Therapeutic apheresis; for red blood cells
CPT4 code
Name of the Procedure:
Therapeutic apheresis for red blood cells, also known as red cell exchange or erythrocytapheresis.
Summary
In layman's terms, therapeutic apheresis for red blood cells is a medical procedure where a patient's red blood cells are removed and replaced with healthy red blood cells from a donor. This is done to treat certain blood disorders or conditions that affect the quality or quantity of the patient's red blood cells.
Purpose
Therapeutic apheresis for red blood cells is used to treat conditions such as sickle cell disease, certain types of anemia, and other blood disorders. The goal is to reduce or eliminate abnormal red blood cells in the patient's bloodstream, improve their oxygen-carrying capacity, and alleviate symptoms.
Indications
- Severe sickle cell disease
- Autoimmune hemolytic anemia
- Thalassemia
- Hyperviscosity syndromes
Suitable candidates are those who have been diagnosed with these conditions and have not responded adequately to other treatments.
Preparation
- Follow specific dietary restrictions, if any, advised by your healthcare provider.
- Adjust or discontinue certain medications as instructed.
- Undergo necessary blood tests and assessments to determine eligibility and optimal treatment plan.
Procedure Description
- The patient is connected to an apheresis machine via intravenous (IV) lines.
- Blood is withdrawn from the patient and passed through the machine.
- The apheresis machine separates the red blood cells from the rest of the blood components.
- The patient's red blood cells are removed, and donor red blood cells are introduced into the bloodstream.
- The remaining blood components (plasma, white blood cells, platelets) are returned to the patient.
The procedure is usually performed without anesthesia, but local anesthesia may be used for IV line insertion.
Duration
The procedure typically takes 2-4 hours.
Setting
Therapeutic apheresis for red blood cells is performed in specialized outpatient clinics, hospital apheresis units, or blood centers.
Personnel
- Apheresis nurse or technician
- Hematologist or attending physician
- Phlebotomist for IV line insertion
- Support nursing staff
Risks and Complications
- Low blood pressure
- Allergic reactions to donor blood
- Blood clotting issues
- Infection at IV site
- Temporary dizziness or fatigue
Management strategies include constant monitoring during the procedure, pre-medication for allergic reactions, and strict sterile techniques.
Benefits
- Improved oxygen delivery to tissues
- Reduced symptoms related to blood disorders
- Prevention of complications associated with abnormal red blood cells Benefits are typically seen within days to weeks following the procedure.
Recovery
- Monitor for any immediate reactions post-procedure.
- Drink plenty of fluids and rest after the procedure.
- Follow-up appointments to assess treatment efficacy and plan future apheresis sessions if needed.
Alternatives
- Blood transfusions
- Medications to manage blood disorders
- Bone marrow or stem cell transplant
Each alternative has its own set of benefits and drawbacks. For example, medications may have side effects, and transplants may not be suitable for all patients or carry higher risks.
Patient Experience
During the procedure, the patient might feel slight discomfort from the IV insertion and numbness or tingling from the citrate used to prevent clotting. Post-procedure, they might experience light-headedness or fatigue, which can usually be managed with rest and hydration. Pain management, if necessary, will be provided based on individual patient needs.