Platelets, pheresis, leukocytes reduced, irradiated, each unit
HCPCS code
Name of the Procedure:
Common name(s): Platelet Transfusion, Apheresis Platelet Transfusion
Technical/Medical term: Platelets, pheresis, leukocytes reduced, irradiated, each unit (HCPCS Code P9037)
Summary
This procedure involves the transfusion of platelets that have been collected from a donor, filtered to reduce the number of leukocytes (white blood cells), and irradiated to deactivate any remaining white blood cells. This process helps to reduce the risk of transfusion-related complications.
Purpose
Medical Conditions: Thrombocytopenia, bleeding disorders, bone marrow suppression (e.g., from chemotherapy). Goals: To increase platelet count, reduce bleeding risk, and improve clotting ability.
Indications
Symptoms/Conditions: Low platelet count, excessive bleeding, prior to major surgery in patients with low platelets. Patient Criteria: Patients with chronic conditions leading to low platelet count, undergoing chemotherapy, or preparing for surgery.
Preparation
Pre-procedure Instructions: No specific fasting required. Inform the doctor about any ongoing medications, especially anticoagulants. Diagnostic Tests: Blood tests to determine platelet count, blood type, and cross-matching for compatibility.
Procedure Description
- Collection: Platelets are collected from a donor through apheresis, where blood is drawn, platelets are separated, and the rest is returned to the donor.
- Preparation: The collected platelets are leukocyte-reduced (filtered to remove white blood cells) and irradiated to deactivate residual leukocytes.
- Transfusion: The patient receives the prepared unit of platelets through an intravenous (IV) line.
- Monitoring: Vital signs and platelet counts are monitored before, during, and after the transfusion.
Tools/Equipment: Apheresis machine, IV line, blood bags. Anesthesia/Sedation: Not typically required.
Duration
Typically, apheresis donation takes 60-90 minutes for the donor. For the recipient, the transfusion process takes about 30-60 minutes.
Setting
Performed in a hospital, outpatient clinic, or specialized transfusion center.
Personnel
Healthcare Professionals: Hematologist, transfusion specialist, nurse, possibly a medical technician.
Risks and Complications
Common Risks: Mild allergic reactions (rash, fever), iron overload if repeated transfusions. Rare Risks: Transfusion-related acute lung injury (TRALI), infections, graft-versus-host disease (GvHD).
Benefits
Expected Benefits: Increased platelet count, reduced bleeding risk. Realization of Benefits: Typically within a few hours to a day post-transfusion.
Recovery
Post-procedure Care: Observation for a few hours after transfusion. Expected Recovery Time: Immediate to a few hours. Restrictions/Follow-Up: Minimal activity restrictions; follow-up blood tests to monitor platelet count.
Alternatives
Other Treatments: Fresh frozen plasma (FFP), platelet growth factors. Pros and Cons: Platelet transfusion is rapid and highly effective; alternatives may take longer to be effective or have other side effects.
Patient Experience
During Procedure: Mild discomfort at the IV site, potential for mild reactions. After Procedure: Typically feel normal, with potential for mild fatigue or bruising at the IV site. Pain Management: Local anesthetic for IV site, medications for any minor allergic reactions.