Name of the Procedure:

Therapeutic Apheresis; for Platelets
(Commonly referred to as Platelet Apheresis, Pheresis)

Summary

Therapeutic apheresis for platelets is a procedure where a patient's blood is drawn, and platelets are separated and removed while the remainder of the blood is returned. This treatment is primarily used to manage conditions involving excessive platelet counts or specific ailments where platelet removal can be beneficial.

Purpose

The primary purpose of therapeutic apheresis for platelets is to treat conditions associated with thrombocythemia (excessive platelet count), which can lead to clotting issues or bleeding disorders. The goal is to reduce the platelet count to a safer level, alleviating symptoms and lowering the risk of complications.

Indications

• Essential thrombocythemia
• Polycythemia vera with thrombocythemia
• Myeloproliferative disorders
• Acute conditions with critically high platelet counts

Preparation

• Avoid eating or drinking for a few hours before the procedure if instructed by your healthcare provider.
• Medication adjustments may be necessary, particularly if anticoagulants or other blood-thinning medications are taken.
• Pre-procedure tests, such as a complete blood count (CBC) and coagulation profile, will be required to assess your current health status.

Procedure Description

1. A needle is inserted into a vein, typically in the arm, to draw blood.
2. The drawn blood is passed through an apheresis machine that separates platelets from other blood components.
3. The remaining blood components (red and white blood cells, plasma) are returned to the patient.
4. The collected platelets are discarded or used appropriately, depending on the treatment plan.
5. The process continues until the desired number of platelets have been removed.

Tools and Equipment:

• Apheresis machine
• Sterile needles and tubing
• Anticoagulant solutions (administered during the procedure to prevent blood clotting)

Anesthesia:

• Typically, no anesthesia or sedation is required, although a local anesthetic may be used to minimize discomfort at the needle insertion site.

Duration

The procedure usually takes about 2-3 hours to complete.

Setting

Therapeutic apheresis for platelets is typically performed in a hospital's apheresis unit or an outpatient clinic specializing in this treatment.

Personnel

• Hematologists or apheresis specialists
• Registered nurses trained in apheresis
• Medical technicians

Risks and Complications

• Common risks: discomfort at needle site, dizziness or light-headedness, low calcium levels (hypocalcemia)
• Rare risks: infection at needle site, allergic reactions to anticoagulants, blood clotting issues

Benefits

• Decreased platelet count, reducing risk of clot-related complications or bleeding
• Rapid symptom relief for conditions associated with high platelet counts
• Improvement in overall blood function and patient well-being

Recovery

• Patients can typically go home the same day.
• It's advised to rest and avoid strenuous activities for the remainder of the day.
• Follow-up appointments will be necessary to monitor platelet levels and overall health.

Alternatives

• Medication to reduce platelet count (e.g., hydroxyurea)
• Regular phlebotomy (blood removal) for certain conditions
• Particularly for mild cases, watchful waiting and lifestyle adjustments

Patient Experience

• Patients may feel a slight pinprick during needle insertion and some pressure at the site.
• Throughout the procedure, you may experience coolness or tingling due to the anticoagulant.
• Pain management and comfort measures include ensuring hydration and possibly taking a mild analgesic if needed.
• Post-procedure, you might feel fatigued but should regain normal energy levels within a day.