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Red blood cells, frozen/deglycerolized/washed, leukocytes reduced, irradiated, each unit

HCPCS code

Red Blood Cells, Frozen/Deglycerolized/Washed, Leukocytes Reduced, Irradiated, Each Unit (P9057)

Name of the Procedure:

  • Common Name(s): Frozen red blood cells, Deglycerolized red blood cells
  • Technical/Medical Terms: Leukocytes reduced, Irradiated red blood cells

Summary

This procedure involves transfusing specially treated red blood cells into a patient. The red blood cells are frozen and deglycerolized (to remove glycerol used during freezing), washed to remove plasma, leukocyte-reduced (to decrease white blood cells), and irradiated (to inactivate any remaining white blood cells).

Purpose

The procedure is primarily used to treat patients who require red blood cell transfusions but are at risk of adverse reactions from the components in standard red blood cell units. The goals are to provide essential red blood cells while minimizing the risk of transfusion-related complications.

Indications

  • Patients with a history of severe allergic reactions to blood transfusions.
  • Patients at risk of graft-versus-host disease, such as those with weakened immune systems.
  • Patients requiring long-term transfusion support, like those with thalassemia or sickle cell disease.

Preparation

  • Patients may be advised to stay hydrated and avoid certain medications that could affect clotting.
  • Blood tests (e.g., blood type and crossmatch) are conducted beforehand to ensure compatibility.

Procedure Description

  1. Blood is first collected from a donor and processed to freeze the red blood cells.
  2. Upon need for transfusion, these cells are thawed and deglycerolized to remove the glycerol used during freezing.
  3. The cells are washed to remove plasma and other unwanted proteins.
  4. Leukocytes are reduced to lower the number of white blood cells.
  5. The red blood cells are irradiated to inactivate any remaining white blood cells that could cause a reaction.
  6. Finally, the prepared red blood cells are transfused into the patient through an IV line.

Duration

The entire preparation of the blood and the actual transfusion process can take several hours, though the transfusion of a single unit typically takes 2 to 4 hours.

Setting

The procedure is performed in a hospital or specialized outpatient clinic with the capability for blood transfusion.

Personnel

  • Hematologists or transfusion medicine specialists
  • Nurses
  • Medical laboratory technicians
  • In some cases, anesthesiologists if sedation is required

Risks and Complications

  • Allergic reactions
  • Fever and chills
  • Transfusion-related acute lung injury (TRALI)
  • Graft-versus-host disease (though risks are minimized with irradiation)
  • Rarely, infection

Benefits

  • Improved oxygen-carrying capacity of the blood
  • Lower risk of transfusion reactions
  • Better outcomes for patients needing long-term transfusion support

Recovery

  • Patients are monitored for several hours post-transfusion for any reactions.
  • Hydration is encouraged.
  • Follow-up appointments may be required to assess the effectiveness of the transfusion.

Alternatives

  • Standard red blood cell transfusion: Higher risk of transfusion reactions.
  • Erythropoiesis-stimulating agents: Less effective for severe anemia.
  • Blood substitutes (experimental): Not widely available and still under research.

Patient Experience

  • During the procedure, patients might feel a cool sensation or slight discomfort at the IV site.
  • They may experience some fatigue or mild side effects which are generally manageable.
  • Pain management is typically minimal as the procedure is relatively non-invasive.

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