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Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage

CPT4 code

Name of the Procedure:

Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage (commonly referred to as "Hematopoietic Stem Cell Cryopreservation").

Summary

Hematopoietic stem cell cryopreservation is a procedure where stem cells are collected, processed, and stored at extremely low temperatures for future transplantation. These cells can later be thawed and used to treat various blood-related diseases and conditions.

Purpose

The procedure is used to address disorders like leukemia, lymphoma, and other conditions requiring bone marrow transplants. The goal is to preserve healthy stem cells that can be used to regenerate the patient’s blood and immune system after high-dose chemotherapy or radiation therapy.

Indications

This procedure is indicated for patients with certain types of blood cancers, severe blood disorders, or immune system deficiencies who are likely to benefit from a stem cell transplant. Candidates typically include those who are in remission or need to have their stem cells collected for recovery post high-dose therapy.

Preparation

Patients may need to undergo blood tests, imaging studies, and other diagnostic tests to ensure they are suitable candidates. They might be instructed to fast and adjust medications as advised by their healthcare provider. Apheresis—a process to collect the stem cells—might be conducted after pre-treatment with medications that mobilize stem cells into the bloodstream.

Procedure Description

  1. Stem Cell Collection: Stem cells are collected from the patient's blood or bone marrow.
  2. Processing: The collected cells are processed to purify and concentrate the stem cells.
  3. Cryopreservation: The stem cells are mixed with a cryoprotectant to prevent ice crystal formation and stored in special bags.
  4. Freezing: The cells are gradually frozen to reach very low temperatures and then stored in liquid nitrogen tanks until needed for transplantation. Typically, no anesthesia is required for this procedure itself unless bone marrow harvesting is performed, which might involve sedation or general anesthesia.

Duration

The full process, including collection and cryopreservation, typically takes a few hours spread over a couple of days. The freezing and storage process takes several hours.

Setting

This procedure is performed in specialized medical facilities such as hospitals or outpatient clinics with capabilities for stem cell collection and processing.

Personnel

The procedure involves a team of healthcare professionals, including hematologists, nurses, laboratory technicians, and potentially anesthesiologists.

Risks and Complications

Commonly, risks include mild discomfort or bruising at the site of stem cell collection. Rarely, complications could include allergic reactions to the cryoprotectant or issues with the freezing/thawing process, but these are minimal when performed correctly.

Benefits

The primary benefit is the availability of healthy stem cells for future transplantation, which can significantly improve and even cure certain blood-related diseases. Benefits are realized after transplantation, following aggressive treatments like chemotherapy.

Recovery

Post-procedure involves minimal recovery as the procedure itself is mostly non-invasive. Patients might experience temporary discomfort or bruising from the collection site. Follow-up appointments may be necessary to ensure cells are appropriately stored.

Alternatives

Alternatives include immediate transplantation without cryopreservation, or relying on donor stem cells. Each alternative has its pros and cons; for example, donor cells might pose a risk of rejection, whereas cryopreserved cells offer a matched option for auto-transplants later.

Patient Experience

During the collection, patients might experience mild discomfort or pain, akin to a blood donation. Post-procedure, ensuring comfort and minimizing any discomfort from collection sites is important. Most of the experience revolves around the preparation and minimal invasive procedures rather than the cryopreservation itself.

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