Name of the Procedure:

Whole blood, leukocytes reduced, irradiated, each unit (HCPCS Code: P9056).

Common Name(s): Leukocyte-reduced irradiated blood transfusion, Leukoreduced irradiated whole blood.

Technical/Medical Term: Leukocyte-reduced irradiated whole blood unit transfusion.

Summary

This procedure involves the transfusion of whole blood that has been specially treated to reduce the number of white blood cells (leukocytes) and to irradiate the blood to prevent certain immune reactions. It's used to decrease the risk of complications in patients needing a blood transfusion.

Purpose

• Medical Conditions: Used for patients requiring a blood transfusion, especially those with weakened immune systems or those who might have adverse reactions to donor leukocytes.
• Goals/Outcomes: To safely provide necessary blood components while minimizing the risk of immune reactions, graft-versus-host disease (GVHD), and other transfusion-related complications.

Indications

• Symptomatic anemia refractory to other treatments
• Patients undergoing chemotherapy or stem cell transplants
• Those with congenital or acquired immunodeficiency
• Pregnant women at risk of GVHD
• Patients with previous transfusion reactions

Preparation

• Patient Instructions: Typically minimal preparation; patients may continue most medications unless advised otherwise by their healthcare provider.
• Diagnostic Tests: Blood typing and crossmatching to ensure compatibility.

Procedure Description

1. Blood Collection: Whole blood is collected from a compatible donor.
2. Leukocyte Reduction: The blood is filtered to remove most leukocytes, reducing the potential for immune response.
3. Irradiation: The blood is irradiated to inactivate lymphocytes and prevent GVHD.

4. Administration: Blood is transfused into the patient via an intravenous (IV) line.

   Tools/Equipment: IV line, blood bags, specialized filters, irradiation equipment.

Anesthesia/Sedation: Generally not required; the procedure is usually done with the patient fully conscious.

Duration

The transfusion itself typically takes 1-4 hours, depending on the amount of blood being transfused and the patient's condition.

Setting

Performed in hospital settings, outpatient clinics, or transfusion centers.

Personnel

• Transfusion medicine specialist or hematologist
• Trained nurses
• Laboratory technicians
• Blood bank staff

Risks and Complications

• Common Risks: Mild allergic reactions, fever, chills.
• Rare Risks: Transfusion-associated reactions such as GVHD, anaphylaxis, fluid overload.
• Management: Immediate cessation of transfusion and appropriate medical intervention for severe reactions.

Benefits

• Improved oxygen-carrying capacity of blood
• Decreased risk of transfusion-related immune reactions and infections
• Rapid improvement in symptoms of anemia

Recovery

• Post-Procedure Care: Observation for any adverse reactions, ensuring proper hydration.
• Recovery Time: Immediate improvement in some symptoms; full recovery varies based on underlying condition.
• Follow-up: May include additional blood work or consultations with specialists.

Alternatives

• Non-transfusion Treatments: Iron supplements, erythropoiesis-stimulating agents.
• Other Transfusion Options: Red blood cell transfusions, plasma transfusions.
• Pros and Cons: Alternatives may be less effective or slower to improve symptoms; risk profiles differ.

Patient Experience

• During the Procedure: Generally a painless procedure, though inserting the IV line may cause brief discomfort.
• After the Procedure: Patients may feel fatigued but usually notice immediate symptom relief. Pain management and comfort measures are available if needed.