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Leukocyte transfusion

CPT4 code

Name of the Procedure:

Leukocyte Transfusion
(Also known as: White Blood Cell Transfusion)

Summary

Leukocyte transfusion is a medical procedure where white blood cells are transferred from a healthy donor to a patient. This is often done to boost the patient's immune system, especially when it is particularly compromised.

Purpose

The main purpose of a leukocyte transfusion is to treat patients with severe infections that their bodies cannot fight off due to a low white blood cell count. It aims to reestablish the patient's immune system defenses to prevent or combat infections.

Indications

  • Severe neutropenia (low levels of neutrophils, a type of white blood cell)
  • Refractory infections that do not respond to antibiotics
  • Bone marrow failure or suppression
  • Patients undergoing chemotherapy or bone marrow transplant

Preparation

  • The patient may be advised to avoid eating or drinking for a certain period before the procedure.
  • Blood tests and assessments to determine white blood cell count and compatibility with the donor's cells.
  • Review and adjustment of current medications as necessary.

Procedure Description

  1. Donor Selection: Identifying a compatible donor with an adequate white blood cell count.
  2. Collection: The donor's white blood cells are collected through a process called apheresis, which separates white blood cells from the rest of the blood.
  3. Transfusion: The prepared leukocyte concentrate is transfused into the patient through an intravenous (IV) line.
    • Tools include an IV catheter, apheresis machine, and sterile transfusion bags.
    • Sedation is generally not required, but local anesthetics may be used for the IV insertion site.

Duration

The procedure usually takes about 1 to 2 hours.

Setting

Typically performed in a hospital or specialized outpatient clinic.

Personnel

  • Hematologist or oncologist
  • Trained nurses
  • Medical technicians
  • Transfusion medicine specialist

Risks and Complications

  • Allergic reactions
  • Fever and chills
  • Transmission of infections
  • Graft-versus-host disease (GVHD)
  • Possible exacerbation of pre-existing conditions

Benefits

  • Enhanced ability to fight infections
  • Improved short-term immune response
  • Potentially life-saving for patients with severe neutropenia or infections

Recovery

  • Monitoring for several hours post-transfusion for adverse reactions.
  • Possible temporary side effects like fever or chills.
  • Follow-up blood tests to monitor white blood cell count.
  • Instructions on activity restrictions and medications, if needed.

Alternatives

  • Antibiotic therapy
  • Granulocyte-colony stimulating factor (G-CSF) injections to stimulate white cell production
  • Bone marrow or stem cell transplant for long-term treatment
  • Each alternative varies in effectiveness, duration, and risk profile compared to leukocyte transfusion.

Patient Experience

  • Patients may feel a slight discomfort or pain at the IV insertion site.
  • Typically, patients experience minimal discomfort during the transfusion.
  • Pain management includes over-the-counter pain relievers and comfort measures like warm compresses.
  • Monitoring and support from healthcare staff throughout the procedure and recovery process.