38214 Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion

Name of the Procedure:

Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion

Summary

This procedure involves preparing the blood’s hematopoietic progenitor cells (cells that give rise to other blood cells) for transplantation by removing a portion of the plasma, which is the liquid component of blood.

Purpose

The procedure is primarily used to prepare hematopoietic progenitor cells for a stem cell transplant. By depleting the plasma volume, the concentration of these cells can be increased, making the transplant more effective.

Indications

• Patients needing a stem cell transplant due to conditions like leukemia, lymphoma, or multiple myeloma.
• Criteria include a diagnosis that indicates bone marrow failure or ineffective hematopoiesis.
• Patients might have undergone chemotherapy or radiation therapy that necessitates a stem cell transplant.

Preparation

• Patients may be required to fast for a specific period before the procedure.
• Medication adjustments might be needed, including blood thinners or other medications that affect blood clotting.
• Pre-procedure diagnostics may include blood tests to determine cell counts and overall health.

Procedure Description

1. Blood is extracted from the patient’s or donor’s body.
2. The collected blood is processed through a machine that separates the hematopoietic progenitor cells from the plasma.
3. A significant portion of the plasma is then depleted or removed.
4. The concentrated cell product, now with reduced plasma volume, is prepared for transplantation.
   • Specialized apheresis machines are used for processing.
   • No anesthesia is typically required, but local anesthesia may be used at the needle insertion site.

Duration

The procedure generally takes about 2 to 4 hours, depending on the volume of blood processed and the patient’s condition.

Setting

This procedure is typically performed in a hospital or specialized outpatient clinic equipped with apheresis machines.

Personnel

• Hematologists or oncologists
• Specialized nursing staff
• Laboratory technicians might assist with the processing of cells

Risks and Complications

• Common risks include dizziness, lightheadedness, or low blood pressure due to blood processing.
• Rare complications might include allergic reactions or infections.
• Management might involve supportive care and monitoring during the procedure.

Benefits

• Increases the concentration of hematopoietic progenitor cells, potentially improving the success of the stem cell transplant.
• Helps in faster recovery of the patient’s hematopoietic system.

Recovery

• Patients might be observed for a few hours post-procedure to ensure stability.
• Recovery time is typically short, with most patients feeling normal within a day.
• Follow-up appointments might be necessary to monitor the success of the transplantation.

Alternatives

• Direct stem cell transfusion without plasma depletion.
• Pros: Fewer procedural steps, less equipment.
• Cons: Lower concentration of progenitor cells, potentially less effective transplant outcome.

Patient Experience

• Patients might feel some discomfort at the needle insertion site and experience lightheadedness during the procedure.
• Pain management typically involves local anesthetics and post-procedural rest.
• Comfort measures include adequate hydration and monitoring by the medical staff.