Exchange transfusion, blood; other than newborn
CPT4 code
Name of the Procedure:
Exchange Transfusion, Blood (Other than Newborn)
Summary
An exchange transfusion is a medical procedure where a patient's blood is removed and replaced with donor blood. This is typically done to treat certain medical conditions by removing harmful substances or abnormal cells and replenishing healthy components.
Purpose
Exchange transfusion is used to treat disorders such as severe sickle cell disease, certain types of poisoning, and acute severe anemia. The goal is to improve the patient's condition by reducing the concentration of harmful elements in their blood and restoring normal blood function.
Indications
- Severe sickle cell crisis
- Acute liver failure with hyperbilirubinemia
- Severe malaria
- Certain types of drug or toxin poisoning
- Exchange transfusion may be appropriate for patients showing symptoms of severe anemia, hemolysis, or toxic substance exposure that are unresponsive to other treatments.
Preparation
- Fasting for a certain period may be required.
- Pre-procedure blood tests to determine blood type, cross-matching, and other relevant diagnostics.
- Adjustments to current medications, as instructed by the physician.
Procedure Description
- The patient is connected to an apheresis machine through intravenous (IV) lines.
- Blood is removed from the patient and processed by the machine to separate red cells, plasma, and other components.
- Donor blood, matched for compatibility, is then transfused back into the patient.
- Continuous vital signs monitoring is performed throughout the procedure.
- The procedure may be performed multiple times depending on the patient’s condition.
Tools, Equipment, and Technology
- Apheresis machine
- IV lines and catheters
- Donor blood supplies
Anesthesia or Sedation
- Local anesthesia may be used at the site of IV insertion.
- Sedation may be administered to ensure patient comfort.
Duration
The procedure typically takes several hours and may be performed in sessions over several days.
Setting
- Hospital settings, particularly in specialized units like intensive care or hematology.
Personnel
- Hematologists or specialized physicians
- Nurses and technicians trained in apheresis
- Anesthesiologists, if sedation is required
Risks and Complications
- Rare but serious: transfusion reactions, infections, blood clots
- Common: mild allergic reactions, temporary low blood pressure, electrolyte imbalances
Benefits
- Improvement in symptoms related to the underlying condition
- Reduction in levels of harmful substances in the blood
- Generally, benefits can be realized soon after the procedure, depending on the condition being treated.
Recovery
- Typically, patients are observed in the hospital for a short time post-procedure.
- Follow-up appointments to monitor blood counts and overall health.
- Possible dietary or activity restrictions as advised by the physician.
Alternatives
- Medication therapy for conditions like sickle cell disease or poisoning.
- Simple blood transfusions for anemia.
- Each alternative has its own risks and benefits, and some may be less effective compared to exchange transfusion in severe cases.
Patient Experience
During the procedure, patients might experience discomfort at the IV insertion sites or mild sedation effects. Post-procedure, they might feel tired but should gradually improve as their condition stabilizes. Pain management and comfort measures will be provided as needed.