device, infusion equipment.
   • Anesthesia: None typically required for thawing process, but sedation may be used during the actual stem cell infusion if needed.

Duration

The thawing process itself can be completed within 30 minutes to an hour. The entire transplant procedure may take several hours.

Setting

This procedure is usually performed in a hospital setting, specifically in a specialized transplant unit or oncology ward.

Personnel

• Hematologist/Oncologist
• Transplant coordinator
• Registered nurses
• Laboratory technicians

Risks and Complications

• Potential for cell loss or reduced viability during thawing.
• Infection risk due to the immunocompromised state of the patient.
• Allergic reactions to substances used in the freezing and thawing process.
• Risk of transplant rejection or graft-versus-host disease (GVHD).

Benefits

• Enables the reestablishment of the patient’s blood-forming system.
• Can lead to remission or cure of hematologic diseases.
• Recovery of normal blood cell counts within weeks to months.

Recovery

• Close monitoring post-procedure, including frequent blood tests.
• Patients might need to stay in a sterile environment to minimize infection risk.
• Recovery time varies but typically spans several weeks to months.
• Regular follow-up appointments to assess engraftment and check for complications.

Alternatives

• Autologous transplant (using the patient’s own previously collected stem cells).
• Alternative donor sources if patient-specific stem cells are not viable.
• Supportive care treatments, which may not offer a cure but can manage symptoms.

Patient Experience

• During the thawing and waiting process, patients might feel anxious but should experience minimal discomfort.
• During infusion, patients may feel warmth from the infusion and might have some mild side effects such as chills or fever.
• Post-procedure, patients often experience fatigue and will need to follow intensive care and monitoring protocols to ensure successful engraftment. Pain management and supportive care will be provided as needed.